Simultaneous acute hepatitis B virus and hepatitis C virus infection leading to fulminant hepatitis and subsequent chronic hepatitis C.

A 22-year-old male Taiwanese was admitted to the hospital for acute hepatitis B associated with fulminant hepatic failure. After receiving supportive treatment, the patient's clinical condition improved and the results of liver function tests (including prothrombin time) gradually improved. However, in spite of seroconversion from hepatitis B surface antigen to antibody, hepatitis relapsed and serum alanine aminotransferase levels were persistently abnormal during the 3-year follow-up period. Liver biopsy performed 2 years after the onset of illness revealed chronic hepatitis. A retrospective review of the patient's serological test results revealed hepatitis C virus (HCV) RNA and the development of antibodies to HCV during the acute phase of illness as well as the persistence of HCV RNA during follow-up. Thus, we serologically and virologically proved that our patient had simultaneous acute infections with hepatitis B and C viruses and that these infections led to fulminant hepatic failure, relapse of hepatitis, and chronic hepatitis C.