Clearance of HCV RNA following acute hepatitis A superinfection

Dig Liver Dis. 2009 May;41(5):371-4. doi: 10.1016/j.dld.2007.11.015. Epub 2008 Jan 7.

Abstract

A transient reduction of hepatitis C virus replication during the course of acute hepatitis A virus infection has already been reported in the literature. The present study reports the case study of a subject with chronic hepatitis due to hepatitis C virus who went on to develop an acute hepatitis A. From the early onset of acute disease, hepatitis C virus ribonucleic acid became undetectable. Following recovery from acute hepatitis, alanine amino-transferase levels became persistently normal and liver biopsy revealed a reduction in the Knodell histological activity index score. Hepatitis C virus ribonucleic acid clearance was maintained up to 4 years after the onset of acute hepatitis A. During the course of the acute disease, a sharp increase in interferon gamma levels was detected in serum and in the supernatant of both unstimulated and phytoemagglutinin/lipopolysaccharide-stimulated peripheral blood mononuclear cells. Interferon gamma levels were still high 3 months later. We hypothesize that acute hepatitis A virus superinfection during the course of chronic hepatitis C may lead to hepatitis C virus ribonucleic acid clearance through an immunological mechanism related to interferon gamma production.

Publication types

  • Case Reports

MeSH terms

  • Alanine Transaminase / blood
  • Bilirubin / blood
  • Cytokines / blood
  • Hepacivirus / metabolism*
  • Hepatitis A / virology*
  • Hepatitis A Antibodies / blood
  • Hepatitis C, Chronic / blood
  • Hepatitis C, Chronic / diagnosis
  • Hepatitis C, Chronic / virology*
  • Humans
  • Liver / pathology
  • Liver / virology
  • Male
  • RNA, Viral / blood*
  • Remission, Spontaneous
  • Superinfection / virology*
  • Young Adult
  • gamma-Glutamyltransferase / blood

Substances

  • Cytokines
  • Hepatitis A Antibodies
  • RNA, Viral
  • gamma-Glutamyltransferase
  • Alanine Transaminase
  • Bilirubin