Viral Hepatitis Non: B, C, D and Acute and Acute on Chronic Liver Failure

Da, Ben L.; Nguyen, Andrew; Khan, Ali; Dieterich, Douglas T.

Acute liver failure (ALF) and acute on chronic liver failure (ACLF) are two unique clinical syndromes associated with a high risk of mortality. Non-HBV/HCV/HDV viruses including the hepatotrophic viruses (HAV and HEV) and non-hepatotrophic viruses (EBV/CMV/VZV) are important causes of both syndromes. Diagnosis of ALF and ACLF relies on proper physician awareness especially in high risk populations and the correct testing in the setting of a compatible clinical picture. Prevention of certain viruses such as HAV and HEV in endemic populations with proper hygiene and vaccination is critical. Prognosis and management differs with each disease condition but includes supportive care for failing organ systems, virus directed treatment, and liver transplantation.