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Rationale:
- Cholestasis has been reported as an occasional complication of hepatitis A.
- Relapsing disease has been reported as an occasional complication in children and adults.
- Fulminant hepatitis A is a rare complication of HAV infection.
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Evidence:
- In one study of hospitalized patients with hepatitis A, cholestasis was documented in 4 of 59 (7%) patients (78).
- A short course of corticosteroids in patients with severe cholestasis may reduce the severity of symptoms and decrease bilirubin
levels (106).
- Detection of plasma HAV RNA after 20 days of illness may predict a prolonged course of hepatitis A (107).
- Relapsing hepatitis A occurs in approximately 3% to 20% of patients with acute hepatitis A (87).
- Approximately 8% of the 2000 cases of fulminant hepatitis in the U.S. are due to hepatitis A (98).
- Of the approximately 7% of liver transplants performed for fulminant hepatic failure, approximately 7% are due to fulminant
HAV infection (98).
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Comments:
- Cases of relapsing hepatitis A generally resolve without sequelae.
- The severity of hepatitis A increases with age.
- Persons with underlying chronic disease are more likely to have severe disease.
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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
> Consultation for Management
