Acute Viral Hepatitis: Hepatitis A, Hepatitis E, and Other Viruses

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