Skip to main content

Advertisement

Log in

Treatment of acute hepatitis C: recommendations from an expert panel of the Italian Society of Infectious and Tropical Diseases

  • Review
  • Published:
Infection Aims and scope Submit manuscript

Abstract

Aim

This paper is aimed at providing practical recommendations for the management of acute hepatitis C (AHC).

Methods

This is an expert position paper based on the literature revision. Final recommendations were graded by level of evidence and strength of the recommendations.

Results

Treatment of AHC with direct-acting antivirals (DAA) is safe and effective; it overcomes the limitations of INF-based treatments.

Conclusions

Early treatment with DAA should be offered when available.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Santantonio T, Wiegand J, Gerlach JT. Acute hepatitis C: current status and remaining challenges. J Hepatol. 2008;49:625–33.

    Article  CAS  PubMed  Google Scholar 

  2. Westbrook RH, Dusheiko G. Natural history of hepatitis C. J Hepatol. 2014;61:S58–68.

    Article  PubMed  Google Scholar 

  3. Williams IT, Bell BP, Kuhnert W, Alter MJ. Incidence and transmission patterns of acute hepatitis C in the United States, 1982–2006. Arch Intern Med. 2011;171:242–8.

    Article  PubMed  Google Scholar 

  4. Spada E, Mele A, Mariano A, Zuccaro O, Tosti ME. SEIEVA collaborating group. Risk factors for and incidence of acute hepatitis C after the achievement of blood supply safety in Italy: results from the national surveillance system. J Med Virol. 2013;85:433–40.

    Article  PubMed  Google Scholar 

  5. Santantonio T, Medda E, Ferrari C, et al. Risk factors and outcome among a large patient cohort with community-acquired acute hepatitis C in Italy. Clin Infect Dis. 2006;43:1154–9.

    Article  CAS  PubMed  Google Scholar 

  6. Suryaprasad AG, White JZ, Xu F, et al. Emerging epidemic of hepatitis C virus infections among young nonurban persons who inject drugs in the United States, 2006–2012. Clin Infect Dis. 2014;59:1411–9.

    Article  CAS  PubMed  Google Scholar 

  7. Indolfi G, Azzari C, Resti M. Perinatal transmission of hepatitis C virus. J Pediatr. 2013;163:1549–52.

    Article  PubMed  Google Scholar 

  8. van de Laar TJ, van der Bij AK, Prins M, et al. Increase in HCV incidence among men who have sex with men in Amsterdam most likely caused by sexual transmission. J Infect Dis. 2007;196:230–8.

    Article  PubMed  Google Scholar 

  9. Lambers FA, Prins M, Thomas X, Molenkamp R, Kwa D, Brinkman K, van der Meer JT, Schinkel J. MOSAIC (MSM Observational Study of Acute Infection with hepatitis C) study group. Alarming incidence of hepatitis C virus re-infection after treatment of sexually acquired acute hepatitis C virus infection in HIV-infected MSM. AIDS. 2011;3(25):F21–7.

    Article  Google Scholar 

  10. Wandeler G, Gsponer T, Bregenzer A, et al. Hepatitis C virus infections in the Swiss HIV Cohort Study: a rapidly evolving epidemic. Clin Infect Dis. 2012;15(55):1408–16.

    Article  Google Scholar 

  11. McFaul K, Maghlaoui A, Nzuruba M, et al. Acute hepatitis C infection in HIV-negative men who have sex with men. J Viral Hepat. 2015;22:535–8.

    Article  CAS  PubMed  Google Scholar 

  12. Vanhommerig JW, Lambers FA, Schinkel J, et al. Risk factors for sexual transmission of hepatitis C virus among human immunodeficiency virus-infected men who have sex with men: a case-control study. Open Forum Infect Dis. 2015;2:ofv115.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Martin TC, Martin NK, Hickman M, et al. HCV reinfection incidence and treatment outcome among HIV-positive MSM in London. AIDS. 2013;27:2551–7.

    Article  PubMed  Google Scholar 

  14. Martinello M, Grebely J, Petoumenos K, et al. HCV reinfection incidence among individuals treated for recent infection. J Viral Hepat. 2016. https://doi.org/10.1111/jvh.12666.

    Google Scholar 

  15. Ingiliz P, Martin TC, Rodger A, et al. HCV reinfection incidence and spontaneous clearance rates in HIV-positive men who have sex with men in Western Europe. J Hepatol. 2017;66:282–7.

