Recurrent clinical exacerbations of liver disease during the course of infection with hepatitis C virus.

Symptomatic clinical relapses during the course of chronic hepatitis C virus (HCV) infection are uncommon. Furthermore, acute liver dysfunction with elevated bilirubin during alpha-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 alpha-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.