II. Epidemiology
- Enteric transmission of non-A, non-B Hepatitis
- Most common cause of Acute Viral Hepatitis in world
- Regions with Waterborne Illness epidemics (esp. with monsoon flooding)
- India
- Asia
- Africa
- Mexico
III. Pathophysiology
- Transmission: Fecal-Oral Route (similar to Hepatitis A Virus)
- Incubation Period: 15-60 days (mean 40 days)
- Infectivity: Virus excretion in stool for <14 days
- Calicivirus (diameter 32-34 nm))
IV. Course
- Self-limited illness
V. Findings: Signs and Symptoms
- See Viral Hepatitis
VI. Differential Diagnosis
VII. Management
-
General and symptomatic
- High calorie diet (better tolerated in morning)
- IV Hydration when indicated for severe Dehydration
- Cholestyramine up to 4g PO qid for severe Pruritus
- Avoid drugs with hepatic metabolism
-
Antiviral Agents may be considered (consult infectious disease)
- Ribavirin
- Interferon-alpha
VIII. Prognosis: Increased Morbidity and Mortality Risks
- Pregnant women (mortality 10-20% in some studies)
- Extremes of age
- Immunocompromised patients
- Chronic Liver Disease
IX. Complications
- Self-limited in most otherwise healthy patients
- Chronic hepatitis (rare)
- Primarily limited to Immunocompromised patients
- Cirrhosis may occur in these patients