What are the indications for referral to a specialist in cases of Hepatitis A with severe symptoms or complications?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025Updated: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

In cases of hepatitis A with severe symptoms or complications, referral to a specialist or hospital admission is indicated under several circumstances .

  • Severe Illness: Any person with hepatitis A infection who is severely unwell should be admitted to hospital . This includes individuals experiencing significant vomiting, dehydration, or signs of hepatic decompensation (such as a change in personality or level of consciousness) .
  • Worsening Liver Function: Specialist advice should be sought if the person has significantly abnormal liver function tests or coagulation screen, or if their liver function appears to be worsening .
  • Difficult Symptom Management: If the person has more severe hepatic impairment or their symptoms (such as pain, nausea, or itch) are difficult to manage, specialist advice should be sought regarding the choice and dosage of medications .
  • Potentially Hepatotoxic Drugs: Specialist advice is also recommended if there is uncertainty about withholding potentially hepatotoxic drugs .

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