Clinical Findings in Hepatitis:
Feature Viral Hepatitis Type A Viral Hepatitis Type B Viral Hepatitis Type
C
Incubation period 10–50 days (avg, 25–30) 50–180 days (avg, 60–90) 15–160 days (avg,
50)
Principal age distribution Children, young adults 15–29 years, babies Adults
Seasonal incidence Throughout the year but
tends to peak in autumn
Throughout the year Throughout the
year
Route of infection Predominantly fecal-oral Predominantly parenteral Predominantly
parenteral
Occurrence of virus
Blood 2 weeks before to 1 week
after jaundice
Months to years Months to years
Stool 2 weeks before to 2 weeks
after jaundice
Absent Probably absent
Urine Rare Absent Probably absent
Saliva, semen Rare (saliva) Frequently present Present (saliva)
Clinical and laboratory features
Onset Abrupt Insidious Insidious
Fever > 38 °C (100.4 °F) Common Less common Less common
Duration of aminotransferase
elevation
1–3 weeks 1–6+ months 1–6+ months
Immunoglobulins (IgM levels) Elevated Normal to slightly elevated Normal to slightly
elevated
Complications Uncommon, no chronicity Chronicity in 5–10% (95% of neonates) Chronicity in 70–
90%
Mortality rate (icteric cases) < 0.5% < 1–2% 0.5–1%
HBsAg Absent Present Absent
Immunity
Homologous Yes Yes Probably no
Heterologous No No No
Duration Probably lifetime Probably lifetime ?
Immune globulin intramuscular
(IG, gamma globulin, ISG)
Regularly prevents jaundice Prevents jaundice only if immune
globulin is of sufficient potency against
HBV
?
Interpretation HAV, HCV and HDV Serologic Markers in patients with Hepatitis:
Assay Results Interpretation
Anti-HAV IgM-positive Acute infection with HAV
Anti-HAV IgG-positive Past infection with HAV
Anti-HCV-positive Current or past infection with HCV
Anti-HDV-positive, HBsAg-positive Infection with HDV
Anti-HDV-positive, anti-HBc IgM-positive Coinfection with HDV and HBV
Anti-HDV-positive, anti-HBc IgM-negative Superinfection of chronic HBV infection with HDV