Opinion statement
The mainstay of treatment for acute viral hepatitis is supportive care, as most cases are self-limited. General measures in all types of acute viral hepatitis include bedrest if the patient is very symptomatic, a high-calorie diet, avoidance of hepatotoxic medications, and abstinence from alcohol with the anticipation that most patients will recover uneventfully. In severe cases, hospitalization may be necessary for intravenous rehydration if the patient is unable to maintain adequate oral intake due to nausea and vomiting or if there is any alteration of mental status to suggest evolving fulminant hepatic failure. Acute hepatitis A is a self-limited disease, but can be fulminant. Lamivudine at a dosage of 100 mg/d orally may be beneficial in acute hepatitis B. Interferon-alpha therapy in acute hepatitis C may decrease the risk of developing chronic hepatitis C. Fulminant liver failure due to acute viral hepatitis is uncommon, but orthotopic liver transplantation occasionally may be life saving.
Keywords
Lamivudine Acute Hepatitis Orthotopic Liver Transplantation Main Drug Interaction Acute Viral HepatitisPreview
Unable to display preview. Download preview PDF.
References and Recommended Reading
- 1.Sjogren M: Serologic diagnosis of viral hepatitis. Med Clin North Am 1996, 80(5):929–956. A helpful review of the serologic markers of viral hepatitis.Google Scholar
- 2.Seeff LB: Acute Viral Hepatitis. In Liver and Biliary Diseases. Edited by Kaplowitz N. Philadelphia: Williams & Wilkins; 1996:289–316. A complete review of the clinical aspects and diagnosis of acute viral hepatitis.Google Scholar
- 3.Dulai G, Higa L, Kobashigawa J, Martin P: Successful use of lamivudine for severe acute hepatitis B virus infection in a cardiac transplant recipient. Transplantation 1999, 67(9):1288–1289.PubMedCrossRefGoogle Scholar
- 4.Markowitz JS, Martin P, Conrad AJ, et al.: Prophylaxis against hepatitis B recurrence following liver transplantation using combination lamivudine and hepatitis B immune globulin. Hepatology 1998, 28(2):585–589.PubMedCrossRefGoogle Scholar
- 5.Camma C, Almasio P, Craxi A: Interferon as treatment for acute hepatitis C. A meta-analysis. Dig Dis Sci 1996, 41(6):1248–1255. A meta-analysis of all studies looking at interferon therapy in acute hepatitis C.CrossRefGoogle Scholar
- 6.Vogel W, Graziadei I, Umlauft F, et al.: High-dose interferon-alpha 2b prevents chronicity in acute hepatitis C: a pilot study. Dig Dis Sci 1996, 41(suppl 12):81S-85S.Google Scholar
- 7.Friedman LS, Martin P, Munoz SJ: Liver function tests and the objective evaluation of the patient with liver disease.In In Hepatology: A Textbook of Liver Disease, vol 1, edn 3. Edited by Zakim D, Boyer TD. 1996:817.Google Scholar