    Article  PubMed  Google Scholar 

  16. Kim AY, Nagami EH, Birch CE, Bowen MJ, Lauer GM, McGovern BH. A simple strategy to identify acute hepatitis C virus infection among newly incarcerated injection drug users. Hepatology. 2013;57:944–52.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Pawlotsky JM, Aghemo A, Back D, et al. EASL recommendations on treatment of hepatitis C 2016. J Hepatol. 2017;66:153–194.

    Article  Google Scholar 

  18. AASLD-IDSA. Recommendations for testing, managing, and treating hepatitis C 2016. http://www.hcvguidelines.org. Accessed 13 Sept 2017.

  19. Deterding K, Grüner N, Buggisch P, et al. Hep-Net Acute HCV-III Study Group. Delayed versus immediate treatment for patients with acute hepatitis C: a randomized controlled non-inferiority trial. Lancet Infect Dis. 2013;13:497–506.

    Article  PubMed  Google Scholar 

  20. Santantonio T, Fasano M, Sagnelli E, et al. Acute hepatitis C: a 24 week course of Peg-interferon a-2b versus a 12 week-course of Peginterferon a-2b alone or with ribavirin. Hepatology. 2014;59:2101–9.

    Article  CAS  PubMed  Google Scholar 

  21. Kamal SM, Moustafa KN, Chen J, et al. Duration of peginterferon therapy in acute hepatitis C: a randomized trial. Hepatology. 2006;43:923–31.

    Article  CAS  PubMed  Google Scholar 

  22. Kamal SM, Fouly AE, Kamel RR, et al. Peginterferon alfa-2b therapy in acute hepatitis C: impact of onset of therapy on sustained virologic response. Gastroenterology. 2006;130:632–8.

    Article  CAS  PubMed  Google Scholar 

  23. Kamal SM, Ismail A, Graham CS, et al. Pegylated interferon a therapy in acute hepatitis C: relation to hepatitis C virus-specific T cell response kinetics. Hepatology. 2004;39:1721–31.

    Article  CAS  PubMed  Google Scholar 

  24. Tillmann HL, Thompson AJ, Patel K, et al. A polymorphism near IL28B is associated with spontaneous clearance of acute hepatitis C virus and jaundice. Gastroenterolgy. 2010;139:1586–92.

    Article  CAS  Google Scholar 

  25. Vogel M, Nattermann J, Baumgarten A, et al. Pegylated interferon-alpha for the treatment of sexually transmitted acute hepatitis C in HIV-infected individuals. Antivir Ther. 2006;11:1097–101.

    CAS  PubMed  Google Scholar 

  26. Dominguez S, Ghosn J, Valantin MA, et al. Efficacy of early treatment of acute hepatitis C infection with pegylated interferon and ribavirin in HIV-infected patients. AIDS. 2006;20:1157–61.

    Article  CAS  PubMed  Google Scholar 

  27. Matthews GV, Hellard M, Haber P, et al. Australian Trial in Acute Hepatitis C Study Group. Characteristics and treatment outcomes among HIVinfected individuals in the Australian Trial in Acute Hepatitis C. Clin Infect Dis. 2009;48:650–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Piroth L, Larsen C, Binquet C, Steering Committee of the HEPAIG Study, et al. Treatment of acute hepatitis C in human immunodeficiency virus infected patients: the HEPAIG study. Hepatology. 2010;52:1915–21.

    Article  PubMed  Google Scholar 

  29. Dore GJ, Hellard M, Matthews GV, et al. Australian Trial In Acute Hepatitis C Study Group. Effective treatment of injecting drug users with recently acquired hepatitis C virus infection. Gastroenterology. 2010;138(1):123–35.

    Article  PubMed  Google Scholar 

  30. Lambers FA, Brinkman K, Schinkel J, et al. MOSAIC (MSM Observational Study of Acute Infection with hepatitis C) study group. Treatment of acute hepatitis C virus infection in HIV-infected MSM: the effect of treatment duration. AIDS. 2011;25(10):1333–6.

    Article  PubMed  Google Scholar 

  31. Grebely J, Hellard M, Applegate T, ATAHC Study Group, et al. Virological responses during treatment for recent hepatitis C virus: potential benefit for ribavirin use in HCV/HIV co-infection. AIDS. 2012;26:1653–61.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Fierer DS, Dieterich DT, Mullen MP, et al. New York Acute Hepatitis C Surveillance Network. Telaprevir in the treatment of acute hepatitis C virus infection in HIV-infected men. Clin Infect Dis. 2014;58:873–9.

    Article  CAS  PubMed  Google Scholar 

  33. Boesecke C, van Assen S, Stellbrink HJ, et al. Peginterferon-alfa mono-therapy in the treatment of acute hepatitis C in HIV-infection. J Viral Hepat. 2014;21(11):780–5.

