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Acute hepatitis C virus infection is associated with high rates of spontaneous clearance and variable rates of treatment-induced clearance.
The benefit of early treatment versus awaiting spontaneous clearance is unknown, as is the optimal timing of treatment.
Dr Raymond Chung and colleagues from Massachusetts, USA performed a MEDLINE and EMBASE search for the time period 1950 to 2008.
 | | The sustained virologic response rate for treated patients was 78% | | Journal of Viral Hepatitis |
All English language abstracts using the search terms acute hepatitis C, hepatitis C and acute and hepatitis C and acute disease or acute infection were reviewed.
Bibliographies were reviewed.
The research team identified 22 studies including 1075 patients.
The sustained virologic response rate for treated patients was 78%, significantly higher than 55% in untreated patients.
Mean time from diagnosis to spontaneous clearance was 10 weeks.
The team noted that the sustained virologic response rates varied inversely with time from acute hepatitis c virus diagnosis.
The research team observed that the sustained virologic response rates for treatment within 12 weeks was 83%, significantly better than the clearance rates in untreated patients.
Response rates fell to 67% for treatment between 12 and 24 weeks, and decreased further to 63% for treatment beyond 24 weeks.
Rates of viral clearance in treated patients with acute hepatitis C virus infection were significantly higher than that in untreated patients.
Treatment rates were highest when treatment was initiated within 12 weeks of diagnosis.
Dr Chung's team concludes, "Based on these findings, we would advocate a 12 week period of observation for spontaneous clearance before treatment initiation."
"If no clearance has occurred by 12 weeks, treatment should be initiated."
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