A 24-year-old man who has sex with men is seen in a sexual health clinic with urethral discharge. He is diagnosed and treated for gonorrhea
A 24-year-old man who has sex with men is seen in a sexual health clinic with urethral discharge. He is diagnosed and treated for gonorrhea. During the visit he also reports having dark urine, anorexia, fatigue, and intermittent fever. Physical examination is notable for a temperature of 38.2°C, scleral icterus, and right upper quadrant tenderness. Laboratory studies are sent for causes of acute hepatitis, and he is seen back the following day. The laboratory studies confirm a diagnosis of acute hepatitis A (anti-IgM positive and anti-IgG negative). He has no known chronic medical problems. Which one of the following is recommended for the management of acute hepatitis A infection? Supportive care with no restrictions in diet and physical activity Hepatitis A immune globulin 0.02 mL/kg now and repeated 7 days later Hepatitis A immune globulin 0.02 mL/kg in a single dose plus prednisone 60 mg orally once daily for 7 days Tenofovir alafenamide-emtricitabine once daily for 4 weeks
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