Abstract
Viral hepatitis is still, as it has been for many centuries, a major worldwide cause of acute and chronic liver disease. Outbreaks of jaundice resembling viral hepatitis were described as early as the fifth century
bc, and the term
epidemic jaundice appeared in the writings of Hippocrates in Greece. Nevertheless, proof of the infectious nature of the disease was established only during and shortly after World War II, in a series of studies that involved feeding contaminated material to human volunteers.
107,134
The successful infection of marmosets with a virus from the feces of patients with infectious hepatitis and the finding of a viral antigen in the feces of such patients
47,62,63
led to the identification and the description of the hepatitis A virus (HAV) by Feinstone et al in 1973.
47
The first description of percutaneously transmitted hepatitis is attributed to Lurman,
106
who reported 191 cases of jaundice that developed 2 to 8 months after smallpox vaccination with glycerinated human lymph in 1885. Subsequently, many more authors reported similar outbreaks, but the association between the transfusion of blood or plasma and the development of hepatitis was reported for the first time in 1943.
8,124
The landmark studies of Krugman and colleagues in the late 1950s and the early 1960s documented the transmissibility of hepatitis by human plasma and confirmed the long-standing clinical observation that both parenteral and enteric transmission could occur.
86,87,88
One of the most important breakthroughs came in the mid-1960s with the discovery of the hepatitis B surface antigen (HBsAg) and its antibody (anti-HBs) by Blumberg and colleagues,
11,121
a discovery that led, in 1977, to their receiving the Nobel prize in Medicine. This discovery also led to the description of the morphologic and immunochemical features of hepatitis B virus (HBV) and, later, to the development of specific passive and active hepatitis B immunoprophylaxis. Soon after the identification of the hepatitis A and B viruses, it became apparent that many cases of posttransfusion hepatitis were neither HBV or HAV. The entity non-A non-B hepatitis was formally introduced in the mid-1970s,
48,147
and the hepatitis C virus (HCV) was finally identified in 1989 by Choo and associates.
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