{ "schemaVersion": 2, "eyebrow": "Infectious Diseases", "title": "Hepatitis A", "summary": "Diagnose acute hepatitis A with symptom-directed IgM anti-HAV testing, interpret discordant serology cautiously, provide supportive care, identify acute liver failure early, report confirmed cases, and rapidly deliver exposure prophylaxis within 14 days.", "seoDescription": "Physician guide to hepatitis A diagnosis, serology interpretation, acute liver failure escalation, supportive management, vaccination, and postexposure prophylaxis.", "clinicalQuestion": "How should clinicians confirm, manage, and prevent hepatitis A infection and secondary transmission?", "specialty": "Infectious Diseases", "audience": "U.S. physicians and medical trainees", "tags": [ "hepatitis A", "HAV", "anti-HAV IgM", "postexposure prophylaxis", "hepatitis A vaccine", "acute liver failure" ], "keyTakeaways": [ "Order IgM anti-HAV only in symptomatic patients when acute HAV is clinically suspected; total anti-HAV and IgG anti-HAV do not diagnose acute illness. [18]", "A positive IgM anti-HAV supports current or recent infection but can reflect recent vaccination or false positivity; reconcile low-pretest-probability results with the clinical syndrome and other laboratory findings. [18][1][19]", "HAV has no virus-specific therapy; use supportive care, but urgently escalate encephalopathic acute hepatitis as possible acute liver failure and pursue early transplant-center evaluation. [12][20][23]", "For susceptible exposed persons aged 12 months or older, give single-antigen HepA vaccine as soon as possible and within 14 days; add intramuscular immune globulin 0.1 mL/kg for immunocompromised persons or those with chronic liver disease, and consider it for persons older than 40 years after risk assessment. [12][9]", "Do not use Twinrix for HAV postexposure prophylaxis because supporting PEP data are unavailable. [9]" ], "sections": [ { "id": "test-the-right-patient", "eyebrow": "Diagnosis", "heading": "Use symptom-directed serology to confirm suspected acute HAV", "intro": "Clinical features alone cannot distinguish HAV from other causes of viral hepatitis. [1][18]", "paragraphs": [ "Order serum IgM anti-HAV when a patient is symptomatic and acute hepatitis A is in the differential; obtain ALT and total bilirubin concurrently to define hepatic injury and severity. CDC advises against using IgM anti-HAV as a screening test in asymptomatic persons because false-positive or clinically misleading results occur when pretest probability is low. [18][19]", "In acute hepatitis, do not stop at an HAV result when the presentation is severe, atypical, or discordant. Obtain competing viral hepatitis serologies, including hepatitis A through E where clinically indicated, and autoimmune serologies promptly in suspected acute liver failure. [23] A symptomatic viremic patient can transiently have nonreactive IgM anti-HAV, so a negative result does not exclude HAV during an early compatible illness; reassess timing and alternative etiologies rather than treating one assay as definitive. [1]", "Confirm and report clinically compatible cases through local or state public health channels. Hepatitis A is nationally notifiable, and public-health confirmation of true cases is important because an erroneous positive IgM result can trigger unnecessary contact investigations and prophylaxis efforts. [12][1]" ], "bullets": [ "Ask specifically about a completed HepA vaccine series, vaccination in the preceding weeks, known exposure, travel, and outbreak-associated risks; recent vaccination can yield detectable IgM anti-HAV. [12][18]", "Review assay-specific borderline or gray-zone results with the laboratory; for one recalled assay configuration, a cutoff index of 0.90-1.10 required review and repeat testing when interpretation was discrepant. [2]", "Do not use total anti-HAV alone to diagnose acute hepatitis: it cannot distinguish prior infection, current infection, or prior