I appreciate Dr Casey's interest in my report of intercurrent hepatitis A in chronic B viral hepatitis. It is true that newer viral hepatitis serological tests are being rapidly generated. Inasmuch as viral hepatitis A, B, and non-A, non-B are more accurately defined by serological testing, such would be anticipated. Nevertheless, both radioimmunoassays employed in the patient reported were current at the time of study.1,2 Without documentation of the unreliability of the various serological tests, it is difficult to interpret Dr Casey's impressions fully. Indeed, two recent reports using older-generation and newer-generation radioimmunoassays arrive at similar conclusions in their serological sorting of hepatitis A and hepatitis B in a population at high risk for both.3,4 Consequently, based on the methods used at the time, the serological interpretation remains most consistent with an intercurrent viral hepatitis A.
Willson RA. Intercurrent Hepatitis A in Chronic B Viral Hepatitis-Reply. JAMA. 1982;247(5):584. doi:10.1001/jama.1982.03320300014013
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