Acute coinfection with hepatitis B and hepatitis C viruses (Part 1)

Acute coinfection of hepatitis B virus (HBV) and hepatitis C virus (HCV) is rare but more prevalent in intravenous drug abusers . The few previous cases all describe acute HBV followed by acute HCV, leading to HBV clearance but chronic HCV . We present a patient with acute coinfection of HBV and HCV, and subsequent spontaneous clearance of both viruses.
A 54-year-old Caucasian man presented with a transient flulike illness in September 2003. After apparent recovery, a recurrence of symptoms occurred in October 2003, with extreme fatigue, lethargy, right upper quadrant pain and jaundice. He admitted to one episode of shared injection drug use in late June 2003. Other habits included intranasal cocaine and marijuana smoking sporadically over the previous 15 to 20 years, and unprotected and condom-protected sex with prostitutes. Alcohol intake was approximately two to three drinks daily. Past medical history included mild asthma controlled with salbutamol, salmeterol and fluticasone, and possible Reiter’s syndrome.
The only abnormality on the physical examination was jaundice. Encephalopathy, ascites, hepatosplenomegaly and stigmata of chronic liver disease were absent.