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

• Published in: Journal of general internal medicine : JGIM 2013-05, Vol.28 (5), p.734-738
• Main Authors: Driver, Todd H., Terrault, Norah, Saxena, Varun
• Format: Article
• Language: English
• Subjects: Acute Disease; Antiviral Agents - therapeutic use; Antiviral drugs; Biological and medical sciences; Clinical Practice: Clinical Vignettes; Coinfection; Drug Therapy, Combination; General aspects; Hepacivirus - isolation & purification; Hepatitis; Hepatitis C - complications; Hepatitis C - diagnosis; Hepatitis C - drug therapy; Hepatitis C - transmission; Hepatitis C virus; HIV; HIV Infections - complications; Homosexuality; Human immunodeficiency virus; Human viral diseases; Humans; Infectious diseases; Interferon; Interferon-alpha - therapeutic use; Internal Medicine; Male; Medical diagnosis; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Polyethylene Glycols - therapeutic use; Recombinant Proteins - therapeutic use; Ribavirin - therapeutic use; RNA, Viral - blood; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Viral hepatitis; Viral Load
• ISSN: 0884-8734; 1525-1497
• DOI: 10.1007/s11606-012-2258-3

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.