| [ Summary ] |
Unlike acute hepatitis A and B, acute hepatitis C is frequently asymptomatic and fulminant hepatitis is rare. At the present time, there are no specific therapies for any form of acute hepatitis. However, except in the case of hepatitis C, more cases are self-limiting and are followed by full recovery. 50 to 80% of patients with acute hepatitis C develop subsequent chronic hepatitis, and possibly hepatocellular carcinoma, several decades after the acute phase. If antiviral therapy can prevent acute hepatitis C from advancing to chronic hepatitis, it may eventually decrease the incidence of hepatocellular carcinoma in the future. 5 previous studies showed a decrease in chronicity among patients treated with alpha-interferon during the acute phase of the disease, in which the sustained response rate (loss of HCV RNA) ranged from 39 to 64%. For these reasons, patients with acute hepatitis C should be started on interferon therapy only if serum HCV RNA persists with a fluctuation of serum aminotransferase levels for 2 to 3 months after onset, indicating the patient is developing chronic hepatitis. Although even in small dose interferon therapy in the early phase of HCV in fection may be very effctive in eradicating the virus, the regimen for acute hepatitis C patients should as a general rule, be the same as for chronic hepatitis C patients. |