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A comprehensive article about hepatitis A, i.e. pathogen, mode of transmission, …

Tables
- Hepatitis A: Old and New

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TABLE 1. The major hepatitis viruses

Virus	Classification	Genome	Envelope	Spread

HAV	Picornaviridae, genus Hepatovirus	RNA	Nonenveloped	Fecal-oral
HBV	Hepadnaviridae	DNA	Lipid enveloped	Parenteral
HCV	Flaviviridae, genus Hepacivirus	RNA	Lipid enveloped	Parenteral
HDV	Unclassified	RNA	Lipid enveloped (from HBV)	Parenteral
HEV	Caliciviridae, genus proposed	RNA	Nonenveloped	Fecal-oral

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TABLE 2. Findings in epidemic jaundice in the 1930s and 1940s^a

Symptom	% with symptom
Detroit civilians (n = 194)	Mediterranean military (n = 200)	New York military (n = 200)

Anorexia	93	82	92
Nausea, vomiting	84	75	79
Malaise	$---$ ^b	82	69
Fever	61	53	42
Headache	57	35	27
Abdominal pain	50	$---$	57

^a Data are from references 102, 113, and 173.
^b $---$ , not reported.

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TABLE 3. Physical examination findings in epidemic jaundice during World War II^a

Sign	% with symptom
Mediterranean (n = 200)	New York (n = 200)

Hepatomegaly	59	51
Hepatic tenderness	54	38
Splenomegaly	11	14
Bradycardia	9	25

^a Data are from references 102 and 113.

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TABLE 4. Findings in epidemic and sporadic hepatitis A^a

Symptom	% with symptom
Epidemic cases	Sporadic cases, 1985-1994 (hospitalized)
1930s-1940s^b (hospitalized)	San Diego 1974 (all)

Anorexia	89	71	75
Nausea, vomiting	79	61	$---$ ^c
Malaise	76	76	80
Fever	52	18	58
Headache	40	19	22
Abdominal pain	54	26	41

^a Data are from references 70, 102, 113, 173, and 246.
^b Mean data for icteric cases from Table 2.
^c Not stated except as between 41 and 75%.

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TABLE 5. Physical examination findings in epidemic and sporadic hepatitis A^a

Sign	% with symptom
Epidemic cases	Sporadic cases, 1985-1994 (hospitalized)
1930s-1940s^b (hospitalized)	San Diego 1974 (all)

Hepatomegaly	55	14	78
Hepatic tenderness	46	39	Not stated
Splenomegaly	13	3	7
Bradycardia	17	$---$ ^c	$---$

^a Data are from references 70, 102, 113, 173, and 246.
^b Mean data for icteric cases from Table 3.
^c $---$ , not reported.

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TABLE 6. Laboratory investigations among hospitalized patients with sporadic hepatitis A^a

Test	Pasadena, 1985-1994	Dallas, 1997-1998

Bilirubin (mg/dl)	7	13.3^b (4.9-46.4)
Alkaline phosphatase (U/liter)	319	335 (117-1,104)
AST (mIU/liter)	1,754	3,664 (428-10,420)
ALT (mIU/liter)	1,952	3,628 (1,029-9,220)
Albumin (g/dl)	$---$ ^c	2.6 (1.5-3.1)
Globulin (g/dl)	$---$	4.0 (3.2-5.6)
Prothrombin time(s)	$---$	15.1 (11.7-26.4)

^a Data are mean peaks (ranges). Data are from reference 246 and unpublished sources.
^b Mean peak of 10 mg/dl, excluding data for a patient with hemolysis and hepatitis A (bilirubin, 46.4 mg/dl).
^c $---$ , not reported.

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TABLE 7. Reported cases of acute hepatitis A in the United States^a

Site	No. of cases/100,000 population	Total cases
1985-1994	1987-1997	1996	1997

Total U.S.			31,032	30,021
California	21.9	20	6,653	6,422
Texas	15.0	16	3,460	4,511
Arizona	48.1	48	1,767	2,330
Oklahoma	12.5	24	2,586	1,445
Michigan	NS	NS	506	1,372
New York	3.6	NS	1,047	1,302
Missouri	14.4	19	1,414	1,151
Washington	5.6	30	1,001	1,015
Utah	27.2	33	1,073	550

^a CDC data (10, 13; www.cdc.gov/nciod/diseases/hepatitis/h96surve.htm). NS, not stated.

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Source: Clinical Microbiology Reviews,Vol. 14, No. 1, p. 38-58, January 2001

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