Table of contents
Hepatitis A virus infection
Guidelines
Key sources
The following summarized guidelines for the evaluation and management of hepatitis A virus infection are prepared by our editorial team based on guidelines from the American Academy of Family Physicians (AAFP 2024,2021), the British Association for Sexual Health and HIV (BASHH 2023,2017), the European Association for the Study of the Liver (EASL 2023), the Center for Disease Control (CDC 2021,2020), ...
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Screening and diagnosis
Indications for testing, at-risk population
As per BASHH 2017 guidelines:
Consider obtaining testing for HAV in the sexual health setting in at-risk patients, especially MSM, injection drug users, patients with HBV, HCV, and HIV infections,
B
with unknown immune status and no definite history of completed HAV vaccination course, depending on local funding arrangements and the risk of not returning for vaccination. C
Offer the first vaccine dose on the same day as testing in an outbreak situation or if the patient may not return. ⁄
Do not obtain screening for HAV infection in the sexual health setting in patients known to be immune or fully vaccinated against HAV.
D
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Indications for testing (contacts of patients)
Diagnostic investigations
Serologic testing: as per AAFP 2021 guidelines, obtain anti-HAV IgM to confirm suspected HAV infection.
B
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Screening for STIs
Medical management
Specific circumstances
Pregnant patients, prevention
As per EASL 2023 guidelines:
Offer HAV vaccination in pregnant women at risk for HAV infection during pregnancy.
B
Offer hepatitis A vaccine and immunoglobulin for post-exposure prophylaxis during pregnancy.
B
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Pregnant patients (indications for testing)
Pregnant patients (counseling)
Pregnant patients (delivery and breastfeeding)
Pregnant patients (newborn immunization)
Patient education
Preventative measures
Immunization, indications: as per AAFP 2024 guidelines, offer hepatitis A vaccination in MSM of all ages.
B
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Immunization (pre-vaccination testing)
Immunization (post-vaccination testing)
Post-exposure prophylaxis (vaccination)
Post-exposure prophylaxis (immunoglobulin)