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Mildly Elevated Liver Transaminase Levels: Causes and Evaluation - American Family ...

Dec 1, 2017 - Mild, asymptomatic elevations (less than five times the upper limit of normal) of alanine transaminase and aspartate transaminase levels are common in primary care. It is estimated that approximately 10% of the U.S. population has elevated transaminase levels. An approach based on the ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1201/p709.html

Evaluation of Jaundice in Adults - American Family Physician

Feb 1, 2017 - Jaundice in adults can be an indicator of significant underlying disease. It is caused by elevated serum bilirubin levels in the unconjugated or conjugated form. The evaluation of jaundice relies on the history and physical examination. The initial laboratory evaluation should include ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0201/p164.html

Hepatitis B: Screening, Prevention, Diagnosis, and Treatment - American Family Physician

Mar 1, 2019 - Hepatitis B virus (HBV) is a partly double-stranded DNA virus that causes acute and chronic liver infection. Screening for hepatitis B is recommended in pregnant women at their first prenatal visit and in adolescents and adults at high risk of chronic infection. Hepatitis B vaccination ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0301/p314.html

Hepatitis (and Other Liver Diseases) - American Family Physician

Aug 15, 2019 - This collection features AFP content on hepatitis and other liver disease, including cirrhosis, chronic liver failure, hemochromatosis, hepatitis A, hepatitis B, hepatitis C, jaundice, and nonalcoholic fatty liver disease. This collection features AFP content on hepatitis and other ...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=38

Causes and Evaluation of Mildly Elevated Liver Transaminase Levels - American Family ...

Nov 1, 2011 - Mild elevations in levels of the liver enzymes alanine transaminase and aspartate transaminase are commonly discovered in asymptomatic patients in primary care. Evidence to guide the diagnostic workup is limited. If the history and physical examination do not suggest a cause, a stepwise...

American Family Physician : Article

https://www.aafp.org/afp/2011/1101/p1003.html

Diagnosis and Management of Hepatitis C - American Family Physician

Jun 15, 2015 - Hepatitis C virus (HCV) infection, a major cause of chronic liver disease and cirrhosis, is predominantly transmitted by exposure to blood or body fluids. The infection progresses to a chronic state in 80% of patients, whereas the virus clears completely after the acute infection in 20%...

American Family Physician : Article

https://www.aafp.org/afp/2015/0615/p835.html

Nonalcoholic Fatty Liver Disease: Diagnosis and Management - American Family Physician

Jul 1, 2013 - Nonalcoholic fatty liver disease is characterized by excessive fat accumulation in the liver (hepatic steatosis). Nonalcoholic steatohepatitis is characterized by steatosis, liver cell injury, and inflammation. The mechanism of nonalcoholic fatty liver disease is unknown but involves ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0701/p35.html

Cirrhosis: Diagnosis, Management, and Prevention - American Family Physician

Dec 15, 2011 - Cirrhosis is the 12th leading cause of death in the United States. It accounted for 29,165 deaths in 2007, with a mortality rate of 9.7 per 100,000 persons. Alcohol abuse and viral hepatitis are the most common causes of cirrhosis, although nonalcoholic fatty liver disease is emerging ...

American Family Physician : Article

https://www.aafp.org/afp/2011/1215/p1353.html

Hepatitis A - American Family Physician

Dec 1, 2012 - Hepatitis A is a common viral illness worldwide, although the incidence in the United States has diminished in recent years as a result of extended immunization practices. Hepatitis A virus is transmitted through fecal-oral contamination, and there are occasional outbreaks through food ...

American Family Physician : Article

https://www.aafp.org/afp/2012/1201/p1027.html

Considerations for Safe Use of Statins: Liver Enzyme Abnormalities and Muscle Toxicitiy...

Mar 15, 2011 - Statins play an important role in the care of patients with cardiovascular disease and have a good safety record in clinical practice. The risk of hepatic injury caused by statins is estimated to be about 1 percent, similar to that of patients taking a placebo. Patients with ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0315/p711.html

Hepatitis B: Diagnosis and Treatment - American Family Physician

Apr 15, 2010 - Although an estimated 1 million persons in the United States are chronically infected with hepatitis B virus, the prevalence of hepatitis B has declined since the implementation of a national vaccination program. Hepatitis B virus is transmitted in blood and secretions. Acute infection ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0415/p965.html

Jaundice in the Adult Patient - American Family Physician

Jan 15, 2004 - Jaundice in an adult patient can be caused by a wide variety of benign or life-threatening disorders. Organizing the differential diagnosis by prehepatic, intrahepatic, and posthepatic causes may help make the work-up more manageable. Prehepatic causes of jaundice include hemolysis and ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0115/p299.html

Mildly Elevated Liver Transaminase Levels in the Asymptomatic Patient - American Family...

