The clinical course of acute type A hepatitis in chronic HBsAg carriers--a report of 3 cases.

Introduction It is now recognized that the hepatitis A virus (HAV), and hepatitis B virus (HBV) are antigenically and morphologically distinct (Dane, Cameron and Briggs, 1970; Feinstone, Kapikian and Purcell, 1973) and there are reports of patients who have had repeated attacks of hepatitis owing to exposure to the different viruses (Mosley et al., 1977). It is not surprising, therefore, that chronic HBsAg carriers do not appear to be protected against infection with epidemic HAV (Dietzman et al., 1972), and sporadic non-A, non-B agents. As the outcome of these double infections is unclear and documented attacks of acute HAV infection in chronic HBsAg carriers with biopsy-proved liver disease are rare, the authors present the clinical and virological course of 3 chronic HB5Ag carriers who contracted an acute HAV infection.