Comparison of clinical, virologic and pathologic features in patients withacute hepatitis B and C

Background and Aims: The clinical outcomes of adult-acquired acute infectio n of hepatitis C virus (HCV) and hepatitis B virus (HBV) are quite differen t. In order to compare the clinical, biochemical, virologic and pathologic pictures in these two groups of patients, we enrolled 22 adult patients wit h acute hepatitis C and 16 adult patients with acute hepatitis B, on whom l iver biopsies were performed within 3 months of acute onset of the illness. Results: The results showed that a significantly younger age, a higher rati o of the clinical symptoms of jaundice, nausea, vomiting, and poor appetite , a higher mean serum level of alanine transaminase, aspartate transaminase , and total bilirubin were present in patients with acute hepatitis B patie nts than in those with acute hepatitis C (P < 0.05). There was a significan tly higher degree of periportal inflammation and total necro-inflammatory a ctivity in the acute hepatitis B patients (P = 0.002 and 0.049, respectivel y). Fifteen (68.2%) of the 22 patients with acute hepatitis C had detectabl e serum HCV-RNA, but only two (14.3%) of the 14 tested patients with acute hepatitis B had detectable serum HBV-DNA, detected by using the branched DN A signal amplification assay. Eighteen (82%) of the 22 acute hepatitis C pa tients and none of the 16 acute hepatitis B patients progressed into a chro nic hepatitis stage (P < 0.001). Conclusion: The manifestations of mild clinical symptoms, lower mean serum transaminases and bilirubin levels, a lesser degree of histological peripor tal necroinflammation, and more patients with a high circulatory viral load among the acute hepatitis C patients, may lead to more of that group devel oping chronicity than patients with acute hepatitis B. (C) 2001 Blackwell S cience Asia Pty Ltd.