Symptomatic acute hepatitis C: the importance of diagnosis

Chronic infection by the hepatitis C virus (HCV) is one of the leading causes of chronic liver disease with an estimate worldwide prevalence of over 200 million people. Acute hepatitis C infection is usually asymptomatic and rarely identified in clinical practice, leading to chronic infection in about 80% of all cases. However, when symptomatic, only about 50% of acute infections progress to chronicity. Correctly identifying acute HCV infection is of paramount importance once it presents itself as an unique treatment opportunity with sustained virological response of about 90%, which is very distant from the 30% to 80% of sustained virological response achieved with standard chronic HCV treatment. The authors present four cases of acute HCV infection. There was spontaneous viral clearance in two pa- tients at week 12 of follow-up. In one case viral RNA was positive at week 12 but sustained virological response was eventually achieved after peginterferon alpha2a monotherapy.