vaccination. [18]" ], "subsections": [], "table": { "caption": "Interpret hepatitis A serology in the clinical context; IgM findings may be misleading without a compatible acute illness. [18][1]", "columns": [ "Total anti-HAV", "IgM anti-HAV", "Interpretation", "Immediate action" ], "rows": [ [ "Positive", "Positive", "Current or recent infection; recent vaccination is also possible. [18]", "Correlate with symptoms, ALT, bilirubin, vaccination history, and public-health case criteria. [18][1]" ], [ "Positive", "Negative", "Prior infection or vaccination; immune. [18][12]", "Do not diagnose acute HAV from this pattern. [18]" ], [ "Negative", "Negative", "No serologic evidence of infection or immunity; susceptible. [18]", "Vaccinate when indicated; if exposure was within 14 days, provide PEP. [12]" ], [ "Negative or not done", "Positive", "Current infection or false-positive/cross-reactive IgM result. [18]", "Reassess pretest probability, repeat or clarify discrepant testing, and evaluate alternative causes of hepatitis. [18][1]" ] ] } }, { "id": "triage-severe-hepatitis", "eyebrow": "Urgent care", "heading": "Separate uncomplicated HAV from acute liver failure at presentation", "intro": "The immediate management decision is whether acute hepatic injury has progressed to encephalopathic liver failure. [23]", "paragraphs": [ "Patients with acute hepatitis and encephalopathy require urgent management as suspected acute liver failure, regardless of whether HAV IgM is positive. AASLD emphasizes that acute liver failure hinges on an acute hepatic insult plus encephalopathy; obtain viral hepatitis serologies including A-E and autoimmune serologies promptly while arranging higher-level care. [23]", "Treat HAV-associated acute liver failure with supportive care because no virus-specific treatment has proven effective. [20] Early referral to a liver transplant center is critical when acute liver failure is suspected, since transplant eligibility and timing can materially determine prognosis. [21][23]", "Older age and underlying chronic liver disease should lower the threshold for close observation and early escalation. Reported U.S. hepatitis A case-fatality was 0.3% overall, increasing to 1.8% among adults older than 50 years; chronic liver disease is also associated with increased fulminant HAV risk. [7][24]" ], "bullets": [ "Escalate immediately for altered mental status in acute hepatitis; coordinate intensive monitoring and transplant-center evaluation rather than outpatient observation. [23][21]", "Continue etiologic evaluation in acute liver failure even with positive HAV IgM, including autoimmune testing and viral serologies, because diagnostic anchoring can miss a concurrent or alternative treatable cause. [23]", "Do not use antiviral therapy for HAV-associated acute liver failure; management remains supportive while transplant candidacy is assessed. [20]" ], "subsections": [], "table": { "caption": "Disposition framework for acute hepatitis with suspected HAV. [20][23][21]", "columns": [ "Clinical branch", "Key discriminator", "Next action" ], "rows": [ [ "Suspected acute HAV without encephalopathy", "Symptomatic hepatitis with appropriately interpreted IgM anti-HAV. [18]", "Provide supportive care, assess laboratory severity, counsel on transmission prevention, and report confirmed cases. [12][1]" ], [ "Suspected acute liver failure", "Acute hepatic insult plus encephalopathy. [23]", "Urgently obtain viral A-E and autoimmune serologies, provide supportive care, and arrange early liver-transplant-center evaluation. [23][20][21]" ], [ "Higher-risk acute HAV", "Age older than 50 years or chronic liver disease. [7][24]", "Use a lower threshold for close monitoring and escalation because fulminant disease and mortality risk are higher. [7][24]" ] ] } }, { "id": "manage-confirmed-infection", "eyebrow": "Management", "heading": "Manage confirmed HAV with supportive care and transmission control", "intro": "No HAV-directed antiviral regimen is