ICD-11

A group of liver diseases characterised by liver inflammation and fibrosis, caused by less than 6 months of infection with one or more of hepatitis B virus, hepatitis C virus and hepatitis D virus, with or without HIV. Even at stage of cirrhosis there are often no symptoms. Otherwise, clinical features include fatigue, hard liver edge and complications of cirrhosis (muscle wasting, ascites, splenomegaly/portal hypertension). Transmission of hepatitis B and C viruses is by blood and body fluid contamination, sexual transmission, and from mother to baby at the time of birth (vertical transmission). In addition to detection of specific antigens (HBsAg) and antibodies (anti-HCV), diagnostic assessment requires assay of viral nucleic acids (HBV DNA, HCV RNA etc).

Acute liver injury and inflammation caused by recent and short-term (less than 6 months) infection with hepatitis A virus (HAV). Transmission is by the faecal-oral route. Diagnosis is confirmed by presence of IgM-anti-HAV in serum. Clinical features, if they occur, are characterised by anorexia, nausea and fever, with jaundice in severer cases.

Acute hepatitis A is acute liver injury caused by infection with hepatitis A virus (HAV), which is a small, 27nm in length, cubically symmetrical RNA picorna virus (enterovirus type 72). HAV is usually spreads by faecal-oral transmission. The incubation period is 2 to 6 week after infection. Acute hepatitis A is diagnosed by positive serum IgM anti-HAV and usually shows a self-limiting course although fulminant course can occur rarely (the risk increases with age) and 5-10% of cases can be complicated by cholestasis persisting up to 6 weeks and 0.2% developing acute liver failure. It never progresses to chronic hepatitis or cirrhosis.