In uncertain cases, liver biopsy usually distinguishes alcoholic from viral hepatitis. In patients with findings suggesting acute viral hepatitis, the following studies are done to screen for hepatitis viruses A, B, and C:. If any are positive, further serologic testing may be necessary to differentiate acute from past or chronic infection see tables Hepatitis A Serology , Hepatitis B Serology , and Hepatitis C Serology.
If serology suggests hepatitis B, testing for hepatitis B e antigen HBeAg and antibody to hepatitis B e antigen anti-HBe is usually done to help determine the prognosis and to guide antiviral therapy. Biopsy is usually unnecessary but, if done, usually reveals similar histopathology regardless of the specific virus:.
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HBV infection can occasionally be diagnosed based on the presence of ground-glass hepatocytes caused by HBsAg-packed cytoplasm and using special immunologic stains for the viral components. Liver biopsy may help predict prognosis in acute hepatitis but is rarely done solely for this purpose. Complete histologic recovery occurs unless extensive necrosis bridges entire acini bridging necrosis.
Most patients with bridging necrosis recover fully. However, some cases progress to chronic hepatitis. No treatments attenuate acute viral hepatitis. Alcohol should be avoided because it can increase liver damage. Restrictions on diet or activity, including commonly prescribed bed rest, have no scientific basis.
Posttransfusion infection is minimized by avoiding unnecessary transfusions and by screening all donors for HBsAg and anti-HCV. Vaccines for hepatitis A and hepatitis B are available in the US. Routine vaccination for hepatitis A and B is recommended in the US for all children and for adults at high risk see Adult Immunization Schedule. Standard immune globulin prevents or decreases the severity of HAV infection and should be given to family members and close contacts of patients.
Hepatitis B immune globulin HBIG probably does not prevent infection but prevents or attenuates clinical illness. The propensity of HCV for changing its genome hampers vaccine development. Transmission is the fecal-oral route for hepatitis A and parenterally or via blood for hepatitis B and C. Routine vaccination for hepatitis A and B is recommended in the US for all children and for adults at high risk. From developing new therapies that treat and prevent disease to helping people in need, we are committed to improving health and well-being around the world.
The Merck Manual was first published in as a service to the community. Learn more about our commitment to Global Medical Knowledge. Common Health Topics. Videos Figures Images Quizzes. Commonly Searched Drugs. Brought to you by. Symptoms and Signs. Initial diagnosis of acute viral hepatitis Serology Biopsy. General measures Immunoprophylaxis. Key Points.
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Test your knowledge. Add to Any Platform. Click here for Patient Education. Simplified diagnostic approach to possible acute viral hepatitis. Overview of Viral Hepatitis. Other unidentified viruses probably also cause acute viral hepatitis. Characteristics of Hepatitis Viruses Characteristic.
Recovery phase: During this 2- to 4-wk period, jaundice fades. Acute hepatitis can usually be differentiated from other causes of jaundice by. Liver biopsy is usually not needed unless the diagnosis is uncertain. A history of drinking.
Patchy cell dropout. Supportive care. Viral hepatitis should be reported to the local or state health department.
Because treatments have limited efficacy, prevention of viral hepatitis is very important. Immunoprophylaxis can involve active immunization using vaccines and passive immunization. A vaccine for hepatitis E is not available in the US but is available in China. Hepatitis B and C, unlike hepatitis A, predispose to chronic hepatitis and liver cancer.
Patients with acute viral hepatitis may be anicteric or even asymptomatic. Drug Name Select Trade immune globulin. Was This Page Helpful? Yes No. Fulminant Hepatitis. Hepatitis A Virus. The GB virus C is another potential viral cause of hepatitis that is probably spread by blood and sexual contact. The virus first known to cause hepatitis was the yellow fever virus , a mosquito-borne flavivirus. Other viruses than can cause hepatitis include:. KIs-V is a virus isolated in from four patients with raised serum alanine transferases without other known cause; a causal role is suspected.
From Wikipedia, the free encyclopedia. Viral hepatitis Micrograph showing ground glass hepatocytes , which are seen in chronic hepatitis B infections a type of viral hepatitis , and represent accumulations of viral antigen in the endoplasmic reticulum. Main article: Hepatitis A. Main article: Hepatitis B. Main article: Hepatitis C. Main article: Hepatitis D.
Hepatitis: Viral Hepatitis A, B, & C
Main article: Hepatitis E. Main article: Hepatitis F. Main article: GB virus C. Retrieved The Lancet.
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