recommended. [12][20]", "paragraphs": [ "Provide supportive care for uncomplicated hepatitis A. [12][13] Reassess clinically and with liver biochemical tests when symptoms worsen, jaundice deepens, oral intake is inadequate, or mental status changes; the latter requires immediate acute-liver-failure escalation rather than routine follow-up. [18][23]", "Counsel patients and households that infection is reportable and that contact management is time-sensitive. Public-health involvement is operationally important for identifying exposed persons and directing outbreak response; false-positive index-patient testing can otherwise create unnecessary investigations. [1][12]", "Do not label persistent liver test abnormalities as chronic hepatitis A without reassessing the diagnosis or considering relapsing illness and other liver diseases. Chronic hepatitis A does not occur. [7]" ], "bullets": [ "Document HepA vaccination status and prioritize vaccination of susceptible persons with ongoing exposure risk. [9][11]", "For patients with HIV, obtain HAV IgG and vaccinate antibody-negative individuals regardless of CD4 count; in those at increased risk of HAV morbidity or mortality, measure post-vaccination HAV IgG at least 1 month after the final dose. [15]", "Avoid delaying public-health action for a clearly compatible, confirmed case, but scrutinize isolated or unexpected IgM positivity before treating it as definitive acute HAV. [18][1][19]" ], "subsections": [], "table": { "caption": "Management priorities after suspected or confirmed hepatitis A. [12][20][23]", "columns": [ "Priority", "Action", "Escalation trigger" ], "rows": [ [ "Clinical management", "Provide supportive care; no virus-specific HAV treatment has proven effective. [12][20]", "Acute hepatitis with encephalopathy requires urgent acute-liver-failure evaluation. [23]" ], [ "Diagnostic safety", "Interpret IgM anti-HAV with clinical findings, ALT, bilirubin, and vaccination history. [18][1]", "Unexpected or discordant IgM result warrants reassessment or repeat/clarifying testing. [1][2]" ], [ "Public health", "Report confirmed HAV and identify susceptible exposed contacts promptly. [12][1]", "Exposure within 14 days requires immediate PEP assessment. [12]" ] ] } }, { "id": "postexposure-prophylaxis", "eyebrow": "Prevention", "heading": "Deliver hepatitis A postexposure prophylaxis within 14 days", "intro": "Act immediately after a credible exposure; efficacy beyond 14 days has not been established. [12]", "paragraphs": [ "For exposed, susceptible persons aged 12 months or older who have not completed the HepA vaccine series, administer one dose of single-antigen hepatitis A vaccine as soon as possible, ideally within 14 days after exposure. [12] Do not delay indicated prophylaxis for routine preexposure serologic testing. [14]", "Add intramuscular immune globulin at 0.1 mL/kg to vaccine PEP for exposed persons who are immunocompromised or have chronic liver disease. For persons older than 40 years, decide whether to add IG using an individualized risk assessment that includes age, immune status, underlying conditions, exposure type, transmission risk, and IG availability. [12][9]", "If HepA vaccine is contraindicated, administer IG 0.1 mL/kg as soon as possible within 14 days of exposure. [9] Use single-antigen HepA vaccine rather than the combined HepA-HepB product Twinrix for PEP because PEP data for Twinrix are unavailable. [9]" ], "bullets": [ "Separate HepA vaccine and IG into different anatomic sites when both are administered. [14]", "After IG administration, do not give MMR or varicella vaccine for less than 6 months. [9]", "For an exposed traveler who is asymptomatic and unvaccinated, use one dose of single-antigen vaccine or IG 0.1 mL/kg within 14 days; consider vaccine plus IG in the higher-risk groups above. [12]" ], "subsections": [], "table": { "caption": "HAV postexposure prophylaxis selection for susceptible exposed persons within 14 days. [12][9]", "columns": [ "Exposed