Infective Hepatic Jaundice

Barber, Hugh

doi:10.1136/bmj.1.3966.67

Cited by 14 publications

(1 citation statement)

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“…In 1937, Hugh Barber correctly predicted the natural history of hepatitis A infections based on his own observations and a review of the literature. He wrote, "If infective hepatic jaundice is due to a virus, which sets up acute hepatitis; if it is highly infectious in children, but well resisted by them; if most adults have acquired immunity, but those who become infected have a liver less capable of regeneration than the child, the natural history of epidemic and sporadic cases may be explained" (24).…”

Section: Anicteric and Asymptomatic Hepatitismentioning

confidence: 99%

Hepatitis A: Old and New

2001

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The hepatitis A virus (HAV), a picornavirus, is a common cause of hepatitis worldwide. Spread of infection is generally person to person or by oral intake after fecal contamination of skin or mucous membranes; less commonly, there is fecal contamination of food or water. Hepatitis A is endemic in developing countries, and most residents are exposed in childhood. In contrast, the adult population in developed countries demonstrates falling rates of exposure with improvements in hygiene and sanitation. The export of food that cannot be sterilized, from countries of high endemicity to areas with low rates of infection, is a potentially important source of infection. After ingestion and uptake from the gastrointestinal tract, the virus replicates in the liver and is excreted into the bile. Cellular immune responses to the virus lead to destruction of infected hepatocytes with consequent development of symptoms and signs of disease. Humoral immune responses are the basis for diagnostic serologic assays. Acute HAV infection is clinically indistinguishable from other causes of acute viral hepatitis. In young children the disease is often asymptomatic, whereas in older children and adults there may be a range of clinical manifestations from mild, anicteric infection to fulminant hepatic failure. Clinical variants include prolonged, relapsing, and cholestatic forms. Management of the acute illness is supportive, and complete recovery without sequelae is the usual outcome. Research efforts during World War II led to the development of passive immunoprophylaxis. Pooled immune serum globulin is efficacious in the prevention and attenuation of disease in exposed individuals. More recently, active immunoprophylaxis by vaccination has been accomplished. Future eradication of this disease can now be contemplated

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Section: Anicteric and Asymptomatic Hepatitismentioning

confidence: 99%