Also in the May 2008 American Journal of Gastroenterology, S.M. Kamal presented a systematic review of acute hepatitis C, or the first six months after infection. About 25% of people with acute HCV infection spontaneously clear the virus without treatment, while the rest go on to develop chronic infection. A MEDLINE medical literature search of prior studies revealed no consistent, reliable predictors of spontaneous HCV clearance. Several clinical trials found that treatment of acute hepatitis C with interferon-based therapy produced high SVR rates ranging from 75% to 100%. But because acute HCV infection is often asymptomatic, many people are never diagnosed during this early stage; in addition, decisions about therapy are complicated by the fact that some patients will clear the virus even if left untreated. “Optimization of therapy for acute hepatitis C infection and identification of predictors of SVR represent a real challenge,” the researchers concluded. “[A]n improvement in our ability to diagnose and treat patients with acute hepatitis C would have a significant impact on the prevalence of chronic hepatitis and its associated complications particularly in countries with a high endemic background of the infection.”

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