person", "PEP regimen", "Key limitation" ], "rows": [ [ "Age 12 months or older, no completed HepA series", "One dose of single-antigen HepA vaccine as soon as possible, ideally within 14 days. [12]", "Efficacy when administered more than 14 days after exposure is not established. [12]" ], [ "Immunocompromised or chronic liver disease", "Single-antigen HepA vaccine plus IM IG 0.1 mL/kg within 14 days. [12][9]", "Give vaccine and IG in separate anatomic sites. [14]" ], [ "Age older than 40 years", "Single-antigen HepA vaccine; consider adding IM IG 0.1 mL/kg after risk assessment. [12]", "Consider exposure intensity, immune status, comorbidities, and IG availability. [12]" ], [ "HepA vaccine contraindicated", "IM IG 0.1 mL/kg as soon as possible within 14 days. [9]", "Defer MMR and varicella vaccination for less than 6 months after IG. [9]" ], [ "Considering Twinrix", "Do not use Twinrix for HAV PEP. [9]", "No PEP data are available for the combined product. [9]" ] ] } }, { "id": "preexposure-vaccination", "eyebrow": "Vaccination", "heading": "Use vaccination to prevent primary HAV infection", "intro": "Vaccination is the main durable preventive intervention. [9][11]", "paragraphs": [ "Use the routine two-dose IM HepA vaccine series beginning at age 12 months, with doses separated by 6 months; adults can also receive a two-dose series. [11] For adults needing both HAV and HBV prevention outside the PEP setting, the three-dose combined HepA-HepB vaccine series is an option, but it should not replace single-antigen vaccine for PEP. [11][9]", "Vaccinate travelers and other persons at increased risk, including those with chronic liver disease. [7][12] For infants aged 6-11 months traveling outside the United States, CDC guidance includes a specific travel-vaccination recommendation. [9] In people with HIV, vaccinate those without HAV antibody regardless of CD4 count rather than deferring vaccination for immune reconstitution. [15]", "Do not routinely perform prevaccination serology. Consider total anti-HAV or IgG anti-HAV testing only when avoiding vaccination of persons already immune would materially affect cost or program implementation; a positive total or IgG anti-HAV with negative IgM indicates immunity from prior infection or vaccination. [18][12]" ], "bullets": [ "Use age-appropriate pediatric or adult vaccine formulations; formulations have different approved dosing by age. [11]", "For patients with HIV at increased risk for HAV morbidity or mortality, check HAV IgG at least 1 month after the final vaccine dose to document response. [15]", "Do not defer vaccination solely because CD4 count is below 200 cells/mm3. [15]" ], "subsections": [], "table": { "caption": "Preexposure vaccination decisions for hepatitis A. [9][11][15][18]", "columns": [ "Population or setting", "Action", "Testing consideration" ], "rows": [ [ "Children", "Start the two-dose IM HepA series at age 12 months; separate doses by 6 months. [11]", "Routine prevaccination serology is not recommended. [18]" ], [ "Adults requiring HAV prevention", "Use a two-dose HepA series; combined HepA-HepB vaccine is an option for dual protection outside PEP. [11][9]", "Consider immunity testing only when cost of vaccinating immune persons is a concern. [18]" ], [ "Travelers and chronic liver disease", "Vaccinate before exposure risk when indicated. [7][9][12]", "Travel guidance includes infants aged 6-11 months traveling outside the United States. [9]" ], [ "HIV infection", "Measure HAV IgG and vaccinate antibody-negative persons regardless of CD4 count. [15]", "For higher morbidity or mortality risk, measure HAV IgG at least 1 month after the final dose. [15]" ] ] } } ], "faq": [ { "question": "Should an asymptomatic patient with an isolated positive IgM anti-HAV be diagnosed with acute hepatitis A?", "answer": "No. IgM anti-HAV should be ordered for symptomatic patients with suspected HAV. In an asymptomatic or low-pretest-probability setting, interpret isolated positivity