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Hepatitis A - Management
Basis for recommendation

Notification

  • The recommendation to notify the local Health Protection Unit promptly is based on guidance for the prevention and control of hepatitis A infection from the Health Protection Agency [HPA, 2009a].

Lifestyle advice and medication

  • Recommendations regarding rest, alcohol, and medications are based on expert opinion in the textbook Principles and practice of infectious diseases [Curry and Chopra, 2009].

Treatment of pain

  • The recommendations regarding analgesia are based on the opinion of CKS expert reviewers and the text book Drugs and the liver [North-Lewis, 2008].

Treatment of nausea

  • Most CKS expert reviewers suggested offering metoclopramide or cyclizine in normal dosages in mild liver disease, but to exercise caution in more severe liver disease.

Treatment of itch

  • The recommendation to try simple measures is based on the opinion of one CKS expert reviewer.
  • The recommendation to consider offering chlorphenamine first-line is based on the opinion of CKS expert reviewers, but is to be avoided in severe liver disease. There was a difference of opinion regarding the use of ursodeoxycholic acid, colestyramine, and corticosteroids, therefore CKS recommends seeking specialist advice.

Liver function tests and prothrombin time

  • The recommendations regarding monitoring of liver function and prothrombin time are based on guidelines produced by the British Association for Sexual Health and HIV [BASHH, 2008] and the opinion of CKS expert reviewers.

Screen for sexually transmitted infections

  • The recommendation to screen for other sexually transmitted infections where appropriate is based on guidelines issued by the British Association for Sexual Health and HIV [BASHH, 2008].

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