PRIOR HEPATITIS-A VIRUS-INFECTION ENHANCES ACUTE HEPATITIS-E VIRUS-INFECTION

The epidemiology and clinical manifestations of hepatitis E virus (H E V) and hepatitis A virus (HAV) are similar. However, two distinct dise ases develop after exposure to each one of the viruses, which are appa rently unrelated clinically. It is interesting to note that all report ed epidemics and single cases of acute HEV infection indicate previous exposure to HAV. This fact leads us to hypothesize that acute HEV inf ection is dependent on past infection by hepatitis A virus, and that t he sequential infections could not solely be explained on independent outbreaks. This hypothesis, where past HAV infection serves to support acute HEV infection, may have current practical implications, and cou ld improve our understanding of the virology and pathophysiology of th e disease.