Diagnostic Dilemma

Acute hepatitis with Positive Hepatitis A virus IgM and Positive HBsAg

A 9 1/ 2 years old boy was diagnosed to have acute hepatitis. The referring pediatrician had done Hepatitis A virus {HAV} IgM which was positive. HBsAg which was also positive. Mother was also HBsAg positive though father was negative. Hepatitis B viral load in the child was 75 copies, ml and HbeAg was negative. The child`s liver function tests normalized in 1 month of the acute episode. HIV, Hepatitis C markers were negative and on presentation, he had a soft palpable liver. Other systems were normal. Ultrasound abdomen did not show coarse echotexture of liver.

Is this acute Hepatitis A or Hepatitis B_?
Expert Opinion :
The child`s acute episode of hepatitis could be due to Hepatitis A virus. Hepatitis B could have been vertically acquired from the mother or could be a horizontal transmission. It would be best to do a repeat HBs Ag after 6 months and see if it has disappeared. If it is negative, it suggests resolved Hepatitis B infection. If it is still positive, it suggests chronic Hepatitis B that would require a long term follow up.
Answer Discussion :
dawn gnes
hepatitis a
7 years ago
Osama Ali
Acute hepatitis A
7 years ago

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