Outcomes of Treatment for Acute Hepatitis C

By Liz Highleyman

Without treatment, acute hepatitis C virus (HCV) infection progresses to chronic disease in approximately 80% of infected individuals. Prior research from Europe showed that early treatment of acute hepatitis C produced sustained virological response (SVR) rates as high as 80%-98%, but there has been little research on the outcome of acute hepatitis C in U.S. cohorts.

As reported in the October 2006 issue of Clinical Gastroenterology and Hepatology, researchers from Massachusetts General Hospital and Harvard Medical School described the clinical course of 28 episodes of acute hepatitis C infection in 24 patients at their institution.

Results

Of the 28 infections, 7 episodes resolved spontaneously without treatment.

Of the remaining 21 episodes, 16 were treated, and 5 did not receive treatment.

Of the 16 treated episodes:

- 4 received conventional interferon plus ribavirin;
- 11 received pegylated interferon plus ribavirin;
- 1 was treated initially with conventional interferon monotherapy followed by pegylated interferon monotherapy.

Among the episodes treated with conventional interferon, 3 of 4 resulted in sustained virological response.

Among the episodes treated with pegylated interferon, all 12 resulted in SVR.

In total, 15 of 16 treated patients (94%) achieved SVR.

Overall, 18 of the 24 patients (75%) experienced either spontaneous or treatment-induced sustained HCV clearance.

Conclusion

"Our experience with treated and untreated acute HCV infection is comparable to that observed in Europe," the researchers concluded. "Patients treated with antiviral therapy had an excellent response. Randomized trials to investigate immediate versus delayed treatment of acute hepatitis C infection are warranted. In view of these strongly positive outcomes, increased vigilance for acute hepatitis C becomes essential."

12/08/06

Reference
K E Corey, A S Ross, A Wurcel, and others. Outcomes and treatment of acute hepatitis C virus infection in a United States population. Clinical Gastroenterology and Hepatology 4(10): 1278-1282. October 2006.