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Hepatitis - Highlights

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of hepatitis.

Highlights:

Causes of Hepatitis

Hepatitis A is caused by the hepatitis A virus (HAV). Hepatitis B is caused by the hepatitis B virus (HBV). Finally, hepatitis C is caused by the hepatitis C virus (HCV). Hepatitis B and C can cause either an acute (short-term) or chronic (long-term) form. Chronic forms of hepatitis B and C increase the risk for serious complications, including cirrhosis and liver cancer.

New Guidelines: Screening for Hepatitis B Virus

In 2008, the U.S. Centers for Disease Control (CDC) expanded its screening guidelines for HBV infection. The CDC now recommends that these additional groups of people be screened for hepatitis B infection:

People born in regions with high rates of HBV infection. These regions include parts of Asia, Pacific Islands, Africa, Middle East, South and Central America, and the Caribbean.
People who self-inject drugs
Men who have sex with men
Patients receiving chemotherapy or immunosuppressive therapy for medical conditions

New Guidelines: Prevention of Hepatitis A After Exposure

Based on several recent studies, the CDC� ' s Advisory Committee on Immunization Practices has changed its recommendation for preventive treatment of hepatitis A after exposure to the virus. The CDC now recommends that healthy patients between the ages of 1- 40 years receive the hepatitis A vaccine within 2 weeks of exposure. Previously, immune globulin was recommended for postexposure prophylaxis.

New Drug Approval

In 2008, the Food and Drug Administration (FDA) approved tenofovir (Viread) for the treatment of chronic hepatitis B. Tenofovir belongs to the same class of drugs as adefovir (Hepsera), and is also used to treat HIV infection. There are now seven approved drugs for chronic hepatitis B treatment.

Resources

www.cdc.gov/hepatitis -- Centers for Disease Control and Prevention
www.aasld.org -- American Association for the Study of Liver Diseases
www.hepfi.org -- Hepatitis Foundation International
www.hepb.org -- Hepatitis B Foundation
www.liverfoundation.org -- American Liver Foundation
www2.niddk.nih.gov -- National Institute of Diabetes and Digestive and Kidney Diseases
www.immunize.org -- Immunization Action Coalition
www.hivandhepatitis.com -- Hepatitis and HIV
www.unos.org -- United Network for Organ Sharing

References

Advisory Committee on Immunization Practices (ACIP) Centers for Disease Controland Prevention (CDC). Update: Prevention of hepatitis A after exposure to hepatitis A virus and in international travelers. Updated recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep. 2007 Oct 19;56(41):1080-4.

American Academy of Pediatrics Committee on Infectious Diseases. Hepatitis A vaccine recommendations. Pediatrics. 2007 Jul;120(1):189-99.

Dienstag JL. Hepatitis B virus infection. N Engl J Med. 2008 Oct 2;359(14):1486-500.

Jou JH, Muir AJ. In the clinic. Hepatitis C. Ann Intern Med. 2008 Jun 3;148(11):ITC6-1-ITC6-16.

Lai CL, Gane E, Liaw YF, Hsu CW, Thongsawat S, Wang Y, et al. Telbivudine versus lamivudine in patients with chronic hepatitis B. N Engl J Med. 2007 Dec 20;357(25):2576-88.

Lok ASF and McMahon BJ. American Association for the Study of Liver Diseases Practice Guidelines: Chronic Hepatitis B. Hepatology. 2007;2:507 -539.

Maheshwari A, Ray S, Thuluvath PJ. Acute hepatitis C. Lancet. 2008 Jul 26;372(9635):321-32.

Mukherjee S, Sorrell MF. Controversies in liver transplantation for hepatitis C. Gastroenterology. 2008 May;134(6):1777-88.

National Institutes of Health. Consensus Development Conference Statement: Management of Hepatitis B. October 20 -22, 2008.

Pungpapong S, Kim WR, Poterucha JJ. Natural history of hepatitis B virus infection: an update for clinicians. Mayo Clin Proc. 2007 Aug;82(8):967-75.

Rambaldi A, Jacobs BP, Gluud C. Milk thistle for alcoholic and/or hepatitis B or C virus liver diseases. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD003620.

Scott JD, Gretch DR. Molecular diagnostics of hepatitis C virus infection: a systematic review. JAMA. 2007 Feb 21;297(7):724-32.

Victor JC, Monto AS, Surdina TY, Suleimenova SZ, Vaughan G, Nainan OV, et al. Hepatitis A vaccine versus immune globulin for postexposure prophylaxis. N Engl J Med. 2007 Oct 25;357(17):1685-94. Epub 2007 Oct 18.

Weinbaum CM, Williams I, Mast EE, Wang SA, Finelli L, Wasley A, et al. Recommendations for identification and public health management of persons with chronic hepatitis B virus infection. MMWR Recomm Rep. 2008 Sep 19;57(RR-8):1-20

Reviewed last on: 12/5/2008
Harvey Simon, MD, Editor-in-Chief, In-Depth Reports; Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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