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HEPATITIS - VIRAL
The majority of acute viral hepatitis infections are asymptomatic or they can cause an anicteric illness that may not be diagnosed as hepatitis.
Hepatitis A generally causes minor illness in childhood with >80% of infections being asymptomatic but more likely to produce clinical symptoms in adults. 
Hepatitis B, C, and D may also be asymptomatic.
Hepatitis A is predominantly transmitted through oral-fecal route.
Hepatitis B is transmitted through perinatal, percutaneous, or sexual routes or close person-to-person contact via open cuts and sores.
Hepatitis C infections are transmitted through perinatal, percutaneous, or sexual routes, blood transfusions, or organ transplants.
Hepatitis D's route of transmission is sexual or percutaneous, especially IV drug use.
Hepatitis E is transmitted primarily through contaminated drinking water and oral-fecal transmission.

Patient Education

PREVENTION and POST-EXPOSURE PROPHYLAXIS OF VIRAL HEPATITIS
Patient Group for Whom Prevention or Post-exposure Prophylaxis is Recommended Recommended Prevention or Post-exposure Prophylaxis Regimen
Prevention
Hepatitis A
Susceptible persons traveling to HAV-endemic areas
Household contacts, daycare children and staff
Healthcare personnel and lab researchers potentially exposed to HAV
Patients who will undergo blood transfusion or will receive clotting factor concentrates
Immunocompromised children (suboptimal response)
Men who have sex with men (MSM)
Illegal drug users (both injection and non-injection drug users)
Persons with chronic liver disease, including persons with chronic HBV and HCV infection who have evidence of chronic liver disease
Hepatitis A Vaccine1
Hepatitis B
Unvaccinated children, adolescents and adults
Premature infants with immediate risk of HBV infection
Unvaccinated persons who attend STD clinics, including pregnant women
Persons with any of the following sexual risk factors: History of STD and HIV, multiple sex partners, sex with an injection drug user, MSM, victims of sexual assault
Illegal IV drug users
Household members, sex partners and drug-sharing partners of a person with chronic HBV infection2
Persons on hemodialysis, or are receiving clotting factor concentrates, or who have occupational exposure to blood
Healthcare personnel in treatment facilities
Patients with diabetes mellitus, chronic liver disease
Travelers to places with endemic HBV infection
Hepatitis B Vaccine
Post-exposure Prophylaxis
Hepatitis A
Unvaccinated or nonimmune persons exposed to hepatitis A virus (HAV) through household or sexual contact or by sharing illegal drugs with a person who has hepatitis A3
Administer a single IM dose of human immunoglobulin (Ig) as soon as possible but not >2 weeks after exposure
Hepatitis B
Unvaccinated or nonimmune sex partners of persons with acute hepatitis B
Administer Ig within 14 days after the most recent sexual contact
1Postvaccination serologic testing is not indicated because most persons respond to the vaccine
2Vaccination of household contacts (especially children and adolescents) of persons with acute HBV infection is also encouraged. Consider postvaccination testing (anti-HBs) for sex partners of persons with chronic HBV infection. Those found to be antibody negative should receive a second, complete, vaccination series
3A person who has had 1 dose of hepatitis A vaccine at least 1 month before exposure to HAV does not need Ig
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