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Hepatitis, Viral, Acute
2000 Case Definition
Clinical case definition
An acute illness with a) discrete onset of symptoms and
b) jaundice or elevated serum aminotransferase levels
Laboratory criteria for diagnosis:
- Hepatitis A: immunoglobulin
M (IgM) antibody to hepatitis A virus (anti-HAV) positive
- Hepatitis B:
- IgM antibody to hepatitis B core antigen (anti-HBc)
positive or hepatitis B surface antigen (HBsAg) positive
- IgM anti-HAV negative (if done)
- Hepatitis C:
Revised 2000
- Serum alanine aminotransferase levels greater
than 7 times the upper limit of normal, and
- IgM anti-HAV negative, and
- IgM anti-HBc negative (if done) or HBsAg negative,
and
- Antibody to hepatitis C virus (anti-HCV) positive,
verified by a n additional more specific assay
- Non-A, Non-B hepatitis (designated non-notifiable
effective January 1, 2003):
- Serum aminotransferase levels greater than
2.5 times the upper limit of normal, and
- IgM anti-HAV negative, and
- IgM anti-HBc negative (if done) or HBsAg negative,
and
- Anti-HCV negative (if done) Delta hepatitis*:
HBsAg or IgM anti-HBc positive and antibody to hepatitis
delta virus positive
Case classification
Confirmed: a case that
meets the clinical case definition and is laboratory confirmed or, for
hepatitis A, a case that meets the clinical case definition and occurs
in a person who has an epidemiologic link with a person who has laboratory-confirmed
hepatitis A (i.e., household or sexual contact with an infected person
during the 15-50 days before the onset of symptoms)
Comment
- Persons who have chronic hepatitis or persons identified
as HBsAg positive or anti-HCV positive should not be reported as
having acute viral hepatitis unless they have evidence of an acute
illness compatible with viral hepatitis (with the exception of
perinatal hepatitis B infection). (See Hepatitis,
Viral, Perinatal Hepatitis B Virus Infection Acquired in the United
States or U.S. Territories.)
- Up to 20% of acute hepatitis C cases will be anti-HCV
negative when reported and will be classified as non-A, non-B hepatitis
because some (5%-10%) have not yet seroconverted and others (5%-10%)
remain negative even with prolonged follow-up (6).
- Available serologic tests for anti-HCV do not distinguish
between acute and chronic or past infection. Thus, other causes
of acute hepatitis should be excluded for anti-HCV positive patients
who have an acute illness compatible with viral hepatitis.
* Delta Hepatitis is not a nationally
notifiable disease.
See also:
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