Mar 15, 2005 - Mild elevations in liver chemistry tests such as alanine transaminase and aspartate transaminase can reveal serious underlying conditions or have transient and benign etiologies. Potential causes of liver transaminase elevations include viral hepatitis, alcohol use, medication use, ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0315/p1105.html

Caring for Pregnant Women and Newborns with Hepatitis B or C - American Family Physician

Nov 15, 2010 - Family physicians encounter diagnostic and treatment issues when caring for pregnant women with hepatitis B or C and their newborns. When hepatitis B virus is perinatally acquired, an infant has approximately a 90 percent chance of becoming a chronic carrier and, when chronically ...

American Family Physician : Article

https://www.aafp.org/afp/2010/1115/p1225.html

Hepatitis C: Diagnosis and Treatment - American Family Physician

Jun 1, 2010 - Hepatitis C, a common chronic bloodborne infection, is found in approximately 2 percent of adults in the United States. Chronic infection is associated with serious morbidity and mortality (e.g., cirrhosis, hepatocellular carcinoma). Testing for hepatitis C is recommended for at-risk ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0601/p1351.html

Nonalcoholic Fatty Liver Disease - American Family Physician

Jun 1, 2006 - Nonalcoholic fatty liver disease is a common condition associated with metabolic syndrome. It is the most common cause of elevated liver enzymes in U.S. adults, and is diagnosed after ruling out other causes of steatosis (fatty infiltration of liver), particularly infectious hepatitis ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0601/p1961.html

Cirrhosis and Chronic Liver Failure: Part I. Diagnosis and Evaluation - American Family...

Sep 1, 2006 - Cirrhosis and chronic liver failure are leading causes of morbidity and mortality in the United States, with the majority of preventable cases attributed to excessive alcohol consumption, viral hepatitis, or nonalcoholic fatty liver disease. Cirrhosis often is an indolent disease; most ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0901/p756.html

Special Considerations in Interpreting Liver Function Tests - American Family Physician

Apr 15, 1999 - A number of pitfalls can be encountered in the interpretation of common blood liver function tests. These tests can be normal in patients with chronic hepatitis or cirrhosis. The normal range for aminotransferase levels is slightly higher in males, nonwhites and obese persons. Severe ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0415/p2223.html

Family Physicians Can Manage Adults with Hepatitis C - Editorials - American Family ...

Oct 1, 2018 - The Centers for Disease Control and Prevention encourages family physicians to treat patients with hepatitis C. Outcomes when primary care physicians prescribe direct-acting antivirals to patients with uncomplicated hepatitis C are comparable to those of subspecialists.

American Family Physician : Editorials

https://www.aafp.org/afp/2018/1001/p413.html

Glecaprevir/Pibrentasvir (Mavyret) for the Treatment of Chronic Hepatitis C - STEPS - ...

Nov 15, 2018 - Glecaprevir/pibrentasvir is an effective treatment for any of six genotypes of HCV infection and has few adverse effects. It can be used to treat more genotypes over a shorter duration (eight weeks for patients without cirrhosis) and is substantially less expensive than other available ...

American Family Physician : STEPS

https://www.aafp.org/afp/2018/1115/p601.html

Hepatitis B Virus Vaccination and Screening: Best Practices from the ACP and CDC - ...

Jul 15, 2018 - The American College of Physicians and Centers for Disease Control and Prevention highlights the consensus among these recommendations, with recent evidence, to develop a best practice advice statement for vaccination, screening, care, and treatment of patients at risk of or who ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2018/0715/p121.html

Antibiotic Prophylaxis in Patients with Cirrhosis and Upper Gastrointestinal Bleeding -...

May 1, 2017 - Antibiotics should be used for prophylaxis in hospitalized patients with cirrhosis and upper gastrointestinal bleeding. Prophylaxis reduces all-cause mortality by 21%, as well as bacterial infections and rebleeding.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2017/0501/p582.html

Cirrhosis and Chronic Liver Failure: Part II. Complications and Treatment - American ...

Sep 1, 2006 - Major complications of cirrhosis include ascites, spontaneous bacterial peritonitis, hepatic encephalopathy, portal hypertension, variceal bleeding, and hepatorenal syndrome. Diagnostic studies on ascitic fluid should include a differential leukocyte count, total protein level, a ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0901/p767.html

Nonalcoholic Fatty Liver Disease: Identifying Patients at Risk of Inflammation or ...

Jun 15, 2017 - NAFLD is defined as hepatic steatosis on imaging or histology in the absence of other etiologies for secondary fat accumulation. It is usually identified during the evaluation of elevated transaminase levels in a patient without heavy alcohol intake, or found incidentally on imaging ...

