Infection

, Volume 32, Issue 3, pp 138–143

Natural History of Acute Symptomatic Hepatitis Type C

  • M. Wawrzynowicz-Syczewska
  • J. Kubicka
  • Z. Lewandowski
  • A. Boroń-Kaczmarska
  • M. Radkowski
Clinical and Epidemiological Study

DOI: 10.1007/s15010-004-3062-8

Cite this article as:
Wawrzynowicz-Syczewska, M., Kubicka, J., Lewandowski, Z. et al. Infection (2004) 32: 138. doi:10.1007/s15010-004-3062-8

Abstract.

Background:

Spontaneous clearance of hepatitis C virus (HCV) after acute hepatitis C, and the course of chronic HCV infection in patients who did not clear the virus, were studied.

Patients and Methods:

Patients with acute C or non-A, non-B hepatitis who were hospitalized between 1988 and 1998 were called for evaluation in 2001. They were tested for anti-HCV, serum HCV-RNA, HCV-RNA in peripheral blood mononuclear cells (PBMC) and liver enzymes. A liver biopsy was performed on chronically infected patients. The course of acute hepatitis C was compared between HCV-RNA-positive and negative subjects to look for factors that might influence spontaneous viral clearance. Factors influencing more progressive liver disease were analyzed in chronic hepatitis C.

Results:

Out of 159 acute hepatitis C patients, 77 (48.4%) participated in the study, and the median observation time was 8 years. Spontaneous clearance of serum HCV was found in 23 subjects (29.9%), but in two cases HCV-RNA was detected in peripherical blood mononuclear cells (PBMC). Only three patients negative for HCV-RNA in serum and PBMC lost anti-HCV. Severity of acute HCV infection and previous alcohol abuse seemed to influence resolution. In non-alcoholic patients, older age at time of primary infection was a significant predictor of virus clearance. In chronic hepatitis C, more than 75% of patients had minimal or mild activity in biopsy, but 40% had advanced fibrosis. Older age at infection, male gender, alcohol abuse, and higher iron content were connected with advanced fibrosis.

Conclusion:

Studies on HCV infection resolution should include at least PBMC testing for HCV-RNA. A healthy carrier state of HCV can be discussed. A longer observation time increased the likelihood of seroreversion. Fibrosis in chronic hepatitis C probably is not a direct result of inflammatory activity.

Copyright information

© Urban & Vogel Medien und Medizin Verlagsgesellschaft 2004

Authors and Affiliations

  • M. Wawrzynowicz-Syczewska
    • 1
  • J. Kubicka
    • 2
  • Z. Lewandowski
    • 3
  • A. Boroń-Kaczmarska
    • 1
  • M. Radkowski
    • 2
  1. 1.Dept. of Infectious DiseasesPomeranian Medical UniversitySzczecinPoland
  2. 2.Dept. of ImmunopathologyWarsaw Medical UniversityWarsawPoland
  3. 3.Dept. of EpidemiologyWarsaw Medical UniversityWarsawPoland