ACUTE HEPATITIS C IN SPAIN. RETROSPECTIVE STUDY OF 131 PATIENTS

Background and Aims: There are few studies concerning epidemiology and evolution of acute hepatitis C (AHC).We conducted a multicentre study to know the epidemiological, clinical and biochemical aspects, genotypes, response to treatment and spontaneous evolution in patients with AHC.Methods: Retrospective data of 139 patients from 18 hospitals of Spain were analyzed.Results are shown as X±DS.Results: Eight were excluded.Age of the 131 patients:43±16 years (17-83).Probable routes of transmission: nosocomial 40% (surgery 8%), IDUs 21%, sexual 12%, inoculation 6%, transfusions 3%, travel to Egypt 1%, unknown 17%.Symptoms 69%.Time from onset of symptoms until confirmation by PCR:50±68 days (11-450).Genotypes: Gt 1: 82%, Gt 2: 2%, Gt 3: 10%, Gt 4: 6%.77 were treated (59%).The delay from onset of symptoms to treatment was 14±13 months (2-58).SVR was 80.5% in the treated group and 57% in the observational group (p = 0.004).No SD in SVR between PEG-IFN+RBV vs. monotherapy (47% vs. 44%).Patients treated within 12 weeks from symptoms achieved 96.4% RVS vs 86.6% after w12 (p = 0.04).No SD in SVR when treatment started at 4, 8 or 12 weeks were found.All patients with RNA-HCV(-) in w4 resolved spontaneously or with treatment vs.only 59% if +ve (p = 0.004).SVR when RNA-HCV(-) at w12 was 91% vs. 8.6% if +ve (p = 0.001).Those with RNA-HCV(-) at w12 did not benefit of treatment (SVR 91% in both groups).In non treated patients with Bilirubin >5 mg/dL spontaneous resolution occurred in 78% vs 40% if Brb ≤5 mg/dL (p = 0.004).Age, sex or BMI were not related to evolution. Conclusions:1.The most frequent source of infection was nosocomial.2. 2/3 were symptomatic.3. RBV was not useful.4. Treatment significantly avoided chronicity. 5. Treatment after w12 is less effective.6. Patients with HCV-RNA(-) in the first 12 weeks achieved high rates of spontaneous resolution.7.There were not differences in the SVR when treatment started in weeks 4, 8 or 12. 8.All patients RNA-HCV(-) at w4 resolved the infection, with or without treatment vs 59% if viremia persisted.9. Patients with RNA-HCV(-) at w12 resolved the hepatitis in 91%.