cautiously, review recent vaccination and the assay result, and evaluate for false positivity or cross-reactivity before assigning an acute diagnosis. [18][1][19]" } ], "references": [ { "number": 1, "title": "Hepatitis A Virus Serological Assays - Class II Special Controls Guidance for Industry and FDA Staff | FDA", "detail": "www.fda.gov", "url": "https://www.fda.gov/medical-devices/guidance-documents-medical-devices-and-radiation-emitting-products/hepatitis-virus-serological-assays-class-ii-special-controls-guidance-industry-and-fda-staff", "authors": "www.fda.gov", "host": "www.fda.gov" }, { "number": 2, "title": "Class 2 Device Recall Elecsys Anti HAV IgM", "detail": "www.accessdata.fda.gov", "url": "https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfres/res.cfm?id=170000", "authors": "www.accessdata.fda.gov", "host": "www.accessdata.fda.gov" }, { "number": 3, "title": "A WWW-accessible knowledge base for the interpretation of hepatitis serologic tests - ScienceDirect", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/abs/pii/S1386505697000920", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com" }, { "number": 4, "title": "Improving the accuracy of clinical interpretation of serological testing for the diagnosis of acute hepatitis a infection - 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Updated Recommendations of \r\nthe Advisory Committee on Immunization Practices (ACIP)", "detail": "www.cdc.gov", "url": "https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5641a3.htm", "authors": "www.cdc.gov", "host": "www.cdc.gov" } ], "editorialNote": "Prepared from cited clinical literature using Astra's research workflow. Verify recommendations against current guidance and patient-specific factors.", "citations": [ { "number": 1, "title": "Hepatitis A Virus Serological Assays - Class II Special Controls Guidance for Industry and FDA Staff | FDA", "detail": "www.fda.gov", "url": "https://www.fda.gov/medical-devices/guidance-documents-medical-devices-and-radiation-emitting-products/hepatitis-virus-serological-assays-class-ii-special-controls-guidance-industry-and-fda-staff", "authors": "www.fda.gov", "host": "www.fda.gov", "snippet": "A false positive measurement can result in incorrect diagnosis of active or past HAV infection. If HAV-specific total antibodies are detected erroneously, an individual may not receive the vaccine for HAV and could continue to be at risk for HAV infection. Hepatitis A virus infection is a public hea", "score": 0.6100127 }, { "number": 2, "title": "Class 2 Device Recall Elecsys Anti HAV IgM", "detail": "www.accessdata.fda.gov", "url": "https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfres/res.cfm?id=170000", "authors": "www.accessdata.fda.gov", "host": "www.accessdata.fda.gov", "snippet": "stores the interpretation and COI information for Anti-HAV IgM, all COI results in the gray zone of 0.90 \u0013 1.10 should be reviewed. Implement the following action for all gray zone results: If discrepant interpretation of results is suspected, re-testing may be advisable in concordance with the reco", "score": 0.4784076 }, { "number": 3, "title": "A WWW-accessible knowledge base for the interpretation of hepatitis serologic tests - ScienceDirect", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/abs/pii/S1386505697000920", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "Title: A WWW-accessible knowledge base for the interpretation of hepatitis serologic tests - ScienceDirect\n# A WWW-accessible knowledge base for the interpretation of hepatitis serologic tests. HEPAXPERT is a knowledge-based system that interprets the results of routine serologic tests for infection", "score": 0.5433243 }, { "number": 4, "title": "Improving the accuracy of clinical interpretation of serological testing for the diagnosis of acute hepatitis a infection - ScienceDirect", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/abs/pii/S138665322200172X", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "### Based