Relatively very little has been published on the course of simultaneous infections with hepatitis A (HAV) and C (HCV) viruses. Some reports suggested a more frequent appearance of a more serious, often fulminant course, while other authors have not confirmed that point. The objective of the present study was to evaluate the course and prognosis of the disease, laboratory findings, and epidemiological aspects in a series of 19 patients down with simultaneous infection with HAV and HCV, hospitalized in the course of 1999 and 2000 at the Department for Infectious Diseases in Košice. The severity of the disease assessed according to clinical course and laboratory tests (bilirubin, AST, ALT) was subsequently compared with that of 291 patients suffering HAV infection that have been hospitalized over the past five years. All the cases in the series of simultaneous HAV and HCV infection were in direct or indirect mutual epidemiological connection. We have not registered any case with a fulminant course. In the severity of the disease we have not found any statistically significant differences between the two groups of patients. In view of intravenous drug abuse in all patients of the group with double infection (in many there was also other risky behavior) it cannot be ruled out that in some cases there has been parenteral transmission of HAV. Although simultaneous HAV and HCV infection presents a potential risk of more serious liver damage with a possible fulminant course of the disease, in our relatively small series that has not been confirmed. Nevertheless, we deem it appropriate in patients suffering chronic type C hepatitis to vaccinate against type A as well as type B hepatitis, and so avoid such a risk.

        Key words: chronic hepatitis C - acute hepatitis A - superinfection - fulminant hepatitis - intravenous drug abuse.