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What is the most safe antihistaminic drug for children with HAV, and is there any vaccine can be used after infection with HAV?

Hossam Elgnainy Selected answer as best January 16, 2025
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Antihistaminic Drugs for Children with Hepatitis A Virus (HAV) Infection:

1. General Considerations:
– Hepatitis A is a viral infection that does not typically cause allergic reactions, so antihistamines are generally not indicated for its treatment.
– If a child with HAV presents with allergic symptoms, antihistamines might be considered, but with caution due to potential liver impairment.

2. Recommended Antihistamines:
– Cetirizine and Loratadine: These second-generation antihistamines are generally safe for children but are contraindicated in severe hepatic impairment. Close monitoring is essential if used in children with liver involvement from HAV.

3. Alternatives:
– First-generation antihistamines like diphenhydramine should be used with caution due to anticholinergic side effects and potential drowsiness.

4. References:
– British National Formulary for Children
– American Academy of Allergy, Asthma & Immunology (AAAAI) guidelines
– European Academy of Allergy and Clinical Immunology (EAACI) recommendations

HAV Vaccination Post-Infection:

1. Post-Infection Vaccination:
– Individuals who have had HAV develop lifelong immunity, so vaccination is not necessary after infection.

2. Vaccination for Prevention:
– The HAV vaccine is recommended for susceptible individuals to prevent infection, not for treatment post-infection.

3. References:
– Centers for Disease Control and Prevention (CDC) guidelines on HAV vaccination

Hossam Elgnainy Selected answer as best January 16, 2025

Postexposure prophylaxis (PEP) with hepatitis A (HepA) vaccine or immune globulin (IG) effectively prevents infection with hepatitis A virus (HAV) when administered within 2 weeks of exposure.
https://www.cdc.gov/mmwr/volumes/67/wr/mm6743a5.htm