Signs and symptoms | >70% of patients are symptomatic with fever, jaundice, scleral icterus, hepatomegaly. Less common: splenomegaly, skin rash, arthralgia. | Approximately 70% of patients are anicteric or subclinical. Younger patients are most likely to be asymptomatic. If symptoms occur, jaundice, dark urine, white stool, abdominal pain, fatigue, fever, chills, loss of appetite, and pruritus are possible. | Approximately 70% of patients are asymptomatic. If symptoms occur, jaundice, dark urine, white stool, abdominal pain, fatigue, fever, chills, loss of appetite, and pruritus are possible. |
Aminotransferase (ALT, AST) elevations | >1000 IU/L (6.7 µkat/L) ALT>AST | 1000–2000 IU/L (16.7–33.3 µkat/L) ALT>AST | Highly variable, can be approximately 1000 IU/L (16.7 µkat/L) ALT>AST |
Bilirubin | Elevated and preceded by aminotransferase elevations | Can be within normal or elevated | Elevated and preceded by aminotransferase elevations |