Book contents
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Part I Clinical syndromes: general
- Part II Clinical syndromes: head and neck
- Part III Clinical syndromes: eye
- Part IV Clinical syndromes: skin and lymph nodes
- Part V Clinical syndromes: respiratory tract
- Part VI Clinical syndromes: heart and blood vessels
- Part VII Clinical syndromes: gastrointestinal tract, liver, and abdomen
- 43 Acute viral hepatitis
- 44 Chronic hepatitis
- 45 Biliary infection: cholecystitis and cholangitis
- 46 Pyogenic liver abscess
- 47 Infectious complications of acute pancreatitis
- 48 Esophageal infections
- 49 Gastroenteritis
- 50 Food poisoning
- 51 Antibiotic-associated diarrhea
- 52 Sexually transmitted enteric infections
- 53 Acute appendicitis
- 54 Diverticulitis
- 55 Abdominal abscess
- 56 Splenic abscess
- 57 Peritonitis
- 58 Whipple’s disease
- Part VIII Clinical syndromes: genitourinary tract
- Part IX Clinical syndromes: musculoskeletal system
- Part X Clinical syndromes: neurologic system
- Part XI The susceptible host
- Part XII HIV
- Part XIII Nosocomial infection
- Part XIV Infections related to surgery and trauma
- Part XV Prevention of infection
- Part XVI Travel and recreation
- Part XVII Bioterrorism
- Part XVIII Specific organisms: bacteria
- Part XIX Specific organisms: spirochetes
- Part XX Specific organisms: Mycoplasma and Chlamydia
- Part XXI Specific organisms: Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific organisms: fungi
- Part XXIII Specific organisms: viruses
- Part XXIV Specific organisms: parasites
- Part XXV Antimicrobial therapy: general considerations
- Index
- References
43 - Acute viral hepatitis
from Part VII - Clinical syndromes: gastrointestinal tract, liver, and abdomen
Published online by Cambridge University Press: 05 April 2015
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Part I Clinical syndromes: general
- Part II Clinical syndromes: head and neck
- Part III Clinical syndromes: eye
- Part IV Clinical syndromes: skin and lymph nodes
- Part V Clinical syndromes: respiratory tract
- Part VI Clinical syndromes: heart and blood vessels
- Part VII Clinical syndromes: gastrointestinal tract, liver, and abdomen
- 43 Acute viral hepatitis
- 44 Chronic hepatitis
- 45 Biliary infection: cholecystitis and cholangitis
- 46 Pyogenic liver abscess
- 47 Infectious complications of acute pancreatitis
- 48 Esophageal infections
- 49 Gastroenteritis
- 50 Food poisoning
- 51 Antibiotic-associated diarrhea
- 52 Sexually transmitted enteric infections
- 53 Acute appendicitis
- 54 Diverticulitis
- 55 Abdominal abscess
- 56 Splenic abscess
- 57 Peritonitis
- 58 Whipple’s disease
- Part VIII Clinical syndromes: genitourinary tract
- Part IX Clinical syndromes: musculoskeletal system
- Part X Clinical syndromes: neurologic system
- Part XI The susceptible host
- Part XII HIV
- Part XIII Nosocomial infection
- Part XIV Infections related to surgery and trauma
- Part XV Prevention of infection
- Part XVI Travel and recreation
- Part XVII Bioterrorism
- Part XVIII Specific organisms: bacteria
- Part XIX Specific organisms: spirochetes
- Part XX Specific organisms: Mycoplasma and Chlamydia
- Part XXI Specific organisms: Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific organisms: fungi
- Part XXIII Specific organisms: viruses
- Part XXIV Specific organisms: parasites
- Part XXV Antimicrobial therapy: general considerations
- Index
- References
Summary
Acute viral hepatitis is a systemic infection with predominant hepatic involvement and remains a significant cause of morbidity and mortality in the United States despite the availability of effective vaccines against the two major causes of acute viral hepatitis, namely A and B. There are five major hepatotropic viruses (A, B, C, D, and E) that cause acute hepatitis with acute hepatic inflammation and necrosis. Acute viral hepatitis typically runs its course in 6 months or less, in contrast to chronic hepatitis, which persists for longer. However, with modern serologic and molecular diagnostic testing, the time course is less important in distinguishing acute from chronic viral hepatitis. The clinical illness produced by these viruses can range from asymptomatic or clinically inapparent to a fulminant and fatal acute infection. A major distinction between hepatitis A and hepatitis B, C, D, and E is that the former causes acute hepatitis only, in contrast to the latter four which cause acute and chronic hepatitis. Other viral infections, such as herpes simplex, Epstein–Barr virus (EBV), cytomegalovirus (CMV), and parvovirus B19, can present with prominent hepatic dysfunction, although they are usually multisystem disorders. Hepatitis G, human herpesviruses, adenovirus, coronavirus, and TT virus (TTV) have also been implicated in causing hepatic dysfunction, but their clinical significance remains dubious.
Hepatitis A virus
The hepatitis A virus (HAV) is an RNA virus, identified in 1973, transmitted via the fecal–oral route and is a common cause of acute viral hepatitis in North America. Community outbreaks due to contaminated water or food are well recognized. Inhabitants in low-socioeconomic areas, international travelers, intravenous drug users, and homosexual men are at particular risk of HAV infection. In the United States, the incidence has decreased remarkably since the introduction (1995) of HAV vaccination and its administration to all children as part of the universal childhood vaccination policy since 2006. In underdeveloped countries, HAV infection typically occurs in childhood and is subclinical (age ≤6 years, 70% are asymptomatic), with most of the population infected before adulthood acquiring life-long immunity. HAV infection occurring in older children and adults is more likely to be symptomatic, with increased morbidity and even mortality (Figure 43.1).
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- Clinical Infectious Disease , pp. 287 - 295Publisher: Cambridge University PressPrint publication year: 2015