Hepatitis A

Fecal-oral

Contaminated food and water

Children and caregivers in daycare centers

Acute

IgM anti-HAV+

Chronic

N/A

Recovered/latent

IgG anti-HAV+

Vaccinated

IgG anti-HAV+

Hepatitis B

Blood

Percutaneous

Sexual

Perinatal

Intravenous drug users

Unsafe sexual practices

Infants born to infected mothers

Health care workers

Transfusion recipients

Acute

HBsAg+

IgM anti-HBc+

HBeAg+

HBV DNA+

Chronic

IgG anti-HBc+

HBeAg+/− (present during periods of high replication)

Anti-HBe+/− (present during periods of low replication)

HBsAg+

HBV DNA +/− (present during periods of high replication)

Recovered/latent

IgG anti-HBc+

HBV DNA-HBeAg− Anti-HBe+/− HBsAg− Anti-HBs+

Vaccinated

Anti-HBs+ only

Hepatitis C

Blood

Percutaneous

Sexual (rare)

Perinatal (rare)

Intravenous drug users

Transfusion recipients

Acute

All tests possibly negative

HCV RNA+

Anti-HCV Ab+ in 8-10 weeks

Chronic

Anti-HCV Ab+

HCV RNA+

Recovered/latent

Anti-HCV Ab+

HCV RNA−

Vaccinated

N/A

Hepatitis D

Blood Sexual (rare)

Any person with hepatitis B

Intravenous drug users

Positive hepatitis B serologies plus the following:

Acute

IgM anti-HDV+

HDV Ag+

Chronic

IgG anti-HDV+

Recovered/latent

IgG anti-HDV+

Vaccinated

N/A

Hepatitis E

Fecal-oral

Contaminated food and water

Travel to endemic regions

IgM anti-HEV through Centers for Disease Control (CDC)

Adapted from Green GB, Harris IS, Lin GA, et al., eds. The Washington Manual of Medical Therapeutics. 31st ed. Philadelphia: Lippincott Williams & Wilkins; 2004:382, with permission.