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To the Editor.—
Richard A. Willson, MD, reported a case of "Intercurrent Hepatitis A in B Viral Hepatitis" (1981;245:2495). The diagnosis of acute hepatitis A was made on the basis of first-generation type testing to distinguish between anti-HA-IgM and anti-HA-IgG. The "differential absorption" technique using staphylococcal cells has been reported to be unreliable when compared with the more recently developed direct radioimmunoassay for anti-HA-IgM. Dr Willson's report did not indicate results of anti-HA testing when the patient's condition was initially evaluated but only the results of testing during the second episode of illness. Thus, the possibility exists that this patient had either a relapse of chronic hepatitis B or a new infection with another virus or even some other type of nonviral hepatitis.
Casey JH. Intercurrent Hepatitis A in Chronic B Viral Hepatitis. JAMA. 1982;247(5):584. doi:10.1001/jama.1982.03320300014012
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