The German Hep-Net acute hepatitis C cohort: impact of viral and host factors on the initial presentation of acute hepatitis C virus infection.
BACKGROUND
The impacts of viral load, genotype, age, sex and BMI on the clinical course of acute hepatitis C are poorly defined. Here we studied 259 patients with acute HCV infection recruited in the German Hep-Net data base between 1998 and 2008. Antiviral treatment with interferon alpha was initiated in 171 patients (66 %) within 4 months after the diagnosis of acute hepatitis C.


RESULTS
In this cohort (i) the mode of infection was associated with age as iv-drug users were significantly younger than non-iv-drug users while the proportion of patients who acquired HCV by medical procedures increased with age; (ii) patients younger than 30 years were more often infected with genotype 3 (26 % versus 8 % for patients older than 50 years; p = 0.03); (iii) 51 % of patients were icteric and 28 % presented with a 30-fold elevation of liver enzymes, however, no fulminant hepatic failure occurred; (iv) HCV genotype was not associated with disease severity and time to onset of symptoms; (v) low HCV viremia was associated with lower serum AST levels and a longer time from exposure to onset of symptoms; (vi) disease severity was independent from the mode of infection, age, sex and body mass index (BMI).


CONCLUSIONS
In this large cohort of patients admitted for antiviral therapy, acute hepatitis C took a rather mild course of disease in the majority of patients. Disease severity was not associated with HCV genotype, viral load, age, sex and BMI.
Deterding
K
K
Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Carl-Neuberg-Str.1 30625 Hannover.
Wiegand
J
J
Grüner
N
N
Hahn
A
A
Jäckel
E
E
Jung
M C
MC
Buggisch
P
P
Galle
P
P
Berg
T
T
Hinrichsen
H
H
Potthoff
A
A
Zeuzem
S
S
Cornberg
M
M
Manns
M
M
Wedemeyer
H
H
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D015992:Body Mass Index; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D005858:Germany / Q000453:epidemiology; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D017678:Sex Distribution; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*; D019562:Viral Load / Q000706:statistics & numerical data*; D055815:Young Adult