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A case-control study of the factors associated with spontaneous resolution of hepatitis C viremia
P G Quinn1, M M Jamal, J D Carey
1University of New Mexico School of Medicine and Veterans Affairs Medical Center, Albuquerque, USA.
Insights
Hepatitis C virus (HCV) clearance is more likely with longer monogamy and lower ferritin levels. Parenteral exposure and longer time since exposure increase the risk of persistent HCV infection.
Area of Science:
- Hepatology
- Virology
- Immunology
Background:
- Hepatitis C virus (HCV) infection frequently leads to chronic disease, affecting 85% of individuals.
- Identifying factors that predict spontaneous viral clearance is crucial for understanding HCV pathogenesis.
Purpose of the Study:
- To investigate risk factors associated with spontaneous clearance of hepatitis C virus (HCV).
- To differentiate between resolved and persistent HCV infection based on clinical and exposure history.
Main Methods:
- A case-control study design was employed.
- Viral clearance was defined by positive HCV antibody and negative HCV RNA by polymerase chain reaction (PCR).
- Data from 44 cases and 214 controls with persistent viremia were analyzed.
Main Results:
- 17% of HCV-antibody-positive patients achieved viral clearance.
- Parenteral exposure and longer time since exposure correlated with persistent viremia.
- Longer periods of sexual monogamy and lower serum ferritin levels were associated with HCV clearance.
Conclusions:
- Route and timing of HCV exposure are significant determinants of persistent infection.
- Host factors, including ferritin levels and relationship status, may influence viral clearance.
Objective:
Infection with the hepatitis C virus (HCV) becomes chronic in 85% of the infected individuals. We studied risk factors that may predict clearance of HCV.
Methods:
A case-control study compared the association between risk factors and viral clearance. Viral clearance was defined as presence of a positive HCV antibody test plus negative HCV test by polymerase chain reaction (PCR). Forty-four cases and 214 controls with persistent viremia were identified in a database of patients evaluated at the Gastroenterology Clinic of the University of New Mexico.
Results:
Of all 258 HCV-antibody-positive patients, 17% had a negative test by PCR. The multivariate logistic regression revealed that a history of parenteral exposure and a long time interval since the most recent exposure were both associated with an increased likelihood of persistent viremia, whereas subjects who had been monogamous for longer time periods were more likely to have cleared HCV from their serum. A low serum level of ferritin also conferred protection against persistent viremia. Case and control subjects did not differ with respect to their demographic characteristics, occurrence of comorbid disease, previous medical history, occurrence of sexually transmitted diseases, blood group, and risky health or sexual practices.
Conclusions:
These data suggest that route of exposure and time when exposure occurred are important in the development of persistent HCV infection.