Clinical characteristics, spontaneous clearance and treatment outcome of acute hepatitis C: a single tertiary center experience

ABSTRACT

Acute hepatitis C is rarely diagnosed due to its predominantly asymptomatic course. However, early treatment results in viral eradication in a high number of patients thus, preventing chronicity. The aim of our study was to describe our experience with patients with acute hepatitis C virus [HCV] infection who presented and followed-up in our liver unit, pointing on treatment strategy, and outcome. Retrospective, descriptive study of 30 patients with acute HCV infection [26 males and 4 females] with a mean age of 32 years. The source of infection was mainly injection drug use in 17/30 [56.7] and medical procedures 6/30 [20%]. Twenty patients [66.6%] were symptomatic. HCV-ribonucleic acid [RNA] was detectable at presentation in 26 [86.7%] patients. The genotype distribution was 13/26 [50%] genotype 1, 3/26 [11.5%] genotype 2, 8/26 [30.8%] genotype 3 and 2/26 [7.7%] genotype 4. Totally, 9 patients [30%] experienced spontaneous viral eradication. No significant differences could be documented between patients who spontaneously cleared the virus and those who had viral persistence. Thirteen patients [44%] were treated with peginterferon-based regimen. All patients [100%] achieved non-detectable HCV-RNA and had normal serum alanine aminotransferase levels at the end of the treatment. Eleven patients achieved sustained virologic response [SVR], one relapsed and one was lost to follow-up. The overall SVR rate was 84.6%. None of the patients required dose reduction or stopped the treatment due to side effects. In conclusion, early initiation of anti-viral treatment in patients with acute hepatitis C results in high-SVR rates [independently of genotype] and is well-tolerated