New infection with heterotypic hepatitis C virus in a patient with long-term hepatitis C virus eradication.
BACKGROUND
Experimental hepatitis C virus infection in chimpanzees has shown that natural hepatitis C virus infection does not induce protective immunity and reinfection can occur in seroconverted animals.


OBJECTIVE
To study the clinical, virological and histological outcome of a new infection sustained by a different hepatitis C virus strain after a primary infection with eradication of the original virus.


METHODS
A young Italian man with chronic hepatitis C virus type 4 hepatitis was treated with Interferon therapy and achieved a sustained biochemical and virological response. After long follow-up, an asymptomatic flare-up of alanine transaminase occurred. This alanine transaminase increase was associated with serum hepatitis C virus RNA positivity and a low viral load, and the infecting hepatitis C virus genotype was type 3. The clinical and virological course of this new infection is described.


CONCLUSIONS
This report shows that there is no protective immunity against hepatitis C virus type 3 after infection by hepatitis C virus type 4 strain.
De Mitri
M S
MS
Department of Internal Medicine, Cardioangiology, Hepatology, University of Bologna, Italy. sdemitri@almadns.unibo.it
Cassini
R
R
Morsica
G
G
Bagaglio
S
S
Zoli
M
M
Bernardi
M
M
D000328:Adult; D000410:Alanine Transaminase / Q000032:analysis; D000998:Antiviral Agents / Q000627:therapeutic use; D001706:Biopsy; D016174:Hepacivirus / Q000145:classification / Q000235:genetics / Q000276:immunology*; D019698:Hepatitis C, Chronic / Q000276:immunology / Q000628:therapy / Q000821:virology*; D006801:Humans; D007372:Interferons / Q000627:therapeutic use; D008297:Male; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000032:analysis
D000998:Antiviral Agents; D012367:RNA, Viral; D007372:Interferons; D000410:Alanine Transaminase