Hepatitis, Viral, Acute
1996 Case Definition
Hepatitis, Viral, Acute
1996 Case Definition
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1996 Case Definition
Clinical Description
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 antibody to hepatitis A virus (IgM 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:
- 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
- Antibody to hepatitis C virus (anti-HCV) positive, verified by a supplemental test
- Non-A, Non-B Hepatitis:
- 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)
Comments
- 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 B, Perinatal)
- 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.1
- 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.
References
- Kuo G, Choo Q-L, Alter HJ, Gitnick GL, Redeker AG, Purcell RH, Miyamura T, Dienstag JL, Alter MJ, Stevens CE, et al. An Assay for Cirulating Antibodies to a Major Etiologic Virus of Human Non-A, Non-B Hepatitis. Science 1989;244(4902):362-4
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Last Reviewed: April 16, 2021