Abstract
BackgroundUnderstanding the patterns of HCV RNA levels during acute hepatitis C virus (HCV) infection provides insights into immunopathogenesis and is important for vaccine design. This study evaluated patterns of HCV RNA levels and associated factors among individuals with acute infection.MethodsData were from an international collaboration of nine prospective cohorts of acute HCV (InC3 Study). Participants with well-characterized acute HCV infection (detected within three months post-infection and interval between the peak and subsequent HCV RNA levels≤120 days) were categorised by a priori-defined patterns of HCV RNA levels: i) spontaneous clearance, ii) partial viral control with persistence (≥1 log IU/mL decline in HCV RNA levels following peak) and iii) viral plateau with persistence (increase or <1 log IU/mL decline in HCV RNA levels following peak). Factors associated with HCV RNA patterns were assessed using multinomial logistic regression.ResultsAmong 643 individuals with acute HCV, 162 with well-characterized acute HCV were identified: spontaneous clearance (32%), partial viral control with persistence (27%), and viral plateau with persistence (41%). HCV RNA levels reached a high viraemic phase within two months following infection, with higher levels in the spontaneous clearance and partial viral control groups, compared to the viral plateau group (median: 6.0, 6.2, 5.3 log IU/mL, respectively; P=0.018). In the two groups with persistence, Interferon lambda 3 (IFNL3) CC genotype was independently associated with partial viral control compared to viral plateau (adjusted odds ratio [AOR]: 2.75; 95%CI: 1.08, 7.02). In the two groups with viral control, female sex was independently associated with spontaneous clearance compared to partial viral control (AOR: 2.86; 95%CI: 1.04, 7.83).ConclusionsAmong individuals with acute HCV, a spectrum of HCV RNA patterns is evident. IFNL3 CC genotype is associated with initial viral control, while female sex is associated with ultimate spontaneous clearance.
Highlights
Initial infection with hepatitis C virus (HCV) is characterized by detection of virus in blood within 2–14 days of exposure, increases in hepatic transaminases, and appearance of detectable HCV-specific antibodies within 30–60 days of exposure [1,2,3,4,5,6]
Interferon lambda 3 (IFNL3) CC genotype is associated with initial viral control, while female sex is associated with ultimate spontaneous clearance
In the two groups with viral persistence, the only factor independently associated with partial viral control was IFNL3 CC genotype
Summary
Initial infection with hepatitis C virus (HCV) is characterized by detection of virus in blood within 2–14 days of exposure, increases in hepatic transaminases, and appearance of detectable HCV-specific antibodies (anti-HCV) within 30–60 days of exposure [1,2,3,4,5,6]. Understanding of early HCV RNA patterns during acute HCV infection provides insights into immunopathogenesis and is important for vaccine design. Among the ~25% with subsequent spontaneous clearance [7, 8], this plateau phase is followed by a decline in HCV RNA to undetectable levels [9,10,11,12] Among those who subsequently develop persistent HCV infection, patterns of HCV RNA levels are heterogeneous [3, 12,13,14,15], but there are limited studies investigated the differential patterns of HCV RNA levels in these individuals. This study evaluated patterns of HCV RNA levels and associated factors among individuals with acute infection
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
