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Differential diagnosis of hepatitis; the presence of IgM antibody to hepatitis A virus is good evidence for acute hepatitis A.
Hepatitis A virus is a picornavirus, and antibody is made to capsid proteins. Fecal excretion of HAV peaks before symptoms develop. If hepatitis A antibody is IgM, the hepatitis A infection is probably acute. IgM antibody develops within a week of symptom onset, peaks in three months, and is usually gone after six months. Hepatitis A antibody of IgG type is indicative of old infection, is found in almost 50% of adults, and is not usually clinically relevant. Many cases of hepatitis A are subclinical, particularly in children. Presence of IgG antibody to HAV does not exclude acute hepatitis B or other forms of hepatitis.
Giacoia GP, Kasprisin DO. Transfusion-acquired hepatitis A. South Med J. 1989; 82(11):1357-1360. PubMed 2683125
Lee HS, Vyas GN. Diagnosis of viral hepatitis. Clin Lab Med. 1987; 7(4):741-757 (review). PubMed 3319367
