The maximal delay from HCV contamination to diagnosis of acute hepatitis C was <3 months in 31 cases and <1 year in 13 cases. selleck chemicals The patients included in the follow-up study did not differ from those who were not included (data not shown) in terms of age, HIV infection (CD4 count, Centers for Disease Control and Prevention
clinical stage, treatment status), the presence of jaundice, concomitant sexually transmitted infections, the type of acute hepatitis C (acute symptomatic, seroconversion). Acute hepatitis C was diagnosed in these patients because of jaundice (n = 6) and/or other clinical symptoms (n = 13, mainly asthenia) and/or because of recent high-risk
sexual intercourse (n = 15) and/or elevated ALT levels (n = 39). Mean (± SD) ALT elevation at diagnosis was 484 ± 67 IU/L (11.1 ± 1.8 times the upper limit of normal). Acute hepatitis C was associated with another sexually transmitted disease in 20 (38%) patients, primarily syphilis (n = 14). Three patients also had positive hepatitis B surface this website antigenemia. In one case, acute hepatitis C was concomitant with HIV primoinfection. The CD4 count was above 500/mm3 in 29 patients, between 350 and 500/mm3 in 14 patients, between 200 and 350/mm3 in eight patients, and below 200/mm3 in two patients. Antiretroviral therapy was ongoing in 42 (79.2%) patients, and 31 patients had an undetectable HIV viral load. Of the 49 patients with an available HCV genotype, 28 (57.1%) 14 (28.6%), and 7 (14.3%) were infected with HCV genotype 4, 1, and 3, respectively. The mean HCV viral load was 5.8 ± 1.1 log10 IU/mL at the time of acute hepatitis C diagnosis. Among the 53 patients in the present study, eight experienced spontaneous clearance. The mean delay between
acute hepatitis C diagnosis and last negative HCV RNA in cases of spontaneous clearance was 25.9 ± 15.0 months. The cumulative rate of spontaneous HCV clearance was 8.3% 1 month after the diagnosis of acute CHIR-99021 price HCV infection, 11.0% at 3 months, and 16.5% at 6 months. The only difference observed between the patients with spontaneous HCV clearance and those without was the HIV viral load (3.54 ± 1.97 versus 2.43 ± 1.30 log10 copies/mL; P = 0.05) at the diagnosis of acute hepatitis C. No other difference was observed, particularly regarding the CD4 strata (P = 0.41) or the HCV viral load (5.58 ± 1.87 versus 5.86 ± 0.90 log10 IU/mL; P = 0.54). Overall, 13 patients were not treated for HCV. The characteristics of patients who were treated and those who were not are presented in Table 1.