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Spontaneous elimination of serum hepatitis C virus (HCV) RNA in chronic HCV carriers: a population-based cohort study

Hisayoshi Watanabe1, Takafumi Saito, Haruhide Shinzawa

  • 1Second Department of Internal Medicine, Yamagata University School of Medicine, Yamagata, Japan.

Journal of Medical Virology
|July 15, 2003
PubMed

Insights

Hepatitis C virus (HCV) can be spontaneously cleared by some chronic carriers. This study found that 3.7% of carriers cleared HCV RNA over 7 years, with low ZTT and normal liver ultrasounds predicting clearance.

Area of Science:

  • Hepatology
  • Virology
  • Immunology

Background:

  • The natural history of Hepatitis C Virus (HCV) infection, particularly spontaneous viral clearance in chronic carriers, remains incompletely understood.
  • Understanding factors influencing spontaneous HCV elimination is crucial for managing chronic infection and developing treatment strategies.

Purpose of the Study:

  • To investigate the rate and predictors of spontaneous Hepatitis C Virus RNA elimination in a cohort of chronic HCV carriers.
  • To explore the association between spontaneous viral clearance and specific clinical, laboratory, and immunological markers.

Main Methods:

  • A long-term, population-based cohort study followed 435 chronic HCV carriers for an average of 7.2 years.
  • Data collected included individual characteristics, serum HCV RNA levels, liver function tests, and abdominal ultrasonography (US).
  • Multivariate analysis identified factors associated with spontaneous viral elimination, and neutralization of binding (NOB) assays were performed on a subset of individuals.

Main Results:

  • Spontaneous elimination of serum HCV RNA occurred in 16 out of 435 (3.7%) individuals over the follow-up period, with an incidence of 0.5% per year.
  • Low Z-globulin-trypsin (ZTT) levels and the absence of US findings indicative of chronic liver disease were significantly associated with spontaneous viral clearance.
  • Among those who cleared HCV RNA, 3 had chronic hepatitis and 13 had normal ALT levels. NOB antibodies were detected in only 3 of the 16 individuals, specifically those with chronic hepatitis.

Conclusions:

  • Serum HCV RNA can be spontaneously eliminated in a proportion of chronic HCV carriers.
  • Factors such as low ZTT and normal liver ultrasound findings may predict spontaneous viral clearance.
  • The development of neutralization of binding (NOB) antibodies appears to be associated with the natural resolution of chronic hepatitis in a minority of individuals who achieve spontaneous viral clearance.

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