Journal Article

Risk Factors and Outcome among a Large Patient Cohort with Community-Acquired Acute Hepatitis C in Italy

T. Santantonio, E. Medda, C. Ferrari, P. Fabris, G. Cariti, M. Massari, S. Babudieri, M. Toti, R. Francavilla, F. Ancarani, G. Antonucci, G. Scotto, V. Di Marco, G. Pastore and T. Stroffolini

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 43, issue 9, pages 1154-1159
Published in print November 2006 | ISSN: 1058-4838
Published online November 2006 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/507640
Risk Factors and Outcome among a Large Patient Cohort with Community-Acquired Acute Hepatitis C in Italy

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Background. The epidemiology of acute hepatitis C has changed during the past decade in Western countries. Acute HCV infection has a high rate of chronicity, but it is unclear when patients with acute infection should be treated.

Methods. To evaluate current sources of hepatitis C virus (HCV) transmission in Italy and to assess the rate of and factors associated with chronic infection, we enrolled 214 consecutive patients with newly acquired hepatitis C during 1999–2004. The patients were from 12 health care centers throughout the country, and they were followed up for a mean (± SD) period of 14 ± 15.8 months. Biochemical liver tests were performed, and HCV RNA levels were monitored.

Results. A total of 146 patients (68%) had symptomatic disease. The most common risk factors for acquiring hepatitis C that were reported were intravenous drug use and medical procedures. The proportion of subjects with spontaneous resolution of infection was 36%. The average timespan from disease onset to HCV RNA clearance was 71 days (range, 27–173 days). In fact, 58 (80%) of 73 patients with self-limiting hepatitis experienced HCV RNA clearance within 3 months of disease onset. Multiple logistic regression analyses showed that none of the variables considered (including asymptomatic disease) were associated with increased risk of developing chronic hepatitis C.

Conclusions. These findings underscore the importance of medical procedures as risk factors in the current spread of HCV infection in Italy. Because nearly all patients with acute, self-limiting hepatitis C—both symptomatic and asymptomatic—have spontaneous viral clearance within 3 months of disease onset, it seems reasonable to start treatment after this time period ends to avoid costly and useless treatment.

Journal Article.  3086 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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