The significance of Hepatitis A virus super-infection in patients with chronic Hepatitis C had been a matter of debate.
While some studies suggested an incidence of fulminant Hepatitis A of up to 35%, this could not be confirmed by others.
Dr Heiner Wedemeyer and colleagues from Germany identified 17 anti-Hepatitis C-positive patients with acute Hepatitis A.
The patients were identified from a cohort of 3170 anti-Hepatitis C-positive patients recruited at a single center over a period of 12 years.
Importantly, none of the anti-Hepatitis C-positive patients had a fulminant course of Hepatitis A.
|Hep C virus replication increased after Hep A recovery|
|Journal of Clinical Oncology|
Hepatitis C virus-RNA was detected by PCR in 84% of the anti- Hepatitis C virus-positive/anti-Hepatitis A-immunoglobulin-negative patients.
However, the investigators detected Hepatitis C virus-RNA only in 65% of anti- Hepatitis C virus-positive patients with acute Hepatitis A.
The investigators noted that this may indicate suppression of Hepatitis C virus replication during Hepatitis A infection.
The investigative team observed that previous Hepatitis A infection had no effect on Hepatitis C replication.
After Hepatitis A recovery, the team found increased Hepatitis C virus replication in 6 of 9 patients with serial quantitative Hepatitis C virus-RNA values.
The team noted that 2 patients remained Hepatitis C virus-RNA negative after clearance of Hepatitis A throughout follow-up of at least 2 years.
Dr Wedemeyer's team comments, “Hepatitis A virus super-infection is associated with decreased Hepatitis C-RNA replication.”
“This may lead to recovery from Hepatitis C in some individuals.”
“Fulminant Hepatitis A is not frequent in patients with chronic Hepatitis C recruited at a tertiary referral center.”