Initial presentation of acute hepatitis C virus (HCV) infection among HIV-negative and HIV-positive individuals-experience from 2 large German networks on the study of acute HCV infection.

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To the Editor—With interest we read the article by Matthews et al [1] on the clinical presentation of acute hepatitis C virus (HCV) infection among human immunodeficiency virus (HIV)-positive and HIV-negative individuals. In particular, the finding that after acquisition of acute HCV infection, HIV-positive individuals were similar with regard to the maximum alanine aminotransferase (ALT) level and clinical presentation, compared with HIV-negative individuals, merits attention. Because of the acquired immunodeficiency, one would expect a less vigorous host-virus interaction among HIV-positive individuals and thus a lessened inflammatory response, with lower maximum ALT levels and less pronounced clinical symptoms or signs.

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