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Rationale:
- Acute liver failure can be caused by HAV infection.
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Evidence:
- Among hepatitis A cases reported to the CDC, the case-fatality ratio is approximately 0.3% to 0.6%, but is up to 1.8% among
persons >50 years of age (25).
- In the U.S., hepatitis A is the leading cause of acute liver failure due to viral hepatitis, but the incidence is decreasing,
likely due to widespread vaccination (96).
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Comments:
- Prolongation of prothrombin time and onset of encephalopathy suggest that the acute HAV infection is running a fulminant course.
- Although some patients with acute liver failure due to hepatitis A recover spontaneously, prediction of outcome is difficult;
thus, refer all persons with acute liver failure to a hepatologist or gastroenterologist for evaluation at a medical center
where transplant services are available.
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Brian J. McMahon, MD, MACP has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Catherine M. Dentinger, FNP, MS has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Steven E. Weinberger, MD, FACP, Acting Editor, PIER, has stock holdings in Glaxosmithkline and Abbott.
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The information included herein should never be used as a substitute
for clinical judgment and does not represent an official position of
ACP. Because all PIER modules are updated regularly, printed web pages
or PDFs may rapidly become obsolete. Therefore, PIER users should
compare the date of the last update on the website with any printout
to ensure that the information being referred to is the most current
available.
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PIER is copyrighted (c) 2009 by the American College of Physicians,
190 N. Independence Mall West, Philadelphia, PA 19106-1572, USA.
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Hepatitis A
> Diagnosis