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2017/0615/p796.html

Sofosbuvir/Velpatasvir (Epclusa) for Hepatitis C - STEPS - American Family Physician

May 15, 2017 - Sofosbuvir/velpatasvir is an effective treatment for patients with HCV and has minimal adverse effects. It is the preferred treatment for patients with genotype 2 or 3. As with other curative treatments, it is very expensive.

American Family Physician : STEPS

https://www.aafp.org/afp/2017/0515/p664.html

Efficacy of Direct-Acting Antivirals Compared with Older Agents for Hepatitis C - ...

Jun 1, 2017 - Although they help patients achieve sustained viralogic response, expensive direct-acting antivirals have yet to show that they can succeed in meeting top-priority treatment goals.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/0601/od1.html

Elbasvir/Grazoprevir (Zepatier) for Hepatitis C Virus Infection - STEPS - American ...

Mar 15, 2017 - Elbasvir/grazoprevir is a safe and effective treatment for HCV genotypes 1 and 4, with or without compensated cirrhosis or HIV-1 coinfection. Patients with renal impairment, including those on hemodialysis, can use the medication.

American Family Physician : STEPS

https://www.aafp.org/afp/2017/0315/p393.html

Liver Disease in Pregnancy - American Family Physician

Feb 15, 1999 - Acute viral hepatitis is the most common cause of jaundice in pregnancy. The course of acute hepatitis is unaffected by pregnancy, except in patients with hepatitis E and disseminated herpes simplex infections, in which maternal and fetal mortality rates are significantly increased. ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0215/p829.html

Hepatitis A - American Family Physician

Jun 15, 2006 - The introduction of hepatitis A vaccines in 1995 led to a drop in the number of reported cases of hepatitis A and a shift to a higher percentage of cases occurring in older age groups. The hepatitis A virus survives for extended periods in the environment. Transmission primarily is ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0615/p2162.html

Should Family Physicians Routinely Screen Patients for Hepatitis C? Yes: Screening ...

Jan 1, 2016 - For patients to receive appropriate care for their chronic infection and receive curative treatment, they must first know they are infected, and it all begins with screening.

American Family Physician : Editorials: Controversies in Family Medicine

https://www.aafp.org/afp/2016/0101/p15.html

Should Family Physicians Routinely Screen Patients for Hepatitis C? No: One-time ...

Jan 1, 2016 - Given current scientific uncertainties, limited resources, and evolving guidelines, a reasonable middle ground would be to focus HCV testing and therapy on patients who are most likely to have long-term complications from the infection.

American Family Physician : Editorials: Controversies in Family Medicine

https://www.aafp.org/afp/2016/0101/p17.html

Screening for Hepatitis B Virus Infection in Nonpregnant Adolescents and Adults - ...

Aug 15, 2015 - P.N. is a 35-year-old man whose parents were born in southeast Asia. Although he was born in the United States, P.N. does not have any vaccination records from his childhood. During an office visit, he mentions that a relative was recently diagnosed with hepatitis B virus (HBV) ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2015/0815/p301.html

Screening for Hepatitis B Virus Infection in Nonpregnant Adolescents and Adults: ...

Apr 15, 2015 - The USPSTF recommends screening for hepatitis B virus (HBV) infection in persons at high risk for infection.

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2015/0415/od2.html

Screening for Hepatitis C Virus Infection in Adults: Recommendation Statement - U.S. ...

Sep 15, 2014 - The U.S. Preventive Services Task Force (USPSTF) recommends screening for hepatitis C virus (HCV) infection in persons at high risk of infection. The USPSTF also recommends offering one-time screening for HCV infection to adults born between 1945 and 1965.

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2014/0915/od1.html

USPSTF Recommendations for Hepatitis B Screening - POEMs - American Family Physician

Dec 1, 2014 - The U.S. Preventive Services Task Force (USPSTF) recommends hepatitis B virus screening for human immunodeficiency virus–positive persons, users of illicit injection drugs, men who have sex with men, household contacts or sex partners of infected persons, and persons born in countries ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/1201/p795.html

HELLP Syndrome: Recognition and Perinatal Management - American Family Physician

Sep 1, 1999 - HELLP, a syndrome characterized by hemolysis, elevated liver enzyme levels and a low platelet count, is an obstetric complication that is frequently misdiagnosed at initial presentation. Many investigators consider the syndrome to be a variant of preeclampsia, but it may be a separate ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0901/p829.html

Screening for Hepatitis C Virus Infection in Adults - Putting Prevention into Practice ...

Sep 15, 2014 - T.S. is a 59-year-old white man born in 1955. He presents as a new patient to request a refill of his cholesterol medication. He has an unremarkable medical history. When you inquire about his social history, he reports that he has been married for 30 years, drinks a moderate amount of ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2014/0915/p405.html

Hepatitis B - American Family Physician

Jan 1, 2004 - Hepatitis B causes significant morbidity and mortality worldwide. More than 400 million persons, including 1.25 million Americans, have chronic hepatitis B. In the United States, chronic hepatitis B virus infection is responsible for about 5,000 annual deaths from cirrhosis and ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0101/p75.html

Management of Hepatitis C: Evaluating Suitability for Drug Therapy - American Family ...

