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Gary N. Fox, MD
Boise, Idaho

JAMA. 1985;254(22):3177.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

Friedman et al¹ assume that lack of IgM antibody to hepatitis A virus (anti-HAV) excludes acute infection with this virus. In their comments, the authors attempt to reconcile their new data with the old, but do not include as a possibility that some individuals developed acute hepatitis A virus infections without detectable IgM anti-HAV. Indeed, the results clearly indicate that two team members whose initial IgG anti-HAV test results were negative later developed persistent IgG anti-HAV without demonstrating detectable IgM anti-HAV. In addition, another 11 subjects, whose initial IgG anti-HAV was undetectable, and who never exhibited IgM anti-HAV, demonstrated positive IgG anti-HAV "on the only or last determination." While these individuals may have had transient IgG due to administration of immune globulin, we are not told the duration of IgG persistence. Based on the data presented, these cases might also represent HAV infections (with IgG seroconversion) . . . [Full Text PDF of this Article]

Footnotes
Edited by Drummond Rennie, MD, Senior Contributing Editor.

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