Background/Aims: Self-limited acute hepatitis C virus (HCV) infection with
spontaneous recovery is only rarely observed in clinical practice. All exis
ting studies correlate strong cellular immune responses to the recovery fro
m HCV infection. Case Report: Here, we present a 49-year-old haemophiliac,
who had successfully recovered from an acute hepatitis, which was classifie
d retrospectively as HCV infection based on his antibody profiles. This pat
ient was reinfected with HCV 18 years later from an exogenous source, and s
uccessfully recovered from this reinfection within 2 months. After his firs
t hepatitis the patient displayed strong cellular responses against recombi
nant HCV proteins. During reinfection, T-cell proliferation was markedly re
duced, while HCV antibody titres increased. However, E2 antibodies were con
sistently not detectable. T-cell proliferation returned to the pre-reinfect
ion level only several months after loss of viraemia. Discussion: Our obser
vations resulted in the unexpected finding that our patient cleared HCV rei
nfection despite an apparent loss of his pre-existing T-cell reactivity in
the peripheral blood. Copyright (C) 2001 S. Karger AG, Basel.