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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 has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Brian J. McMahon, MD, MACP has stock in GSK. Catherine M. Dentinger, FNP, MPH has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Brian J. McMahon, MD, MACP has stock in GSK.
The following editors of ACP Smart Medicine have nothing to disclose: Deborah Korenstein, MD, FACP, Editor in Chief; Richard B. Lynn, MD, FACP, Editor; and Davoren Chick, MD, Editor.
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