Infectious Diseases

Overt hepatitis C: epidemiological and clinical characteristics

We report several cases of overt acute hepatitis C manifesting as infectious jaundice. These patients were misdiagnosed upon admission to hospital or during their visits to outpatient departments due to the low alertness for hepatitis C among clinicians and the predominance of subclinical forms of the disease. Considering the cyclicity of the process (prodromal period of a mixed type), intoxication, disorders of bilirubin metabolism, cytolysis, and hepatomegaly, physicians at both outpatient and inpatient units established a diagnosis of acute viral hepatitis, without specifying the type of etiological agent. Detailed questioning of a patient is crucial for the differential diagnosis between acute hepatitis B and hepatitis C, especially in patients with non-specific manifestations (promiscuity without protection in the first case and use of intravenous drugs in the second case). During the eruptive phase, the patients developed specific hepatitis C symptoms, including severe cytolysis (35–40 times the upper limit of normal values) with a relatively mild course of the disease, which persisted during the period of convalescence. Correct
diagnosis of hepatitis C was established only after laboratory testing using enzyme-linked  immunosorbent assay (ELISA) and polymerase chain reaction (PCR).
Key words: acute hepatitis C, clinical characteristics, clinical syndromes, case report, disease course, subclinical form, epidemiology.
For citation: Kalinina E.N., Emelyanova A.N., Epiphantseva N.V., Chuprova G.A., Nakhapetyan N.A. Overt hepatitis C: epidemiological and clinical characteristics. Infekc. bolezni (Infectious diseases). 2019; 17(2): 88–92. (In Russian).

DOI: 10.20953/1729-9225-2019-2-88-92