Acute hepatitis C in Spain: a retrospective study of 131 cases

作者：Perez Alvarez Ramon^*; Garcia Samaniego Javier; Sola Ricard; Perez Lopez Rosa; Barcena Rafael; Planas Ramon; Canete Nuria; Manzano Maria Luisa; Gutierrez Maria Luisa; Morano Luis; Rodrigo Luis

来源：Revista Espanola de Enfermedades Digestivas, 2012, 104(1): 21-28.

• Acute hepatitis C
• HCV
• Treatment

Background and aims: 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 +/- 13 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.

• 出版日期2012-1