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Last Updated: 9/9/2014  

Hepatitis A

  • Administer hepatitis A vaccine to all children at age 1 year (i.e., 12 to 23 months), with catch-up vaccination of unvaccinated children.

  • Administer hepatitis A vaccine or immunoglobulin to persons traveling to endemic areas of the world.

  • Administer hepatitis A vaccine to persons at increased risk for hepatitis A:

    • Household members and other close personal contacts (e.g., regular babysitters) of adopted children newly arriving from countries with high or intermediate hepatitis A endemicity

    • Men who have sex with men

    • Illicit drug users

    • Persons who regularly receive clotting-factor concentrates

    • Persons who have occupational risks for HAV, such as laboratory workers who work with HAV and persons who work with nonhuman primates

    • Homeless adults

  • Administer hepatitis A vaccine to persons with chronic liver diseases.

  • Confirm the diagnosis of hepatitis A by testing for anti-HAV IgM.

  • Hospitalize persons with severe dehydration or those with signs of severe disease or liver failure, including elevated prothrombin time, encephalopathy, or hepatorenal syndrome.

  • Recommend adequate hydration, avoidance of alcohol, and careful attention to personal hygiene and hand washing in patients with hepatitis A.

  • Consult a hepatologist (or gastroenterologist) and possibly a liver transplant surgeon for patients with elevated prothrombin time or mental-status changes suggesting worsening liver failure and possible need for transplantation.

DOI: 10.7326/d471
The information included herein should never be used as a substitute for clinical judgment and does not represent an official position of ACP.
Disclosures:
Catherine M. Dentinger, FNP, MPH CDC/CEFO/New York City Department of Health and Mental Hygiene
New York, NY
has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Brian J. McMahon, MD, MACP Viral Hepatitis Program at the Alaska Native Tribal Health Consortium; Centers for Disease Control and Prevention/Arctic Investigations Program
Anchorage, AK
Spouse has 100 shares of GSK in her IRA; GSK makes Hepatitis A vaccine.
Catherine M. Dentinger, FNP, MPH Bureau of Communicable Disease, New York City Department of Health and Mental Hygiene
New York, NY
has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Brian J. McMahon, MD, MACP Viral Hepatitis Program at the Alaska Native Tribal Health Consortium; Centers for Disease Control and Prevention/Arctic Investigations Program
Anchorage, AK
Spouse has 100 shares of GSK in her IRA; GSK makes Hepatitis A vaccine.
Deborah Korenstein, MD, FACP, Editor in Chief, ACP Smart Medicine, has no relationships with any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. Richard B. Lynn, MD, FACP, Editor, ACP Smart Medicine, has no relationships with any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.
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