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Hepatitis A to E 

Hepatitis A to E
Hepatitis A to E

Graeme J.M. Alexander

, and Kate Nash

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date: 26 February 2021

The clinical picture with each of the five major hepatitis viruses A, B, C, D, and E depends firstly upon whether infection is acute, with resolution, or evolves into chronic infection; secondly, on the grade of hepatic inflammation; and thirdly, the stage of fibrosis. Acute icteric hepatitis is the most easily recognized consequence of infection and is generally a self-limited condition. In otherwise healthy individuals, only hepatitis B and C cause chronic viral hepatitis. In immunosuppressed individuals, hepatitis A can follow a protracted course, while hepatitis E can evolve to chronic infection. A specific diagnosis is made by the combination of serology and polymerase chain reaction. Uncomplicated cases recover spontaneously; there is no proven therapy to enhance recovery. Acute liver failure caused by viral hepatitis now has a good outcome, with liver transplantation available for those with poor parameters at onset. Protection against hepatitis A and B is available, both by active vaccination and (less often now) by passive administration of hepatitis B immunoglobulin preparations. Vaccines for hepatitis C are some distance away, but for hepatitis E are under investigation. Vaccination against hepatitis B also protects against hepatitis D.

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