[Acute hepatitis C. A clinical and epidemiological study]

The discovery of the hepatitis C virus (HCV) and the possibility of determining anti-HCV serum antibodies has permitted greater etiological, clinical and epidemiological knowledge of non A non B hepatitis (NANB).

The clinical and epidemiological characteristics of 47 patients with acute hepatitis C were studied. Diagnosis was based on compatible clinical and analytical picture as well as positivity of the anti-HCV antibodies.

Thirty-eight percent of the patients were intravenous drug abusers (IVDA). Thirty-four percent had transfusion antecedents and the remaining were sporadic forms of which 3 cases corresponded to health care workers. The study of other viral markers demonstrated that only in the IVDA collective did infections by hepatitis B and delta (HBV and HDV) and by the human immunodeficiency virus (HIV) coexist. Anti-HCV antibodies were detected between 15 days and 8 months (mean 38 +/- 74 days) of clinic initiation; with no differences being found regarding the form of contagion. The incubation period of transfused patients was 50 +/- 15 days. In 2 cases the disease followed a biphasic course, in 4 patients a cholestatic profile was observed, and in 12 the hepatitis was anicteric. In 28% of the cases controlled over 6 months the disease autolimited itself and 72% developed active chronic hepatitis.

Most cases of acute hepatitis C are of intravenous origin with a prolonged period of anti-HCV positivization. No differences exist in the clinical picture of the disease regarding the form of contagion and the great tendency to chronicity of hepatitis C is confirmed, regardless of the mechanisms of acquiring the disease.