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  • Print publication year: 2007
  • Online publication date: December 2009

17 - Acute and Chronic Viral Hepatitis

    • By Jay A. Hochman, Clinical Associate Professor, Division of Pediatric Gastroenterology, Emory University School of Medicine, Atlanta, Georgia; Attending Physician, Children's Center for Digestive Health Care, LLC, and Children's Healthcare of Atlanta, Atlanta, Georgia, William F. Balistreri, Dorothy M. M. Kersten Professor, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; Director, Pediatric Liver Care Center, Department of Pediatric Gastroenterolgy, Hepatology, and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
  • Edited by Frederick J. Suchy, Mount Sinai School of Medicine, New York, Ronald J. Sokol, University of Colorado, Denver, William F. Balistreri, University of Cincinnati
  • Publisher: Cambridge University Press
  • DOI:
  • pp 369-446


Optimal care of children with viral hepatitis necessitates incorporation of recent advances in diagnosis, prevention, and treatment into clinical practice. Though primary viral infection of the liver has been recognized since the time of Hippocrates (460–375 b.c.), only in the past two decades have significant scientific advancements allowed clinicians to alter the outcomes of these infections [1]. Specifically, viral hepatitis can be prevented with vaccines and passive immunization and can be treated with antiviral medications. The availability to detect these infections rapidly and accurately has led to changes in the epidemiology of viral hepatitis.

This chapter details the history, epidemiology, and clinical features as well as the diagnostic, preventative, and therapeutic strategies for the most important group of hepatotropic viruses: hepatitis A (HAV), hepatitis B (HBV), hepatitis C (HCV), hepatitis D (HDV), and hepatitis E (HEV). In 2002, the estimated numbers of new infections in the United States were as follows: 73,000 caused by HAV, 79,000 caused by HBV, and 29,000 caused by HCV/non-A, non-B (NANB) hepatitis [2]. The absolute number of cases of acute hepatitis had been reduced by more than 50% during the preceding 10-year interval (1992–2002). The availability and expansion of vaccination efforts have helped decrease the rates of hepatitis A and hepatitis B. Improvements in the blood supply have dramatically reduced transmission of HCV; the primary means of infection in children is now maternal–infant transmission.

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