Acute hepatitis C: analysis of a 126-case prospective, multicenter cohort

作者：Morin Thierry^*; Pariente Alexandre; Lahmek Pierre; Rabaud Christian; Silvain Christine; Cadranel Jean Francois

来源：European Journal of Gastroenterology and Hepatology, 2010, 22(2): 157-166.

DOI：10.1097/MEG.0b013e328330a8e8

• acute hepatitis
• diagnosis
• epidemiology
• hepatitis C
• natural history
• therapy
• transmission

Objectives 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.
Conclusion 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-a alone being a good option.

• 出版日期2010-2