Journal of General Internal Medicine

, Volume 28, Issue 5, pp 734–738

Acute Hepatitis C in an HIV-Infected patient: A Case Report and Review of Literature

Clinical Practice: Clinical Vignettes

ABSTRACT

With the decrease in transmission via transfusions and injection drug use, acute symptomatic hepatitis C is infrequently seen in developed countries. We report a case of a human immunodeficiency virus (HIV)–infected adult who presented with abdominal pain. His alanine aminotransferase was greater than sixty times the upper limit of normal without any evidence on examination of fulminant hepatic failure. His workup revealed an elevated hepatitis C viral level with a negative hepatitis C antibody. He was discharged once his liver function tests improved. As an outpatient, he had a recurrent bout of symptoms with an elevation of his alanine aminotransferase and hepatitis C viral levels that promoted anti-hepatitis C virus treatment. This case illustrates the importance of considering acute hepatitis C as a cause of acute hepatitis in HIV-infected men who have sex with men. While patients with acute symptomatic hepatitis C generally have a higher rate of spontaneous viral clearance compared to those with an insidious acute infection, most still progress to chronic hepatitis C infection, and patients with HIV coinfection carry a higher risk of progression to chronic disease.

KEY WORDS

acute hepatitis C virus human immunodeficiency virus hepatitis C virus treatment 

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Copyright information

© Society of General Internal Medicine 2012

Authors and Affiliations

  • Todd H. Driver
    • 1
  • Norah Terrault
    • 2
  • Varun Saxena
    • 2
    • 3
  1. 1.School of MedicineUniversity of California, San FranciscoSan FranciscoUSA
  2. 2.Department of GastroenterologyUniversity of California, San FranciscoSan FranciscoUSA
  3. 3.University of California, San FranciscoSan FranciscoUSA

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