Hepatic Flares in Chronic Hepatitis C: Spontaneous Exacerbation Vs Hepatotropic Viruses Superinfection

Overview

Journal World J Gastroenterol

Publisher Baishideng Publishing Group

Specialty Gastroenterology

Date 2014 Jun 20

PMID 24944463

Citations 9

Authors

Evangelista Sagnelli

Caterina Sagnelli

Mariantonietta Pisaturo

Nicola Coppola

Affiliations

Soon will be listed here.

Abstract

The hepatitis C virus (HCV) causes an acute infection that is frequently asymptomatic, but a spontaneous eradication of HCV infection occurs only in one-third of patients. The remaining two-thirds develop a chronic infection that, in most cases, shows an indolent course and a slow progression to the more advanced stages of the illness. Nearly a quarter of cases with chronic hepatitis C (CHC) develop liver cirrhosis with or without hepatocellular carcinoma. The indolent course of the illness may be troubled by the occurrence of a hepatic flare, i.e., a spontaneous acute exacerbation of CHC due to changes in the immune response, immunosuppression and subsequent restoration, and is characterized by an increase in serum aminotransferase values, a frequent deterioration in liver fibrosis and necroinflammation but also a high frequency of sustained viral response to pegylated interferon plus ribavirin treatment. A substantial increase in serum aminotransferase values during the clinical course of CHC may also be a consequence of a superinfection by other hepatotropic viruses, namely hepatitis B virus (HBV), HBV plus hepatitis D virus, hepatitis E virus, cytomegalovirus, particularly in geographical areas with high endemicity levels. The etiology of a hepatic flare in patients with CHC should always be defined to optimize follow-up procedures and clinical and therapeutic decisions.

Citing Articles

Chronic Hepatitis C: Acute Exacerbation and Alanine Aminotransferase Flare.

Kanda T, Matsumoto N, Ishii T, Arima S, Shibuya S, Honda M Viruses. 2023; 15(1).

PMID: 36680223 PMC: 9861769. DOI: 10.3390/v15010183.

Enhanced host immune responses in presence of HCV facilitate HBV clearance in coinfection.

Liu S, Zhao K, Su X, Gao X, Yao Y, Kong R Virol Sin. 2022; 37(3):408-417.

PMID: 35523417 PMC: 9243674. DOI: 10.1016/j.virs.2022.04.001.

Viral Hepatitis E and Chronicity: A Growing Public Health Concern.

Thakur V, Ratho R, Kumar S, Saxena S, Bora I, Thakur P Front Microbiol. 2020; 11:577339.

PMID: 33133046 PMC: 7550462. DOI: 10.3389/fmicb.2020.577339.

Co-Occurrence of Hepatitis A Infection and Chronic Liver Disease.

Kanda T, Sasaki R, Masuzaki R, Takahashi H, Mizutani T, Matsumoto N Int J Mol Sci. 2020; 21(17).

PMID: 32887515 PMC: 7504211. DOI: 10.3390/ijms21176384.

Eradication of HCV Infection with the Direct-Acting Antiviral Therapy in Renal Allograft Recipients.

Calogero A, Sagnelli E, Creta M, Angeletti S, Peluso G, Incollingo P Biomed Res Int. 2019; 2019:4674560.

PMID: 31179323 PMC: 6507153. DOI: 10.1155/2019/4674560.

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