LFT in acute HCV

Q: Normalization of the serum aminotransferases signifies resolution of acute Hepatitis C infection?

A) True

B) False

Answer: B

Aminotransferase i.e., alanine transaminase (ALT) and aspartate transaminase (AST) can be very deceiving in acute Hepatitis C virus (HCV) infection. It can vary widely during acute infection with short periods of time. It can vary from  20 times the upper limit of normal to within normal range. Elevation of LFTs starts prior to symptoms.

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References:

1. Loomba R, Rivera MM, McBurney R, et al. The natural history of acute hepatitis C: clinical presentation, laboratory findings and treatment outcomes. Aliment Pharmacol Ther 2011; 33:559.

2. Maheshwari A, Thuluvath PJ. Management of acute hepatitis C. Clin Liver Dis 2010; 14:169.

3. McGovern BH, Birch CE, Bowen MJ, et al. Improving the diagnosis of acute hepatitis C virus infection with expanded viral load criteria. Clin Infect Dis 2009; 49:1051.

4. Santantonio T, Sinisi E, Guastadisegni A, et al. Natural course of acute hepatitis C: a long-term prospective study. Dig Liver Dis 2003; 35:104.