Hepatitis A. Perspectives and recent advances.

The basis for the epidemiologic and etiologic differentiation of two major forms of viral hepatitis, hepatitis A and B, was established in a series of studies undertaken between 1930 and 1970. Final recovery and visualization of the presumed etiologic agent of hepatitis A was not, however, accomplished until the technique of immune electron microscopy was applied to the examination of specimen materials collected from individuals in the early acute stages of infection. Morphologically homogeneous virus-like particles of 27 nm diameter have now been recovered from stools of patients with hepatitis A ill from a variety of sources. Antibody to these particles has been shown to develop during the course of infection with hepatitis A but not with hepatitis B and disease has been induced in nonhuman primates inoculated with purified particle containing fractions. The classification of hepatitis A virus has not been conclusively established, but it would appear to be either a parvovirus or an enterovirus.