Recurrent Clinical Exacerbations of Liver Disease During the Course of Infection with Hepatitis C Virus¹

Symptomatic clinical relapses during the course of chronic hepatitis C virus (HCV) infection are uncommon. Furthermore, acute liver dysfunction with elevated bilirubin during α‐interferon therapy without other apparent coexisting diagnoses is rare. The case of a 31‐yr‐old man with three clinical exacerbations of HCV infection over an 18‐month period is described. The third episode was characterized by rising serum aminotransferase levels on α‐interferon therapy. The precise cause of this patient's flares is unknown. An immunologically mediated clearance of the hepatitis C virus, mutation of HCV, or infection with different HCV viral strains are the leading possibilities.