Guidelines for serological testing in the diagnosis of acute Hepatitis A and B

Chitkara, Yoginder K.; Fontes, Monica D

doi:10.1016/s0732-8893(98)00141-2

Cited by 5 publications

(2 citation statements)

References 5 publications

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“…In one patient suspected of acute hepatitis, tests for serological markers of acute viral infection were ordered for confirmation and categorisation of viral etiology. Marked abnormalities of serum transaminases occur with HAV, but HBV may not be associated with elevated serum concentrations of transaminases (5).…”

Section: Discussionmentioning

confidence: 98%

Hepatitis A and B Discrimination According to Aminotransferases

Parlakay¹,

Kara²,

Devrim³

et al. 2011

Çocuk Enf Derg

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Objective: Acute infection of hepatitis A and B viruses is accompanied by biochemical evidence of liver injury. In acute symptomatic hepatitis, transaminase tests are markedly elevated, especially, in hepatitis A. This study was carried out to examine the feasibility of discrimination between hepatitis A and B in acute phase using serum transaminase concentrations so as to take isolation precautions and to plan supportive therapy in early phase. Methods: Between January 1996 and December 1998, 444 patients, [239 (53.8%) males and 205 (46.2%) females] are tested for hepatitis B surface antigen (HBsAg), hepatitis B core IgM antigen (anti-HBc IgM), and hepatitis A immunglobuline M (anti-HAV IgM), alanine aminotransferase (ALT), aspartat aminotransferase (AST) and bilirubin concentrations and comparison of transaminase concentrations between patients infected with hepatitis A and hepatitis B has been made. Results: ALT concentrations of HAV-infected patients had a median of 879 (minimum: 4, maximum: 7201), whereas HBV-infected patients had a median of 66 (minimum: 16, maximum: 3118). AST concentrations of HAV-infected patients had a median of 492 (minimum: 8, maximum: 5718), whereas HBV-infected patients had a median of 59,5 (minimum: 13, maximum: 2040). Transaminase concentrations of patients infected with hepatitis A are higher than patients infected with hepatitis B (for ALT and AST p<0,001). Also there was difference in transaminase concentration in acute hepatitis with age. Concentrations of serum transaminases in acute hepatitis increased with age and peaked at 7-8 years, having a median of 1565 (minimum: 9 and maximum: 4014) for AST and 1942 (minimum: 22 and maximum: 3950) for ALT. Conclusion: Discrimination between hepatitis A and B in acute phase using serum transaminase concentrations could be helpful to get isolation precautions and to plan supportive therapy in early phase. (J Pediatr Inf 2011; 5: 1-3)

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Section: Discussionmentioning

confidence: 98%

Hepatitis A and B Discrimination According to Aminotransferases

Parlakay¹,

Kara²,

Devrim³

et al. 2011

Çocuk Enf Derg

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“…[13][14][15] This algorithm, however, is not applicable to patients who present with fulminant hepatic failure or who have had chronic viral hepatitis. Because 75% of cases of acute viral hepatitis result from infection with either HAV or HBV, the initial laboratory investigation should include serologic tests to exclude HAV or HBV.…”

Section: Cost-effective Diagnosis Of Acute Viral Hepatitismentioning

confidence: 99%

Cost-effective evaluation of acute viral hepatitis

Ahmed

Keeffe²

2000

Western Journal of Medicine

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The performance of extensive serologic testing of patients who present to a primary care physician or to a hospital emergency department with possible acute viral hepatitis is not cost-effective (table). A selective serologic investigation is the most prudent approach to the diagnostic workup of this disease. We review two cases of patients with possible acute viral hepatitis to demonstrate the extra cost resulting from extensive serologic testing. In the following discussion, we review the epidemiologic features, demographics, and risk factors for the disease. We also propose a schematic, cost-effective approach to investigate whether acute viral hepatitis is present. The recommendations in this article were formulated after reviewing epidemiologic data from the Centers for Disease Control and Prevention.1 A MEDLINE search was also conducted, and recent articles on this topic were reviewed. REPORT OF CASES Patient 1A 19-year-old man had progressive anorexia and malaise, preceded by fever, for 1 week. Jaundice developed 1 day before he was seen by his physician. These symptoms developed eight days after he returned from a trip to Mexico. He denied injection drug use and was not sexually active. He was not taking any medications.A complete laboratory evaluation revealed the following liver function test results: alanine aminotransferase, 1,200 U/L; aspartate aminotransferase, 900 U/L; total bilirubin, 77 µmol/L (4.5 mg/dL); albumin, 43 g/L (4.3 g/dL); and international normalized ratio, 1.1. Hepatitis B virus (HBV) and hepatitis C virus (HCV) serologic test results were negative for hepatitis B surface antigen (HBsAg); hepatitis B e antigen (HBeAg); and antibodies to hepatitis B core antigen of immunoglobulin M type (anti-HBc IgM), hepatitis B e antigen (anti-HBe), hepatitis B surface antigen (anti-HBs), and HCV (anti-HCV). A finding of total and IgM antibodies to hepatitis A virus (anti-HAV) confirmed the diagnosis of acute hepatitis A.

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Infektionen in der Schwangerschaft und bei der Geburt

Mylonas¹,

Friese²

2015

Die Geburtshilfe

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Guidelines for serological testing in the diagnosis of acute Hepatitis A and B

Cited by 5 publications

References 5 publications

Hepatitis A and B Discrimination According to Aminotransferases

Hepatitis A and B Discrimination According to Aminotransferases

Cost-effective evaluation of acute viral hepatitis

Infektionen in der Schwangerschaft und bei der Geburt

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