Outcomes and treatment of acute hepatitis C virus infection in a United States population.
OBJECTIVE
Acute hepatitis C infection progresses to chronic infection in up to 80% of infected persons. Reports from Europe indicate that early treatment of acute hepatitis C infection produces sustained virologic response rates as high as 80%-98%. However, the outcome of acute hepatitis C infection in United States cohorts is not well-characterized.


METHODS
We describe the clinical course of 28 episodes of acute hepatitis C infection in 24 persons at our institution.


RESULTS
Of the 28 infections, 7 episodes resolved spontaneously. Of the remaining 21 episodes, 16 were treated, and 5 did not receive treatment. Of the 16 treated episodes, 4 received interferon and ribavirin, 11 received pegylated interferon and ribavirin, and 1 was treated initially with interferon monotherapy followed by pegylated interferon monotherapy. Among those episodes treated with interferon, 3 of 4 experienced sustained virologic response. Among those episodes treated with pegylated interferon, all 12 achieved SVR. In total, 15 of 16 treated patients (94%) experienced SVR. In all, 18 of the 24 patients (75%) experienced spontaneous or treatment-induced sustained virologic clearance.


CONCLUSIONS
Our experience with treated and untreated acute HCV infection is comparable to that observed in Europe. Patients treated with antiviral therapy had an excellent response. Randomized trials to investigate immediate versus delayed treatment of acute hepatitis C infection are warranted. In view of these strongly positive outcomes, increased vigilance for acute hepatitis C becomes essential.
Corey
Kathleen E
KE
Medical Services, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA.
Ross
Andrew S
AS
Wurcel
Alysse
A
Schulze Zur Wiesch
Julian
J
Kim
Arthur Y
AY
Lauer
Georg M
GM
Chung
Raymond T
RT
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics; D006526:Hepatitis C / Q000188:drug therapy* / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D019562:Viral Load
D000998:Antiviral Agents; D004279:DNA, Viral