Recovery from Acute Hepatitis C: A 51-Year-Old Man's Successful Treatment Journey

Acute viral hepatitis can present with a variety of symptoms and requires timely diagnosis and treatment. This article shares the successful recovery story of a 51-year-old male patient diagnosed with acute hepatitis C (icteric type), highlighting the importance of early detection, liver-protecting therapy, and enzyme-lowering treatment.

Patient Overview and Diagnosis

The patient was a 51-year-old male who came to the hospital complaining of nausea, aversion to oily food for over 10 days, and yellowing of the eyes and urine for one week. Upon examination, his liver function tests were significantly abnormal: ALT 773 U/L, AST 486 U/L, total bilirubin 83.6 μmol/L, and GGT 1164 U/L. Hepatitis C antibody was positive, while other viral hepatitis markers (A, B, and E) were negative. Further testing confirmed high levels of HCV RNA, leading to a diagnosis of acute icteric hepatitis C.

Hospital Treatment and Therapeutic Approach

The patient was admitted for comprehensive evaluation and treatment. He was placed in isolation until the pathogen was identified. His treatment plan included both oral and injectable medications aimed at protecting liver function, reducing inflammation, and lowering bilirubin levels. Key medications included:

- Oral: Compound Diclorylacetate Tablets, Silymarin Capsules
- Intravenous: Polyene Phosphatidylcholine Injection, Magnesium Isoglycyrrhizinate Injection, and Ornithine Aspartate Injection

An abdominal CT scan revealed fatty liver and possible gallbladder stones, but no signs of malignancy or advanced liver damage were found. The patient responded well to the therapy, with gradual improvement in symptoms and liver function tests.

Positive Outcomes and Recovery

After four weeks of hospitalization, the patient's liver enzymes and bilirubin levels returned to near-normal levels. HCV RNA became undetectable, indicating successful viral clearance without the need for antiviral therapy. He was discharged with stable condition and scheduled for a follow-up visit two weeks later to monitor his recovery progress.

Post-Discharge Recommendations

Even though the patient was in good condition upon discharge, it's important to note that liver cell recovery can take up to three months. The following recommendations were provided:

1. Continue oral liver-protective medication (Silymarin Capsules) and attend scheduled follow-up appointments.
2. Avoid alcohol and maintain a light, healthy diet to prevent fatty liver disease and hyperlipidemia.
3. Engage in moderate physical activity gradually, avoiding strenuous exercise that could stress the liver.

Clinical Insights and Final Thoughts

Acute hepatitis C is less common than acute hepatitis B and often goes undiagnosed due to its subtle initial symptoms. Early and accurate diagnosis played a crucial role in this patient's favorable outcome. While opinions vary on the necessity and timing of antiviral therapy in acute hepatitis C, this case supports the idea that close monitoring of HCV RNA levels can guide treatment decisions. In this case, spontaneous viral clearance occurred, and antiviral therapy was not required.

This case highlights the importance of timely diagnosis, comprehensive liver support therapy, and careful post-treatment monitoring in managing acute hepatitis C effectively.