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Lawrence S. Friedman, MD; Jules L. Dienstag, MD
Jefferson Medical College of Thomas Jefferson University Philadelphia

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.

In Reply.—

We appreciate Dr Fox's concern about the sensitivity of the assay for IgM anti-HAV and the possibility of false-negative results. However, the commercially available assay used in our analysis (HAVAB-M) has been shown to be extremely sensitive for the diagnosis of acute or recent HAV infection, regardless of whether the infection is icteric, anicteric, or subclinical.^1,2 To our knowledge, a confirmed case of acute hepatitis A associated with IgG anti-HAV seroconversion in the absence of an early IgM anti-HAV response has never been documented. The IgM anti-HAV usually appears within a few days of the onset of symptoms and biochemical abnormalities and can be detected for at least two to four months after acute illness.

In light of the temporal relation of events described in our report, the absence of IgM anti-HAV in players at the time of the outbreak excludes a diagnosis of acute hepatitis A. . . . [Full Text PDF of this Article]

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