on reading popularity\n\n## Cited by (8)\n\nHowever, if a pregnant woman develops hepatitis symptoms, such as fatigue, anorexia, nausea and/or vomiting, with or without dark urine and jaundice, or has abnormal liver function test (ALT >5 upper limit of normal and/or elevated bilirubin), hepati", "score": 0.47826138 }, { "number": 5, "title": "S3665 Relapsing Viral Hepatitis A", "detail": "journals.lww.com", "url": "https://journals.lww.com/ajg/fulltext/10.14309/01.ajg.0000788192.70433.c5~s3665relapsing-viral-hepatitis-a", "authors": "journals.lww.com", "host": "journals.lww.com", "snippet": "by J Prasa · 2021 — Hepatitis A IgM was positive indicating active acute hepatitis A. With supportive care, the patient's liver enzymes downtrended and his diarrhea resolved.Read more", "score": 0.5325473 }, { "number": 6, "title": "S5764 Severe Acute Hepatitis A Leading to Liver...", "detail": "journals.lww.com", "url": "https://journals.lww.com/ajg/fulltext/10.14309/01.ajg.0001150516.51875.df~s5764severe-acute-hepatitis-a-leading-to-liver", "authors": "journals.lww.com", "host": "journals.lww.com", "snippet": "by A El-Sadek · 2025 — Emergent liver transplantation remains a critical and life-saving intervention for fulminant hepatitis A.", "score": 0.18435632 }, { "number": 7, "title": "Hepatitis A - an overview | ScienceDirect Topics", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/topics/immunology-and-microbiology/hepatitis-a", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "Chronic hepatitis A does not occur.\n\nPrevention\n\n•\n: In the United States, vaccination with hepatitis A vaccine is recommended for all children at age 12 to 23 months. Vaccination of older children and adults may be warranted, including patients with chronic hepatitis B and C (see Table 176-4).\n\n•", "score": 0.71496695 }, { "number": 8, "title": "Vaccination strategies for control of community outbreaks of hepatitis A: A comparison of two outbreaks in England - ScienceDirect", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/abs/pii/S0264410X19300891", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "### Vaccine\n\n### Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013\n\n### The Lancet\n\n### Weekly epidemiological record Rel", "score": 0.5401241 }, { "number": 9, "title": "Prevention of Hepatitis A Virus Infection in the United States - PMC", "detail": "pmc.ncbi.nlm.nih.gov", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8631741", "authors": "pmc.ncbi.nlm.nih.gov", "host": "pmc.ncbi.nlm.nih.gov", "snippet": "Vaccination of persons who receive blood products for clotting disorders (e.g., hemophilia) is no longer recommended.\n\nNew CDC clinical guidance is provided for the vaccination of the following: infants aged 6–11 months traveling outside the United States, persons aged >40 years, persons with immuno", "score": 0.7099254 }, { "number": 10, "title": "Chronic Viral Hepatitis: Current Management and Future Directions", "detail": "pmc.ncbi.nlm.nih.gov", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7049676", "authors": "pmc.ncbi.nlm.nih.gov", "host": "pmc.ncbi.nlm.nih.gov", "snippet": "| AASLD | Treat | Potentially Treat | Do Not Treat |\n| HBeAg‐positive | HBeAg‐positive | HBeAg‐positive |\n| ALT elevated but <2× ULN and HBV DNA >20,000 IU/mL | ALT elevated <2× ULN and HBV DNA≥2,000 IU/mL persistent >6 months | ALT normal and HBV DNA >20,000 IU/mL |\n| Or | ALT elevated ≥ 2× ULN and", "score": 0.61112726 }, { "number": 11, "title": "Clinical progress note: Hepatitis A virus - PMC", "detail": "pmc.ncbi.nlm.nih.gov", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12954352", "authors": "pmc.ncbi.nlm.nih.gov", "host": "pmc.ncbi.nlm.nih.gov", "snippet": "## SEARCH STRATEGY\n\nThe authors reviewed the recently updated HAV guidance from the Centers for Disease Control and Prevention (CDC).5 Further literature review using PubMed was performed using keywords “hepatitis A,” “outbreak,” “vaccination,” and “hospitalization.”