Identified cases of acute hepatitis C from computerized laboratory database: a hospital-based epidemiological and clinical study.
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.
Hung
Chao-Hung
CH
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.
Lu
Sheng-Nan
SN
Wang
Jing-Houng
JH
Hung
Shu-Fen
SF
Chen
Chien-Hung
CH
Hu
Tsung-Hui
TH
Lee
Chuan-Mo
CM
Changchien
Chi-Sin
CS
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
D000998:Antiviral Agents; D006511:Hepatitis B Antigens; D018937:Hepatitis C Antibodies; D000410:Alanine Transaminase