Journal Article

High Rate of Spontaneous Negativity for Hepatitis C Virus RNA after Establishment of Chronic Infection in Alaska Natives

John D. Scott, Brian J. McMahon, Dana Bruden, Daniel Sullivan, Chriss Homan, Carol Christensen and David R. Gretch

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 42, issue 7, pages 945-952
Published in print April 2006 | ISSN: 1058-4838
Published online April 2006 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/500938
High Rate of Spontaneous Negativity for Hepatitis C Virus RNA after Establishment of Chronic Infection in Alaska Natives

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Background. Hepatitis C virus (HCV) leads to chronic infection in 70%–85% of exposed patients. Spontaneous clearance of the virus after chronic infection is believed to occur rarely.

Methods. Alaska Natives who tested positive for HCV antibodies were enrolled in a prospective study that began in 1994 and were followed up on a regular basis. Individuals who tested positive for HCV RNA on 3 separate dates, each of which were at least 1 year apart, were included. Being negative for the virus was defined as having at least 1 negative HCV RNA test result after chronic viremia had been established.

Results. Of the 815 patients enrolled in the cohort, 139 met entry criteria and were observed for a mean period of 7.0 years. Eleven (8%) of the persons had at least 1 test in which HCV RNA was undetectable; 7 were classified as having either possible or probable clearance of the virus, corresponding to an annualized clearance rate of 0.74% per person-year (95% CI, 0.30%–1.53%). Of 9 patients who underwent subsequent HCV RNA testing, 5 (56%) had negative test results. A low HCV RNA level was significantly associated with spontaneous nondetectability of HCV RNA.

Conclusion. Spontaneous HCV RNA negativity during chronic HCV infection is a surprisingly frequent event and is associated with low HCV RNA titers. Knowledge of immunologic determinants of clearance may open up avenues of novel therapy.

Journal Article.  4184 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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