\n\n## HEPATITIS A VACCINE AND RECO", "score": 0.60694176 }, { "number": 12, "title": "Hepatitis A - CDC Yellow Book, 2026 edition - NCBI Bookshelf", "detail": "www.ncbi.nlm.nih.gov", "url": "https://www.ncbi.nlm.nih.gov/books/NBK620902", "authors": "www.ncbi.nlm.nih.gov", "host": "www.ncbi.nlm.nih.gov", "snippet": "### Post-exposure prophylaxis\n\nTravelers exposed to HAV who are asymptomatic and who have not received hepatitis A vaccine should receive 1 dose of single-antigen hepatitis A vaccine or IG (0.1 mL/kg) as soon as possible, ideally ≤2 weeks following exposure. The efficacy of vaccine or IG when admini", "score": 0.60245985 }, { "number": 13, "title": "From hepatitis A to E: A critical review of viral hepatitis", "detail": "pmc.ncbi.nlm.nih.gov", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8072198", "authors": "pmc.ncbi.nlm.nih.gov", "host": "pmc.ncbi.nlm.nih.gov", "snippet": "### Management\n\nNo specific treatment is available for HAV and the management is mainly symptomatic. The primary focus remains on improving sanitary conditions to minimize the transmission in the community. Historically, immunoglobulins have been used in the prevention of HAV infections. With the av", "score": 0.59655124 }, { "number": 14, "title": "Hepatitis A Vaccine - StatPearls - NCBI Bookshelf - NIH", "detail": "www.ncbi.nlm.nih.gov", "url": "https://www.ncbi.nlm.nih.gov/books/NBK554604", "authors": "www.ncbi.nlm.nih.gov", "host": "www.ncbi.nlm.nih.gov", "snippet": "Hepatitis A vaccine is not currently licensed for use as postexposure prophylaxis. However, if a person receives IG for post-exposure prophylaxis, they may be given any routine recommended HAV due. IG and HAV may be given at the same time, but the injections must be into separate anatomic sites. Imm", "score": 0.5342973 }, { "number": 15, "title": "Prevention and Management of Hepatitis A Virus Infection in Adults With HIV - NCBI Bookshelf", "detail": "www.ncbi.nlm.nih.gov", "url": "https://www.ncbi.nlm.nih.gov/books/NBK570934", "authors": "www.ncbi.nlm.nih.gov", "host": "www.ncbi.nlm.nih.gov", "snippet": "| Pre-Exposure Vaccination Clinicians should obtain an HAV IgG antibody measurement for all individuals with HIV [a] and should administer the HAV vaccine [b] to those who are HAV antibody-negative, regardless of CD4 count. Clinicians should administer the 2-dose anti-HAV vaccine series, with th", "score": 0.48982134 }, { "number": 16, "title": "Hepatitis A - StatPearls - NCBI Bookshelf", "detail": "www.ncbi.nlm.nih.gov", "url": "https://www.ncbi.nlm.nih.gov/books/NBK459290", "authors": "www.ncbi.nlm.nih.gov", "host": "www.ncbi.nlm.nih.gov", "snippet": "Universal pediatric vaccination is the most effective control measure in intermediate-risk regions. Before the advent of HAV vaccines, short-term pre-exposure and postexposure prophylaxis involved injecting intramuscular human immunoglobulin. Effective HAV vaccines have reduced immunoglobulin use du", "score": 0.37600484 }, { "number": 17, "title": "Hepatitis B Virus Infection: Adult and Adolescent OIs | NIH", "detail": "clinicalinfo.hiv.gov", "url": "https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-opportunistic-infections/hepatitis-b-virus", "authors": "clinicalinfo.hiv.gov", "host": "clinicalinfo.hiv.gov", "snippet": "17. Conners EE, Panagiotakopoulos L, Hofmeister MG, et al. Screening and testing for hepatitis B virus infection: CDC recommendations - United States, 2023. _MMWR Recomm Rep_. 