Spontaneous elimination of hepatitis C virus infection: a retrospective study on demographic, clinical, and serological correlates

Abstract

Aim: To find correlates to spontaneous clearance of hepatitis C virus (HCV) infection, this study compared individuals with self-limited and chronic infection with regard to clinical, demographic, and serological parameters.

Methods: Sixty-seven anti-HCV positive and repeatedly HCV RNA negative individuals were considered to have resolved HCV infection spontaneously. To determine the viral genotype these patients had been infected with HCV serotyping was performed. For comparison reasons, 62 consecutive patients with chronic hepatitis C were enrolled. Cases and controls were compared stratified for age and sex.

Results: Retrospective analysis showed (1) a lower humoral reactivity to HCV in patients with self-limited compared to chronic HCV-infection and (2) that younger age, history of iv drug use, and acute/post-acute hepatitis A or B co-infections, but not viral genotypes, are independent correlates for spontaneous HCV clearance.

Conclusion: The stronger humoral reactivity to HCV in patients with persistent infections and in those with a history of iv drug use is supposed to be due to continuous or repeated contact(s) to the antigen. Metachronous hepatitis A or hepatitis B infections might favor HCV clearance.

Figure 1

Serological reactivity to HCV encoded proteins with respect to virus type, the putative source and the outcome of infection. Grey indicates iv drug use and white indicates iv non-use. Mean values are indicated by x, medians by -, boxes show the interquartil range (central 50% of observations) and whiskers show the largest and lowest observed value (if not identified as outlier). By applying a regression model, an overall lower reactivity in patients with self-limited infection could be confirmed (P = 0.0012). Quantitative reactivity appears not to be affected by the outcome or the source of infection in patients with HCV types 2 or 3 (P = 0.9512).