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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
| |
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.
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
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PIER is copyrighted (c) 2009 by the American College of Physicians,
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Hepatitis A
