Outcome of an outbreak of acute hepatitis C among healthy volunteers participating in pharmacokinetics studies.
We identified 15 patients with acute hepatitis C (AHC) among 29 healthy volunteers participating in 2 consecutive pharmacokinetics studies. Molecular techniques were used to determine the relatedness of viral strains, whereas clinical and virologic follow-up was started to establish the course and outcome of the acute infection. After presentation, serum liver enzymes and HCV RNA were monitored weekly for 4 months, then monthly for at least 12 months. Liver biopsy was performed 6 to 12 months after AHC diagnosis. Phylogenetic analysis of coding regions for the envelope glycoproteins E1 and E2 was performed. At presentation, all 15 patients tested HCV RNA-positive and had HCV genotype 2c. Phylogenetic analysis indicated a common source of infection. Fourteen patients agreed to be followed prospectively. Infection resolved spontaneously in 8 patients, HCV RNA becoming undetectable by 4 to 5 months after the presumed time of infection in 5 of them and by 8, 13, and 24 months in the remaining 3. Six patients developed chronic infection. Liver biopsies performed in 9 subjects who were HCV RNA-positive 6 months after AHC diagnosis revealed that the prevalent histologic finding was lobular inflammation. In conclusion, our homogeneous cohort showed a wide spectrum of clinical, virologic and histologic features, and, more importantly, short-term outcome differed noticeably despite the common source of infection.
Larghi
Alberto
A
Division of Internal Medicine, Department of Medicine, Surgery and Dentistry, Ospedale San Paolo, Italy.
Zuin
Massimo
M
Crosignani
Andrea
A
Ribero
Maria Lisa
ML
Pipia
Cristina
C
Battezzati
Pier Maria
PM
Binelli
Giorgio
G
Donato
Francesco
F
Zanetti
Alessandro Remo
AR
Podda
Mauro
M
Tagger
Alessandro
A
D000208:Acute Disease; D000328:Adult; D004279:DNA, Viral / Q000032:analysis; D004196:Disease Outbreaks; D005260:Female; D005500:Follow-Up Studies; D006282:Health Personnel / Q000706:statistics & numerical data; D016174:Hepacivirus / Q000235:genetics* / Q000302:isolation & purification*; D006526:Hepatitis C / Q000453:epidemiology* / Q000473:pathology; D006801:Humans; D008099:Liver / Q000473:pathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D010599:Pharmacokinetics; D010802:Phylogeny; D012367:RNA, Viral / Q000032:analysis; D014759:Viral Envelope Proteins / Q000235:genetics
D004279:DNA, Viral; C087035:E1 protein, Hepatitis C virus; D012367:RNA, Viral; D014759:Viral Envelope Proteins; C091015:glycoprotein E2, Hepatitis C virus