A. Cruz, S. C. Lima, J. Cotter
Resumo
Apresenta-se o caso clínico de um doente toxicómano, com diagnóstico de hepatite aguda por vírus da hepatite C (genótipo 3a). Após iniciar tratamento com interferão alfa 2b e se assistir a uma boa resposta terapêutica, às 12 semanas de tratamento verificou-se um súbito agravamento, cuja investigação mostrou tratar-se de nova hepatite aguda por vírus C (genótipo 1a). O doente tinha mantido consumo de drogas intravenosas. A continuação da terapêutica anteriormente iniciada levou à recuperação clínica e analítica. Aos 6 meses de tratamento, teve aquela de ser interrompida devido a depressão grave. Apesar disto, na avaliação trinta e seis meses após suspensão da terapêutica, o doente mantinha-se assintomático, com aminotransferases normais e determinação negativa do RNA do vírus da hepatite C.
Os autores destacam a raridade do caso, nomeadamente a dupla infecção aguda sequencial por diferentes genótipos do vírus da hepatite C e o facto da segunda infecção ocorrer em pleno período de tratamento com interferão, salientando-se mais uma vez a reconhecida importância da abstinência de consumo de drogas.
Summary
The authors report a case of an intravenous drug user diagnosed with acute hepatitis C virus (genotype 3a). After initial improvement when treatment was begun, sudden decompensation occurred, compatible with the onset of a new acute hepatitis C virus (genotype 1a). The patient had continued using intravenous drugs. Clinical recovery and normalisation of laboratory values were achieved with continuation of the initial therapy. Six months later, treatment had to be discontinued because of the patient’s severe depression. Nevertheless, thirty-six months after treatment was stopped, serum HCV RNA levels were undetectable, ALT levels were normal and the patient was symptom free.
]]> This case shows a rare clinical course, namely double acute sequential infection by different genotypes of hepatitis C virus with the second infection occurring during treatment with interferon. This once again highlights the importance of drug abstinence.
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Bibliografia
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Correspondência:
Armanda Cruz
Serviço de Gastrenterologia
Hospital da Senhora da Oliveira
Rua dos Cutileiros, Creixomil
4800 Guimarães
]]> Serviço de Gastrenterologia do Hospital da Senhora da Oliveira, Guimarães, Portugal.
Recebido para publicação: 24/02/2006
Aceite para publicação: 12/07/2006
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