Viral Hepatitis: Diagnosis and Treatment

Diagnosis

• History and physical examination is the first step and may reveal risk factors.
  
• Blood testing is used to evaluate liver function and to test for the hepatitis viruses.
• An ultrasound of the abdomen is usually needed to evaluate the liver and rule out gallstones.
• A liver biopsy may be necessary.
• Abdominal x–ray, CT scan, MRI, and/or other testing may be necessary to rule out other abdominal diseases, such as pancreatitis, gall bladder disease, and cancer.

Treatment

• Initial treatment often includes hospitalization, intravenous fluids, monitoring of nutrition status, and avoidance of drugs or medications that may be toxic to the liver (e.g., alcohol, acetaminophen, and statins). Abstinence from alcohol is essential, as noted below.
  
• In addition to the above measures, antiviral medications may be necessary, especially for individuals with chronic hepatitis B or C. They may require drug treatment for six months to a year or longer.
  
• Vaccination is available for hepatitis A and hepatitis B. All individuals with chronic hepatitis B should be vaccinated for hepatitis A, and those with hepatitis C should be vaccinated for both hepatitis A and hepatitis B.
  
• Individuals who develop liver failure may require additional testing, medications, and blood transfusions.
  
• Individuals with the most severe liver disease may require liver transplantation.