If travel will take place in fewer than 2 weeks time, or the patient is younger than 2 years of age, then IG should be given. Post-exposure prophylaxis consists of administration of IG to contacts as soon as possible, but not longer then 2 weeks after exposure. Contact precautions recommended for hospitalized patients for 1 week after the onset of symptoms. Complications are few. Fulminant hepatitis with massive hepatic necrosis and liver failure due to HAV infection is rare.
Cholestatic hepatitis occurs in a very small percentage of patients.
It is identified by persistent hyperbilirubinemia, pruritus, and constitutional symptoms that last for 12-16 weeks in the absence of biliary obstruction on ultrasound. Except in rare cases of fulminant hepatitis, pediatric patients recover without sequelae. Chronic active hepatitis, which can be seen in hepatitis B or hepatitis C infections, does not occur in HAV infection. Indications for post-exposure prophylaxis should be explained, and such individuals should be identified and treated appropriately. Local and State Health Departments are instrumental in epidemiologic investigations to identify appropriate contacts in need of post-exposure prophylaxis.