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. 2014 Dec;20(4):368-75.
doi: 10.3350/cmh.2014.20.4.368. Epub 2014 Dec 24.

Predictors of spontaneous viral clearance and outcomes of acute hepatitis C infection

Yoo-Kyung Cho  1 , Young Nam Kim  1 , Byung-Cheol Song  1
Affiliations

Predictors of spontaneous viral clearance and outcomes of acute hepatitis C infection

Yoo-Kyung Cho et al. Clin Mol Hepatol. 2014 Dec.

Erratum in

  • Erratum.
    Song BC, Cho YK, Jwa H, Choi EK, Kim HU, Song HJ, Na SY, Boo SJ, Jeong SU. Song BC, et al. Clin Mol Hepatol. 2015 Mar;21(1):104. doi: 10.3350/cmh.2015.21.1.104. Clin Mol Hepatol. 2015. PMID: 25834809 Free PMC article.

Abstract

Background/aims: This study evaluated the predictors of spontaneous viral clearance (SVC), as defined by two consecutive undetectable hepatitis C virus (HCV) RNA tests performed ≥ 12 weeks apart, and the outcomes of acute hepatitis C (AHC) demonstrating SVC or treatment-induced viral clearance.

Methods: Thirty-two patients with AHC were followed for 12-16 weeks without administering antiviral therapy.

Results: HCV RNA was undetectable at least once in 14 of the 32 patients. SVC occurred in 12 patients (37.5%), among whom relapse occurred in 4. SVC was exhibited in 8 of the 11 patients exhibiting undetectable HCV RNA within 12 weeks. HCV RNA reappeared in three patients (including two patients with SVC) exhibiting undetectable HCV RNA after 12 weeks. SVC was more frequent in patients with low viremia than in those with high viremia (55.6% vs. 14.3%; P=0.02), and in patients with HCV genotype non-1b than in those with HCV genotype 1b (57.1% vs. 22.2%; P=0.04). SVC was more common in patients with a ≥ 2 log reduction of HCV RNA at 4 weeks than in those with a smaller reduction (90% vs. 9.1%, P<0.001). A sustained viral response was achieved in all patients (n=18) receiving antiviral therapy.

Conclusions: Baseline levels of HCV RNA and genotype non-1b were independent predictors for SVC. A ≥ 2 log reduction of HCV RNA at 4 weeks was a follow-up predictor for SVC. Undetectable HCV RNA occurring after 12 weeks was not sustained. All patients receiving antiviral therapy achieved a sustained viral response. Antiviral therapy should be initiated in patients with detectable HCV RNA at 12 weeks after the diagnosis.

Keywords: Acute hepatitis C; HCV RNA; Interferon; Spontaneous viral clearance.

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Conflict of interest statement

The authors have no conflicts to disclose.

Figures

Figure 1
Figure 1
Clinical outcomes of the patients with hepatitis C infection who were followed without antiviral treatment. *Undetectable HCV RNA at least once during follow-up. SVC, spontaneous viral clearance; HCV, hepatitis C virus.
Figure 2
Figure 2
Spontaneous viral clearance according to baseline levels of hepatitis C virus (HCV) RNA and HCV genotypes.
Figure 3
Figure 3
Suggested algorithm for the treatment of patients with acute hepatitis C infection.
See this image and copyright information in PMC

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