Farrell G C
Storr Liver Unit, Westmead Hospital, Sydney, NSW.
Med J Aust. 1998 Jun 1;168(11):565-70.
Most cases of acute hepatitis are caused by hepatitis viruses A, B or C. Diagnosis rests on the risk factor history and serological tests. In seronegative cases, consider other agents, such as Epstein-Barr virus and cytomegalovirus, drug reactions and autoimmune hepatitis. Hepatitis A and B can be prevented by appropriate use of highly effective, safe vaccines. Acute liver failure is an uncommon, devastating complication of acute viral hepatitis; continued vomiting, prolongation of prothrombin time and clouding of consciousness are indications for urgent transfer to a liver transplant unit. Hepatitis A is a simple, enterically transmitted illness that does not cause chronic hepatitis. 95% of adults recover from acute hepatitis B, whereas infection with hepatitis B virus acquired in childhood usually becomes chronic.
大多数急性肝炎病例由甲型、乙型或丙型肝炎病毒引起。诊断基于危险因素病史和血清学检测。在血清学阴性的病例中，应考虑其他病原体，如EB病毒和巨细胞病毒、药物反应及自身免疫性肝炎。适当使用高效、安全的疫苗可预防甲型和乙型肝炎。急性肝衰竭是急性病毒性肝炎罕见但严重的并发症；持续呕吐、凝血酶原时间延长和意识模糊是紧急转至肝移植病房的指征。甲型肝炎是一种简单的经肠道传播的疾病，不会导致慢性肝炎。95%的成年人可从急性乙型肝炎中康复，而儿童期感染乙型肝炎病毒通常会转为慢性。
