The development of serological tests for hepatitis A and hepatitis B viruses demonstrated that a significant proportion of cases of hepatitis were due to neither of these viruses (36). This led to the coining of the term non-A, non-B hepatitis, of which two forms were epidemiologically apparent: a parenteral form with routes of transmission, which appeared similar to parenterally spread hepatitis B virus infection, and an enterically spread non-A, non-B hepatitis with routes of transmission similar to enterically spread hepatitis A virus.
Enterically spread non-A, non-B hepatitis was apparently responsible for vast epidemics of waterborne hepatitis on the Indian subcontinent, Southeast Asia, Asian republics of the former USSR, Africa, and Central America. The development of serological tests confirmed that the etiolog-ical agent was a novel virus, unrelated to hepatitis A, and that infection was considerably more widespread than suggested by the geographic location of the large waterborne outbreaks. In addition to outbreaks, the virus, now termed hepatitis E virus (HEV), was also responsible for sporadic cases of hepatitis both in developing and in developed countries, among indigenous populations as well as imported cases from travelers.
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