Dias Cátia, Pipa Sara, Mota Margarida
Department of Internal Medicine, Centro Hospitalar de Vila Nova de Gaia, Espinho, Portugal.
IDCases. 2018 Aug 30;14:e00448. doi: 10.1016/j.idcr.2018.e00448. eCollection 2018.
The diagnosis of acute hepatitis C (HCV) infection is rare since the majority of cases are asymptomatic, which makes the infection usually detected in a chronic phase, most of the time using serological tests. The main route of HCV transmission is percutaneous, with sexual transmission occurring more often in men who have sex with men. The analytical alterations of acute hepatitis C are varied but usually present with ALT elevation higher than AST, very rarely with hepatic insufficiency. We report a case of a patient with a clinical and analytical picture compatible with toxic acute hepatitis, accompanied by hepatic insufficiency, with negative serology for hepatotropic viruses and with no history compatible with the use of substances with hepatic toxicity other than alcohol. During the diagnostic investigation it was concluded that the patient had acute HCV hepatitis and that the transmission route was heterosexual.
急性丙型肝炎病毒(HCV)感染的诊断较为罕见,因为大多数病例无症状,这使得感染通常在慢性期才被检测到,多数情况下是通过血清学检测。HCV的主要传播途径是经皮传播,性传播在男男性行为者中更为常见。急性丙型肝炎的分析性改变多种多样,但通常表现为ALT升高高于AST,极少出现肝功能不全。我们报告一例患者,其临床和分析表现符合中毒性急性肝炎,伴有肝功能不全,嗜肝病毒血清学阴性,且无除酒精外与使用肝毒性物质相符的病史。在诊断调查过程中,得出该患者患有急性HCV肝炎且传播途径为异性传播的结论。