    Article  CAS  PubMed  Google Scholar 

  34. Liu CH, Sheng WH, Sun HY, et al. Peginterferon plus ribavirin for HIV-infected patients with treatment-naïve acute or chronic HCV infection in Taiwan: a Prospective Cohort Study. Sci Rep. 2015;30(5):17410.

    Article  Google Scholar 

  35. Doyle JS, Deterding K, Grebely J, et al. InC3 Study Group. Response to treatment following recently acquired hepatitis C virus infection in a multicentre collaborative cohort. J Viral Hepat. 2015;22(12):1020–32.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Boesecke C, Ingiliz P, Reiberger T, NEAT Study Group, et al. Dual treatment of acute HCV infection in HIV co-infection: influence of HCV genotype upon treatment outcome. Infection. 2016;44(1):93–101.

    Article  CAS  PubMed  Google Scholar 

  37. Zhang B, Nguyen NH, Yee BE, et al. Treatment of acute hepatitis C infection with pegylated interferon and ribavirin in patients coinfected with human immunodeficiency virus: a systematic review and meta-analysis. Intervirology. 2015;58:242–9.

    Article  CAS  PubMed  Google Scholar 

  38. European AIDS Clinical Society (EACS). Guidelines 2017. http://www.eacsociety.org. Accessed March 15 2017.

  39. Fabrizi F, Dixit V, Messa P, et al. Interferon therapy of acute hepatitis C in dialysis patients: meta-analysis. J Viral Hepat. 2012;19:784–9.

    Article  CAS  PubMed  Google Scholar 

  40. Fierer D, El Sayed A,Palaniswami P. Sofosbuvir/Ledipasvir in the Treatment of Early (“acute”) HCV Infection in HIV-infected Men. EASL Meeting 2017, Amsterdam; Abs THU-250.

  41. Deterding K, Spinner CD, Schott E, et al. Ledipasvir plus sofosbuvir fixed-dose combination for 6 weeks in patients with acute hepatitis C virus genotype 1 monoinfection (HepNet Acute HCV IV): anopen-label, single-arm, phase 2 study. Lancet Infect Dis. 2017;17:215–22.

    Article  CAS  PubMed  Google Scholar 

  42. Basu P, Shah NJ, John N, Aloysius M, Brown R. Sofosbuvir and ledipasvir versus sofosbuvir and simeprevir combination therapy in the management of acute hepatitis C: a randomized open label prospective clinical pilot study. SLAM C study. Interim data. AASLD Meeting 2015, San Francisco, November 13–17; Abstract 1074.

  43. Rockstroh JK, Bhagani S, Hyland RH, et al. Ledipasvir/Sofosbuvir for 6 Weeks to treat acute hepatitis C genotype 1 or 4 infection in patients with HIV coinfecion: an open label, single-arm trial. Lancet Gastroent. 2017;2:347–53.

    Article  Google Scholar 

  44. Naggie S, Cooper C, Saag M, Workowski K, Ruane P, Towner WJ, et al. Sofosbuvir plus ribavirin without interferon for treatment of acute hepatitis C virus infection in HIV-1 infected individuals:SWIFT-C. Clin Infect Dis. 2017;63:528–31.

    Google Scholar 

  45. Fierer DS, Barbati Z, Dieterich D, et al. Sofosbuvir in the Treatment of Acute HCV Infection in HIV-infected Men. AASLD Liver Meeting 2015, San Francisco, November 13–17; Abstract 1090.

  46. Martinello M, Gane E, Hellard M, et al. Sofosbuvir and ribavirin for 6 weeks is not effective among people with recent hepatitis C virus infection: the DARE-C II study. Hepatology. 2016;64:1911–21.

    Article  CAS  PubMed  Google Scholar 

  47. Brancaccio G, Sorbo MC, Frigeri F, et al. Treatment of acute hepatitis C with ledipasvir and sofosbuvir in patients with hematological malignancies allows early re-start of chemotherapy. Clin Gastroenterol Hepatol. 2017. https://doi.org/10.1016/cgh.2017.10.032.

    PubMed  Google Scholar 

  48. Abravanel F, Métivier S, Chauveau M, Péron JM, Izopet J. Transmission of HCV NS5A inhibitor-resistant variants among HIV-infected men who have sex with men. Clin Infect Dis. 2016;63:1271–2.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Giovanni B. Gaeta.

Ethics declarations

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gaeta, G.B., Puoti, M., Coppola, N. et al. Treatment of acute hepatitis C: recommendations from an expert panel of the Italian Society of Infectious and Tropical Diseases. Infection 46, 183–188 (2018). https://doi.org/10.1007/s15010-017-1107-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s15010-017-1107-z

Keywords

Navigation