Acute hepatitis C: analysis of a 126-case prospective, multicenter cohort.
OBJECTIVE
To analyze the data (epidemiology, mode of transmission, course, and outcome) of a large series of patients with acute hepatitis C (AHC) in France.


METHODS
Prospective multicenter register, observational study.


RESULTS
A cohort of 126 patients with AHC was prospectively enrolled between 1999 and 2007. Fifteen (12%) were HIV coinfected. Suspected modes of hepatitis C virus transmission were drug use (38%), sexual contact (21%), nosocomial transmission (18%), and occupational exposure (12%). For 40% of the patients, AHC was revealed by jaundice. Spontaneous viral clearance occurred in 40% of the 72 patients observed for 3 months without treatment. Only jaundice and nosocomial/occupational transmission were predictive of spontaneous viral clearance. Ninety patients were treated with standard or pegylated interferon-alpha alone (58%) or in combination with ribavirin (42%), for 24 weeks or less in 90%. In intention-to-treat, a sustained viral response was obtained in 58 of 78 (74%) hepatitis C virus monoinfected patients [19 of 22 (86%) with 24 weeks of pegylated interferon-alpha alone], but only six of 12 (50%) of HIV coinfected patients.


CONCLUSIONS
AHC remains rare, and drug and sexual transmission are predominant. A 3-month follow-up after diagnosis avoids treatment for four out of 10 patients. Antiviral treatment is highly effective, 24 weeks of pegylated interferon-alpha alone being a good option.
Morin
Thierry
T
Centre Hospitalier de Bigorre, 65013 Tarbes, France. tmorin@ch-tarbes-vic.fr
Pariente
Alexandre
A
Lahmek
Pierre
P
Rabaud
Christian
C
Silvain
Christine
C
Cadranel
Jean François
JF
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D001530:Belgium / Q000453:epidemiology; D004359:Drug Therapy, Combination; D005260:Female; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology; D016174:Hepacivirus / Q000235:genetics; D006526:Hepatitis C / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000635:transmission; D006801:Humans; D007370:Interferon Type I / Q000627:therapeutic use; D008189:Luxembourg / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D011994:Recombinant Proteins; D012042:Registries; D012075:Remission, Spontaneous; D012254:Ribavirin / Q000627:therapeutic use; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D019562:Viral Load; D055815:Young Adult
D000998:Antiviral Agents; D007370:Interferon Type I; D012367:RNA, Viral; D011994:Recombinant Proteins; D012254:Ribavirin