Clearance of HCV RNA following acute hepatitis A superinfection.
A transient reduction of hepatitis C virus replication during the course of acute hepatitis A virus infection has already been reported in the literature. The present study reports the case study of a subject with chronic hepatitis due to hepatitis C virus who went on to develop an acute hepatitis A. From the early onset of acute disease, hepatitis C virus ribonucleic acid became undetectable. Following recovery from acute hepatitis, alanine amino-transferase levels became persistently normal and liver biopsy revealed a reduction in the Knodell histological activity index score. Hepatitis C virus ribonucleic acid clearance was maintained up to 4 years after the onset of acute hepatitis A. During the course of the acute disease, a sharp increase in interferon gamma levels was detected in serum and in the supernatant of both unstimulated and phytoemagglutinin/lipopolysaccharide-stimulated peripheral blood mononuclear cells. Interferon gamma levels were still high 3 months later. We hypothesize that acute hepatitis A virus superinfection during the course of chronic hepatitis C may lead to hepatitis C virus ribonucleic acid clearance through an immunological mechanism related to interferon gamma production.
Cacopardo
B
B
Department of Internal Medicine and Medical Specialties, Via Passo Gravina 187, I-95127 Catania, Italy. cacopardobruno@inwind.it
Nunnari
G
G
Nigro
L
L
D000410:Alanine Transaminase / Q000097:blood; D001663:Bilirubin / Q000097:blood; D016207:Cytokines / Q000097:blood; D016174:Hepacivirus / Q000378:metabolism*; D006506:Hepatitis A / Q000821:virology*; D035922:Hepatitis A Antibodies / Q000097:blood; D019698:Hepatitis C, Chronic / Q000097:blood / Q000175:diagnosis / Q000821:virology*; D006801:Humans; D008099:Liver / Q000473:pathology / Q000821:virology; D008297:Male; D012367:RNA, Viral / Q000097:blood*; D012075:Remission, Spontaneous; D015163:Superinfection / Q000821:virology*; D055815:Young Adult; D005723:gamma-Glutamyltransferase / Q000097:blood
D016207:Cytokines; D035922:Hepatitis A Antibodies; D012367:RNA, Viral; D005723:gamma-Glutamyltransferase; D000410:Alanine Transaminase; D001663:Bilirubin