Mar 15, 2004 - Chronic hepatitis C virus infection is a common and serious disease. Although an estimated 2.7 million persons in the United States have this disease, most have not yet been diagnosed. Recent advances in treatment provide successful cure in 50 to 80 percent of cases. Current drug ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0315/p1429.html

CDC Issues Recommendations for Identifying HCV Infection in Persons Born in 1945 ...

Jul 1, 2013 - Identifying HCV infection through testing is important to improve health outcomes in persons born in 1945 through 1965, because of increased risk of liver cirrhosis, hepatocellular carcinoma, and extrahepatic complications. The HCV Birth Cohort Testing Work Group, including experts from...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2013/0701/p62.html

Screening for Hepatocellular Carcinoma in Patients with Hepatitis C Virus Infection - ...

Mar 15, 2013 - There is no evidence that it is beneficial to screen for hepatocellular carcinoma in symptomatic patients with HCV.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2013/0315/od2.html

Evaluation of Elevated Serum Transaminase Levels - FPIN's Clinical Inquiries - American...

Oct 15, 2012 - The evaluation of patients with elevated transaminase levels should be individualized based on the presence of symptoms or physical examination findings that suggest serious disease or hepatic decompensation.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2012/1015/od4.html

Recognition and Management of Hereditary Hemochromatosis - American Family Physician

Mar 1, 2002 - Hereditary hemochromatosis is the most common inherited single-gene disorder in people of northern European descent. It is characterized by increased intestinal absorption of iron, with deposition of the iron in multiple organs. Previously, the classic description was combined diabetes ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0301/p853.html

Weight Loss for Patients with Nonalcoholic Fatty Liver Disease - Cochrane for ...

Sep 1, 2012 - There are insufficient high-quality studies to determine patient-oriented outcomes of weight loss for the treatment of fatty liver disease. Nonetheless, weight loss remains a reasonable goal because it may reduce liver inflammation and improve comorbidities. In two of the studies ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2012/0901/p415.html

Preventive Strategies in Chronic Liver Disease: Part I. Alcohol, Vaccines, Toxic ...

Nov 1, 2001 - Chronic liver disease is the 10th leading cause of death in the United States. Hepatitis C virus infection is the most frequent cause of chronic liver disease and the most common indication for liver transplantation. Preventive care can significantly reduce the progression of liver ...

American Family Physician : Article

https://www.aafp.org/afp/2001/1101/p1555.html

Preventive Strategies in Chronic Liver Disease: Part II. Cirrhosis - American Family ...

Nov 15, 2001 - Cirrhosis is a diffuse process characterized by fibrosis and the conversion of normal liver architecture into structurally abnormal nodules. The modified Child-Pugh score, which ranks the severity of cirrhosis based on signs and liver function test results, has been shown to predict ...

American Family Physician : Article

https://www.aafp.org/afp/2001/1115/p1735.html

Antiviral Drugs in the Immunocompetent Host: Part I. Treatment of Hepatitis, ...

Feb 15, 2003 - Advertisement << Previous article Next article >> Feb 15, 2003 Issue Antiviral Drugs in the Immunocompetent Host: Part I. Treatment of Hepatitis, Cytomegalovirus, and Herpes Infections RICHARD COLGAN, M.D., University of Maryland School of Medicine, Baltimore, Maryland ROBERT...

American Family Physician : Article

https://www.aafp.org/afp/2003/0215/p757.html

Hepatitis C: Part I. Routine Serologic Testing and Diagnosis - American Family Physician

Jan 1, 1999 - Hepatitis C, which is caused by the hepatitis C virus (HCV), is a major public health problem in the United States. HCV is most efficiently transmitted through large or repeated percutaneous exposures to blood. Most patients with acute HCV infection develop persistent infection, and 70 ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0101/p79.html

Hepatitis C: Part II. Prevention Counseling and Medical Evaluation - American Family ...

Jan 15, 1999 - An estimated 3.9 million Americans are infected with hepatitis C virus (HCV), and most do not know that they are infected. This group includes persons who are at risk for HCV-associated chronic liver disease and who also serve as reservoirs for transmission of HCV to others. Because ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0115/p349.html

Screening for Hepatitis B Virus Infection in Pregnancy: Reaffirmation Recommendation ...

Feb 15, 2010 - The U.S. Preventive Services Task Force (USPSTF) recommends screening for hepatitis B virus (HBV) infection in pregnant women at their first prenatal visit.

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2010/0215/p502.html

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