Treatment of acute hepatitis C infection in HIV‐infected patients: a retrospective analysis of eleven cases

Vogel, Martin; Bieniek, B; Jessen, Heiko; Schewe, CK; Hoffmann, Christian; Baumgarten, Axel; Kroidl, Arne; Bogner, Johannes R.; Spengler, Ulrich; Rockstroh, Jürgen K.

doi:10.1111/j.1365-2893.2005.00580.x

Cited by 58 publications

(31 citation statements)

References 10 publications

(15 reference statements)

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“…The first studies to identify this problem were from Northern Europe, specifically England, France, Germany, and The Netherlands in 2004 and 2005 [7-9, 10•, 11,12]. They reported clusters of new HCV infections in HIV-infected MSM and suggested that transmission could be linked to high-risk sexual and drug-use behaviors.…”

Section: Epidemic Of Hcv Infection In Hiv-infected Msm In Northern Eumentioning

confidence: 97%

“…The earliest published studies of treatment of new HCV infection in HIV-infected MSM were retrospective, the treatment regimens were not standardized (ranging from IFN monotherapy to pegylated IFN and ribavirin [pIFN + RBV] from 24 to 48 weeks), and there was a wide range of sustained virologic response (SVR) rates, from 0% to 91% [8,12,14,20] (Table 1). Prospective studies followed quickly that were similar to each other in allowing time (typically 12 weeks from diagnosis) for spontaneous clearance to occur, and then most patients who did not spontaneously clear were treated with a combination of pIFN + RBV for 24 weeks [10,13,15] (Table 1).…”

Section: Treatmentmentioning

confidence: 99%

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Epidemic of Sexually Transmitted Hepatitis C Virus Infection Among HIV-Infected Men

Fierer

2010

Curr Infect Dis Rep

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Sexual contact is thought to be an inefficient mode of hepatitis C virus (HCV) transmission. However, reports of sexually transmitted HCV infection among HIV-infected men who have sex with men (MSM) began to appear in 2004. The patients were of early middle age with well-controlled HIV infection, participated in unprotected receptive sex, and frequently used noninjection recreational drugs. Molecular studies showed evidence of clusters of transmission between patients in different countries in Europe. Spontaneous clearance was relatively rare, but treatment with pegylated interferon and ribavirin resulted in cure in about two thirds of patients. Of concern was the finding of moderately advanced fibrosis during the early stages of HCV infection. HIV-infected MSM are a new risk group for HCV infection and so should be screened regularly for HCV infection.

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Section: Epidemic Of Hcv Infection In Hiv-infected Msm In Northern Eumentioning

confidence: 97%

Section: Treatmentmentioning

confidence: 99%

Epidemic of Sexually Transmitted Hepatitis C Virus Infection Among HIV-Infected Men

Fierer

2010

Curr Infect Dis Rep

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“…However, better response rates were reported among 11 acutely infected German patients, with 10 having SVR. 131 Ten patients with genotype 4 HCV and HIV were treated in France following a suspected common source sexually transmitted infection cluster. Treatment was provided within a mean time of 49 days from the onset of acute hepatitis, and a variety of interferon-based regimens were used.…”

Section: Treatment Of Acute Hcv Infectionmentioning

confidence: 99%

Acute hepatitis C virus infection: A chronic problem

et al. 2007

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S ince the discovery of the hepatitis C virus (HCV) in the late 1980s, there has been an explosion of information regarding its natural history, treatment, and replication cycle. Nonetheless, there are still relatively few data regarding acute HCV infection. By convention, the term acute hepatitis refers to the presence of clinical signs or symptoms of hepatitis for a period of 6 months or fewer after the presumed time of HCV exposure. Early studies of posttransfusion patients who developed non-A, non-B hepatitis provide a clinical picture of early infection. 1 Following the availability of specific serologic and virologic tests, most such patients were shown to have acute HCV infection. After acute infection, HCV RNA may become detectable in the serum/plasma in as little as 2 weeks ( Fig. 1). Several weeks later, a high percentage of patients experience an increase in serum aminotransferase levels consistent with the development of acute hepatocellular injury. In the majority of cases, patients develop mild constitutional symptoms, including abdominal pain, nausea, vomiting, anorexia, and fatigue. During this acute infection, serum aminotransferases often peak below 1000 IU/mL and may return to normal levels. A minority develops sufficient elevations in bilirubin to lead to overt jaundice or the development of dark urine. Unless the clinical suspicion is high, few patients will be tested for HCV RNA or HCV antibody seroconversion. However, in the majority-but not all-of infected patients, HCV RNA persists, and a chronic disease state develops.The reasons for the general lack of data regarding acute HCV infection are multifactorial and include (1) the relatively high percentage of asymptomatic or unrecognized early infections, (2) the lack of large-scale identification of chronic carriers in the general population who serve as a reservoir for infection, and (3) the decreased number of acute infections that occur in controlled clinical settings such as that of blood transfusions. These factors and the lack of nonprimate animal models necessitate reliance on retrospective studies in chronic carriers, the use of limited historical collections of banked sera, and the extrapolation of outcomes based on small disease outbreaks in unique settings (for example, transmission from a physician to a patient in the operating room setting or following parenteral exposure in healthcare workers). Moreover, there exist only a limited number of population cohorts that continue to experience high rates of HCV transmission (for example, Egypt); nonetheless, there is a growing body of information regarding the clinical presentation, natural history, and treatment outcomes of acute HCV infection.In this article, we review the current information regarding our understanding of the epidemiology, virology, and immunology of HCV with a particular emphasis on acute HCV infection. In addition, we review recent data related to interferon-based treatment intervention and propose an algorithm for the diagnosis and management of acute HCV inf...

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“…[2][3][4] In the UK in 2008 the Health Protection Agency set up an enhanced surveillance of recently acquired HCV. 5 Data were collected prospectively (January 2008 -March 2010) from 22 UK sites in London and the south-east.…”

Section: The Start Of the Epidemicmentioning

confidence: 99%