2023;72(1):1-25. Available at: \n18. Terrault NA, Lok ASF, McMahon BJ, et al. Update on prevention, diagnosis, and treatm", "score": 0.3665676 }, { "number": 18, "title": "Clinical Screening and Diagnosis for Hepatitis A | Hepatitis A | CDC", "detail": "www.cdc.gov", "url": "https://www.cdc.gov/hepatitis-a/hcp/diagnosis-testing/index.html", "authors": "www.cdc.gov", "host": "www.cdc.gov", "snippet": "The following are laboratory markers that, if present, indicate an acute HAV infection:\n\nThe following is the serologic marker that, if present, indicates either immunity from prior infection or vaccination:\n\nSerologic tests for IgG anti-HAV and total anti-HAV (IgM and IgG anti-HAV combined) are not", "score": 0.69697046 }, { "number": 19, "title": "Hepatitis A | Red Book - AAP Publications", "detail": "publications.aap.org", "url": "https://publications.aap.org/redbook/book/755/chapter/14077774/Hepatitis-A", "authors": "publications.aap.org", "host": "publications.aap.org", "snippet": "Presence of serum IgM anti-HAV indicates current or recent infection, although false-positive results may occur, particularly if the pretest probability of", "score": 0.5735118 }, { "number": 20, "title": "Position Paper: The Management of Acute Liver Failure", "detail": "www.aasld.org", "url": "https://www.aasld.org/sites/default/files/2023-03/Acute%20Liver%20Failure%20Update2011.pdf", "authors": "www.aasld.org", "host": "www.aasld.org", "snippet": "Recommendations 13. Viral hepatitis A- (and E-) related acute liver failure must be treated with supportive care as no virus-specific treatment has proven to be effective (III).\n14. Nucleos(t)ide analogues should be considered for hepatitis B-associated acute liver failure and for prevention of post-", "score": 0.6493346 }, { "number": 21, "title": "Management of Acute on Chronic Liver Failure in the Hospitalized ...", "detail": "www.aasld.org", "url": "https://www.aasld.org/liver-fellow-network/core-series/clinical-pearls/management-acute-chronic-liver-failure", "authors": "www.aasld.org", "host": "www.aasld.org", "snippet": "Nutrition and Supportive Care\n\n Oral feeding or enteral nutrition should be introduced early. A nasogastric tube for enteral feeding should be introduced in patients at high risk of aspiration. A nasogastric tube for enteral feeding is not contraindicated in patients with non-bleeding esophageal var", "score": 0.6041426 }, { "number": 22, "title": "Activated T-Cell Hepatitis in Pediatric Acute Liver Failure | AASLD", "detail": "www.aasld.org", "url": "https://www.aasld.org/liver-fellow-network/core-series/clinical-pearls/activated-t-cell-hepatitis-pediatric-acute-liver", "authors": "www.aasld.org", "host": "www.aasld.org", "snippet": "Skip to content\n\n Core Series\n Clinical Pearls\n Activated T-Cell Hepatitis In Pediatric Acute Liver Failure\n\n# Activated T-Cell Hepatitis in Pediatric Acute Liver Failure\n\nNaseem Ravanbakhsh\n\nShare\n\nCopy Link Twitter Facebook\n\nPediatric Acute Liver Failure\n\nAs outlined in the Liver Fellow Network po", "score": 0.35441124 }, { "number": 23, "title": "Management of Acute Liver Failure | AASLD", "detail": "www.aasld.org", "url": "https://www.aasld.org/practice-guidelines/management-acute-liver-failure", "authors": "www.aasld.org", "host": "www.aasld.org", "snippet": "Skip to content\n\n Home\n Practice Guidelines\n\n# Management of Acute Liver Failure\n\nAASLD develops evidence-based practice guidelines and practice guidances which are updated regularly by a multi-disciplinary panel of experts, including hepatologists, and include recommendations of preferred approache", "score": 0.34514993 }, { "number": 24, "title": "Update: Prevention of Hepatitis A After Exposure to Hepatitis \r\nA Virus and in International Travelers. Updated Recommendations of \r\nthe Advisory Committee on Immunization Practices (ACIP)", "detail": "www.cdc.gov", "url": "https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5641a3.htm", "authors": "www.cdc.gov", "host": "www.cdc.gov", "snippet": "(10). Because of the frequency of severe consequences, preventing hepatitis A among exposed older persons and persons with chronic liver disease is\nparticularly vital. The performance of hepatitis A vaccine as postexposure prophylaxis in these groups was not assessed in the\nrecent clinical trial and", "score": 0.80844593 } ], "publishedAt": "2026-09-16T01:04:00.788798+00:00", "updatedAt": "2026-09-16T01:04:00.788798+00:00", "readingMinutes": 6, "slug": "hepatitis-a" }