“…A sensitive nested RT-PCR method was therefore developed to detect serum HAV RNA in the early convalescent phase of hepatitis A with high frequency [Fujiwara et al, 1997], and the viral genomes in the sera from hepatitis A patients with a variety of clinicopathological features were analyzed and the associations between certain viral regions and clinical severities were documented. It has been reported that both viral and host factors should be considered when discussing the mechanisms responsible for the severity of hepatitis A [Fujiwara et al, 2000[Fujiwara et al, , 2001[Fujiwara et al, , 2002, and that several portions of the HAV genome including the 5 0 non-translated region (5 0 NTR) and non-structural protein 2B and 2C [Fujiwara et al, 2003[Fujiwara et al, , 2007a[Fujiwara et al, ,b, 2009], whose mutations have been shown to be important for enhanced replication and virulence in cell culture systems [Zhang et al, 1995] and simians [Raychaudhuri et al, 1998], should be examined.…”