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

Abstract

The natural course of hepatitis C virus (HCV) infection has not been fully elucidated. To investigate whether HCV is spontaneously eliminated in chronic carriers, a long-term population-based cohort study was conducted on 435 chronic HCV carriers. Individual characteristics, serum HCV RNA, and liver function tests were analyzed, and ultra sonography (US) was performed in all subjects. Subjects were followed up for 7.2 +/- 2.4 years (mean +/- SD). Serum HCV RNA was spontaneously eliminated in 16/435 (3.7%) individuals during this period; thus, the incidence of spontaneous elimination of serum HCV RNA was 0.5%/year/person. Multivariate analysis revealed that both a low value of ZTT and no US finding of chronic liver disease were associated with spontaneous viral elimination in HCV carriers. Three of these 16 individuals had chronic hepatitis, and 13 of them had normal ALT levels. When the neutralization of binding (NOB) assay that evaluates inhibition of the HCV envelope-2 protein binding to human cells was examined using sera from these 16 individuals, the NOB antibody was detected in only 3 cases with chronic hepatitis. These results suggest that serum HCV RNA is spontaneously eliminated in chronic HCV carriers in a population, and that the development of NOB antibody is associated with a natural resolution of chronic hepatitis in the minority of them.

Sustained virological response after treatment in patients with chronic hepatitis C infection - a five year follow up

“…Absence of serum HCV RNA 6 months after discontinuation of therapy i.e., sustained virological response (SVR) is generally taken as cure of HCV infection. Sustained virological response rates with Peg-IFN and ribavirin treatment are 42-52% of those with genotype 1 HCV infection and 80% in those with genotype 2 or 3 HCV infection 1 . Successful eradication of HCV is associated with regression of fibrosis and clinical improvement 2,3 .…”

A 5‐year prospective study of the late resolution of chronic hepatitis C after antiviral therapy

“…HCV-RNA clearance rate in genotype 2 and 3 non-responders, breakthroughs or relapsers was higher than in controls with the same genotypes (22.7% vs. 0%; logrank 9.62; P < 0.002). HCV-RNA at the end of treatment or at relapse was <10 5 IU ⁄ mL in the five subjects who cleared the virus and <10 4 IU ⁄ mL in four of them. None of genotype 1 or 4 subjects cleared HCV-RNA during follow-up.…”

“…[5][6][7] However, there are no data to affirm that viral clearance can really occur spontaneously. Using current treatment schedules with PEG-IFN and RIBA, persistent viral clearance can be obtained in about a half of the treated subjects.…”

Long-Term Viral Negativity After Interferon for Chronic Hepatitis C Virus Infection in Hemodialysis

“…Compared with noninfected patients, HCV infection is associated with higher mortality in HD patients (3,4) and higher mortality and graft loss in kidney transplant recipients (5). The rate of spontaneous viral clearance is 0.5% per year for chronic HCV infection, (6) highlighting the importance of effective treatment.…”