Acute hepatitis C in Spain: a retrospective study of 131 cases.
OBJECTIVE
The management of acute hepatitis C (AHC) is controversial. We have conducted a retrospective study to determine the epidemiological and biochemical aspects, the genotypes, the spontaneous clearance of HCV (SVC), and the treatment responses in patients with AHC.


METHODS
We have retrospectively collected data from 131 patients with AHC from 18 Spanish hospitals.


RESULTS
The mean age was 43 ± 16 years (17-83), 69% were symptomatic. The causes of infection were nosocomial in 40% and intravenous drug users in 20%. Eighty two percent had genotype 1. The delay from symptoms-onset to HCV-RNA confirmation was 50 ± 68 days (range, 11-350 days) and to treatment (in 59%) 14±1 3 weeks (range, 2-58 days). In the treated group, 80% achieved sustained virological response (SVR) versus 57% SVC in untreated patients (p = 0.004). Up to 96% of those treated within the first 12 weeks had SVR versus 86% of those treated later (p = 0.04). Patients with HCV-RNA(-) at week 4 resolved with or without treatment more frequently than those HCV-RNA(+) (98% versus 69%, p = 0.005). The treatment was not beneficial if HCV-RNA was undetectable at week 12. No differences in SVR were found in genotype 1 patients treated for 24 or 48 weeks. Patients with low baseline viral load achieved higher SVC and SVR. The SVC in patients with bilirubin > 5 mg/dL was 78 versus 40% in those with lower values (p = 0.004).


CONCLUSIONS
The most common transmission route was nosocomial. SVR was higher in patients treated than SVC in non-treated.Early treatment (before week 12) achieved the highest response rate. SVC and SVR were more common in patients with a low baseline viral load. Undetectable HCV-RNA at week 4 was associated with high SVR and SVC rates. Jaundice was related with SVC.
Hospital Universitario Central de Asturias, Calle Celestino Villamil s/n. 33006, Oviedo, Spain. peralbar@telefonica.net
Ramón
R
Pérez-Álvarez
Javier
J
García-Samaniego
Ricard
R
Solá
Rosa
R
Pérez-López
Rafael
R
Bárcena
Ramón
R
Planas
Nuria
N
Cañete
María Luisa
ML
Manzano
María Luisa
ML
Gutiérrez
Luis
L
Morano
Luis
L
Rodrigo
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000914:Antibodies, Viral / Q000032:analysis; D000998:Antiviral Agents / Q000627:therapeutic use; D015331:Cohort Studies; D003428:Cross Infection / Q000150:complications / Q000628:therapy; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000276:immunology; D006526:Hepatitis C / Q000453:epidemiology* / Q000628:therapy / Q000821:virology; D006801:Humans; D007124:Immunoenzyme Techniques; D007074:Immunoglobulin G / Q000032:analysis; D007371:Interferon-gamma / Q000627:therapeutic use; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D012189:Retrospective Studies; D012254:Ribavirin / Q000627:therapeutic use; D013030:Spain / Q000453:epidemiology; D015819:Substance Abuse, Intravenous / Q000453:epidemiology; D019562:Viral Load; D055815:Young Adult
D000914:Antibodies, Viral; D000998:Antiviral Agents; D007074:Immunoglobulin G; D012367:RNA, Viral; D012254:Ribavirin; D007371:Interferon-gamma