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Natural fluctuations of hepatitis C viral load in a homogeneous patient population: a prospective study
L Fanning1, E Kenny-Walsh, J Levis
1Hepatitis C Unit, Department of Medicine, Cork, University College Cork, Cork, Ireland. l.fanning@ucc.ie
Insights
Most women infected with hepatitis C virus (HCV) genotype 1b show an increasing viral load over time. However, a small number of patients infected early in adulthood may experience a decrease in HCV viral load.
Area of Science:
- Hepatology
- Virology
- Infectious Diseases
Background:
- Hepatitis C virus (HCV) infection is a significant global health concern.
- Understanding the long-term viral load dynamics in patients is crucial for disease management.
- This study focuses on a unique cohort with a homogeneous infection source and genotype.
Purpose of the Study:
- To investigate the longitudinal changes in hepatitis C viral load.
- To determine the factors influencing viral load variation over an extended follow-up period.
- To analyze viral load trends in a cohort infected with hepatitis C virus genotype 1b.
Main Methods:
- Serum samples from 49 female patients infected with HCV from a single source (anti-D immunoglobulin) between 1977-1978 were analyzed.
- Viral load quantification was performed using the Roche Monitor assay.
- Statistical analysis was employed to assess the rate of viral load change and its correlation with clinical factors.
Main Results:
- The mean rate of viral load increase was 0.23 log(10) viral copies/mL/year, significantly different from zero (P < 10(-10)).
- A negative correlation was observed between the rate of viral load change and the initial viral load (r = -.35, P =.01).
- Age at infection did not significantly correlate with the viral load change slope (P =.10).
Conclusions:
- The majority of women infected with hepatitis C virus genotype 1b experience a progressive increase in viral load.
- A subset of patients, particularly those infected early in adulthood, may exhibit a decline in viral load.
- These findings highlight the heterogeneous nature of hepatitis C viral load kinetics over time.
Abstract:
The aim of this study was to determine the variation in hepatitis C viral load over an extended period of patient follow up. Serum samples were collected from 49 female individuals who were identified as having been infected from the same source of hepatitis C-contaminated anti-D immunoglobulin during the period from 1977 (May) to 1978 (November). All patients attended the hepatitis C clinic at Cork University Hospital, Cork, Ireland. The study group was homogeneous with respect to gender, hepatitis C virus (HCV) genotype (1b), and duration of infection. None of the patients had received antiviral therapy at the time of completion of study. Viral load quantifications were assessed using the Roche Monitor (F. Hoffmann-La Roche, Ltd., Basel, Switzerland) assay. The mean age of the study group at time of infection was 30.3 years (SD +/- 6.1) with a range from 18.5 to 43 years. The mean time of follow-up was 4. 1 years (SD +/- 1.0) with a range from 1.2 to 5 years. The mean rate of change of viral load per year was 0.23 log(10) viral copies per mL serum for the study group (SD +/- 0.19) with a range of -0.18 to 0.78 that was significantly different from zero, P < 10(-10). The rate of change of viral load per year was negatively correlated with viral load at first determination, r = -.35, P =.01. Age at infection did not correlate with the slope of change of viral load, P =.10. In conclusion, most women infected with HCV 1b will have an increase in viral load over time but a few patients who acquire infection early in adult life will show a decrease in viral load.