title: Identified cases of acute hepatitis C from computerized laboratory database: a hospital-based epidemiological and clinical study.
abstract: OBJECTIVE
  Diagnosis of acute hepatitis C (AHC) relies on documented positive-seroconversion of antibody to hepatitis C virus (anti-HCV) that is infrequently encountered. To clarify the epidemiology and clinical course of AHC, we tried to find more AHC patients from a computerized laboratory database by using a supplemental criterion of rising anti-HCV titer.
  
  
  METHODS
  All the computerized laboratory databases of anti-HCV and alanine aminotransferase (ALT) were reviewed. Candidates for AHC were identified by either anti-HCV positive seroconversion, rise of anti-HCV titer (signal to cut-off ratio (S/CO) ratio < 40 to > or = 40), or spontaneous HCV RNA clearance. AHC cases and their matched chronic hepatitis C controls were interviewed by a case-control study concerning risk factors.
  
  
  RESULTS
  AHC was identified in 123 patients (68 men and 55 women; median age: 48.4+/-13.9 years), who had higher rates of recent surgery (p=0.037) and frequent injection therapy (p=0.036) compared to controls. Self-limited AHC was observed in 18 (19.1%, 95% confidence interval: 12.3-25.9%) of 94 AHC patients who had been followed for 6 months, with a higher bilirubin level (> or = 2 vs. < 2, p=0.007) compared to those evolved to chronic infection.
  
  
  CONCLUSIONS
  Screening of a laboratory database for anti-HCV and ALT might uncover more AHC candidates to disclose the epidemiology and clinical course of AHC.
authors.affiliation: Division of Hepatogastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, 123 Ta Pei Road, Niao Sung 833, Kaohsiung, Taiwan.
authors.forename: Chao-Hung
authors.initials: CH
authors.lastname: Hung
authors.forename: Sheng-Nan
authors.initials: SN
authors.lastname: Lu
authors.forename: Jing-Houng
authors.initials: JH
authors.lastname: Wang
authors.forename: Shu-Fen
authors.initials: SF
authors.lastname: Hung
authors.forename: Chien-Hung
authors.initials: CH
authors.lastname: Chen
authors.forename: Tsung-Hui
authors.initials: TH
authors.lastname: Hu
authors.forename: Chuan-Mo
authors.initials: CM
authors.lastname: Lee
authors.forename: Chi-Sin
authors.initials: CS
authors.lastname: Changchien
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000097:blood*; D000465:Algorithms; D000998:Antiviral Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D005260:Female; D016174:Hepacivirus / Q000276:immunology*; D006511:Hepatitis B Antigens / Q000097:blood; D006526:Hepatitis C / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology*; D018937:Hepatitis C Antibodies / Q000097:blood*; D006801:Humans; D007124:Immunoenzyme Techniques; D007755:Laboratories, Hospital; D008297:Male; D016347:Medical Records Systems, Computerized; D008875:Middle Aged; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013624:Taiwan / Q000453:epidemiology
chemical_list: D000998:Antiviral Agents; D006511:Hepatitis B Antigens; D018937:Hepatitis C Antibodies; D000410:Alanine Transaminase