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 | | Diagnosis | |
- Obtain a thorough patient history to assess the likelihood of hepatitis A infection.
- Use clinical evaluation to support the diagnosis of hepatitis A.
- Confirm the diagnosis of hepatitis A with appropriate laboratory testing.
- Use serologic testing to exclude HAV infection in persons with unexplained acute liver failure.
- Consider the presence of other liver diseases in persons with unexplained acute hepatitis.
| | History and Physical Examination Elements for Hepatitis A (table)
| | Laboratory and Other Studies for Hepatitis A (table)
| | Differential Diagnosis of Hepatitis A (table)
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Obtain a thorough patient history to assess the likelihood of hepatitis A infection.  |
- Ask about:
- Abrupt onset of fatigue
- Abdominal pain, particularly in the right upper quadrant
- Nausea
- Vomiting
- Anorexia
- Diarrhea
- Fever
- Weight loss
- Malaise
- Myalgias
- Pruritus
- Symptoms of icteric disease, including skin or sclera color change, color change of urine or stool, and pruritic skin
- Risks for hepatitis A:
- Recent travel to endemic country
- Young children who attend day care living in the house
- Contact with a person with hepatitis A
- Occupation
- Receipt of clotting factor concentrates
- Men who have sex with men
- Illicit drug use
- Underlying liver disease
- History of hepatitis
- Pregnancy
- Hydration status
- Alcohol use
- Medications (prescription, over the counter, herbal preparations)
- Vaccine history
- See table History and Physical Examination Elements for Hepatitis A.
| Background | Back to top
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Use clinical evaluation to support the diagnosis of hepatitis A.  |
| Background | Back to top
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Confirm the diagnosis of hepatitis A with appropriate laboratory testing.  |
| Background | Back to top
| |
Use serologic testing to exclude HAV infection in persons with unexplained acute liver failure. |
| Background | Back to top
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Consider the presence of other liver diseases in persons with unexplained acute hepatitis. |
- Screen all persons with unexplained acute hepatitis for hepatitis A, B, and C and consider other causes of acute hepatitis, including:
- Other infectious agents
- Autoimmune hepatitis
- Alcoholic liver disease
- Drug-induced hepatitis
- Ischemic hepatitis
- Metabolic liver diseases
- Biliary obstruction
- See table Differential Diagnosis of Hepatitis A.
| Background | Back to top
| | | FAQs |
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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. |
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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) 2008 by the American College of Physicians,
190 N. Independence Mall West, Philadelphia, PA 19106-1572, USA.
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Hepatitis A
