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Viral and host factors in early hepatitis C virus infection

James W Mosley1, Eva A Operskalski, Leslie H Tobler

  • 1Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, 91214, USA. mosley@usc.edu

Hepatology (Baltimore, Md.)
|June 15, 2005
PubMed

Insights

Host factors significantly influence acute hepatitis C virus (HCV) infection dynamics more than viral factors. This study analyzed 94 transmission pairs, finding shorter latent periods with higher donor RNA levels and overt illness.

Area of Science:

  • Virology
  • Infectious Diseases
  • Hepatology

Background:

  • The Transfusion-transmitted Viruses Study (TTVS) database and serum repository, established 1974-1980, facilitates ongoing research into transfusion-transmitted infections.
  • Acute hepatitis C virus (HCV) infection dynamics, particularly early phase characteristics, require further elucidation.

Purpose of the Study:

  • To investigate parameters of acute HCV infection in 94 donor-recipient pairs with confirmed transmission.
  • To characterize the early course of HCV infection using frequent recipient monitoring.

Main Methods:

  • Analysis of 94 donor-recipient pairs with documented HCV transmission.
  • Quantification of donor HCV RNA load and recipient alanine aminotransferase (ALT) levels.
  • Assessment of latent periods and clinical presentation in recipients.

Main Results:

  • Donor HCV RNA loads varied widely (3.7 to 3,160,000 IU/mL).
  • Recipient viremia onset occurred between days 4-8 post-transfusion in most cases.
  • Shorter latent periods to ALT elevation (> or =90 IU/L) correlated with higher donor RNA levels and clinically overt cases.
  • HCV genotype 1 strains were associated with shorter latent periods compared to non-1 strains.
  • Multivariate analysis identified the highest ALT level within 120 days as the sole significant negative predictor of latent period (P = .014).

Conclusions:

  • Host factors are more critical determinants of acute HCV infection dynamics than virus-associated factors.
  • Higher donor RNA levels and overt clinical presentation are associated with shorter incubation periods.
  • Viral genotype influences the early course of HCV infection, but host response appears dominant.

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