Acute viral hepatitis: Hepatitis A, Hepatitis E, and Other Viruses

Viral infections by hepatotropic and non-hepatotropic viruses are a frequent cause of acute hepatitis. Hepatitis A and E (HAV and HAE) are enterically-transmitted viral infections and are prevalent worldwide. The clinical spectrum ranges from asymptomatic infection to acute liver failure. Diagnosis of hepatitis A relies on serum anti-HAV IgM, while that of hepatitis E requires heightened clinical suspicion and serologic or molecular confirmation. Prognosis is excellent with spontaneous resolution in most cases. Mortality of HEV is greater than that of HAV, especially in pregnant patients, who have a mortality of 25-30%. No specific antiviral treatment is available for HAV or HEV. Effective immunoprophylaxis for hepatitis A is widely accessible, while a safe and effective recombinant HEV vaccine has recently been tested in volunteers. Non-hepatotropic viruses such as herpesviruses, adenoviruses, enteroviruses, and parvovirus B-19, among others, can cause acute hepatitis and have significant consequences in immunocompromised individuals.