BACKGROUND/AIMS: Hepatitis C virus (HCV) infection results in a high frequency of chronic disease. The aim of this study was to identify early prognostic markers of disease resolution by performing a comprehensive analysis of viral and host factors during the natural course of acute HCV infection. METHODS: The clinical course of acute hepatitis C was determined in 34 consecutive patients. Epidemiological and virological parameters, as well as cell mediated immunity (CMI) and distribution of human leukocyte antigens (HLA) alleles were analysed. RESULTS: Ten out of 34 patients experienced self-limiting infection, with most resolving patients showing fast kinetics of viral clearance: at least one negative HCV RNA test during this phase predicted a favourable outcome. Among other clinical epidemiological parameters measured, the self-limiting course was significantly associated with higher median peak bilirubin levels at the onset of disease, and with the female sex, but only the latter parameter was independently associated after multivariate analysis. No significant differences between self-limiting or chronic course were observed for the distribution of DRB1 and DQB1 alleles. HCV specific T cell response was more frequently detected during acute HCV infection, than in patients with chronic HCV disease. A significantly broader T cell response was found in patients with self-limiting infection than in those with chronic evolving acute hepatitis C. CONCLUSION: The results suggest that host related factors, in particular sex and CMI, play a crucial role in the spontaneous clearance of this virus. Most importantly, a negative HCV RNA test and broad CMI within the first month after onset of the symptoms represent very efficacious predictors of viral clearance and could thus be used as criteria in selecting candidates for early antiviral treatment.
BACKGROUND/AIMS: Hepatitis C virus (HCV) infection results in a high frequency of chronic disease. The aim of this study was to identify early prognostic markers of disease resolution by performing a comprehensive analysis of viral and host factors during the natural course of acute HCV infection. METHODS: The clinical course of acute hepatitis C was determined in 34 consecutive patients. Epidemiological and virological parameters, as well as cell mediated immunity (CMI) and distribution of human leukocyte antigens (HLA) alleles were analysed. RESULTS: Ten out of 34 patients experienced self-limiting infection, with most resolving patients showing fast kinetics of viral clearance: at least one negative HCV RNA test during this phase predicted a favourable outcome. Among other clinical epidemiological parameters measured, the self-limiting course was significantly associated with higher median peak bilirubin levels at the onset of disease, and with the female sex, but only the latter parameter was independently associated after multivariate analysis. No significant differences between self-limiting or chronic course were observed for the distribution of DRB1 and DQB1 alleles. HCV specific T cell response was more frequently detected during acute HCV infection, than in patients with chronic HCV disease. A significantly broader T cell response was found in patients with self-limiting infection than in those with chronic evolving acute hepatitis C. CONCLUSION: The results suggest that host related factors, in particular sex and CMI, play a crucial role in the spontaneous clearance of this virus. Most importantly, a negative HCV RNA test and broad CMI within the first month after onset of the symptoms represent very efficacious predictors of viral clearance and could thus be used as criteria in selecting candidates for early antiviral treatment.
Authors: N H Grüner; T J Gerlach; M C Jung; H M Diepolder; C A Schirren; W W Schraut; R Hoffmann; R Zachoval; T Santantonio; M Cucchiarini; A Cerny; G R Pape Journal: J Infect Dis Date: 2000-05-05 Impact factor: 5.226
Authors: A Takaki; M Wiese; G Maertens; E Depla; U Seifert; A Liebetrau; J L Miller; M P Manns; B Rehermann Journal: Nat Med Date: 2000-05 Impact factor: 53.440
Authors: C W Chu; S J Hwang; J C Luo; Y J Wang; R H Lu; C R Lai; S H Tsay; J C Wu; F Y Chang; S D Lee Journal: J Gastroenterol Hepatol Date: 2001-02 Impact factor: 4.029
Authors: F Lechner; N H Gruener; S Urbani; J Uggeri; T Santantonio; A R Kammer; A Cerny; R Phillips; C Ferrari; G R Pape; P Klenerman Journal: Eur J Immunol Date: 2000-09 Impact factor: 5.532
Authors: F Lechner; D K Wong; P R Dunbar; R Chapman; R T Chung; P Dohrenwend; G Robbins; R Phillips; P Klenerman; B D Walker Journal: J Exp Med Date: 2000-05-01 Impact factor: 14.307
Authors: Kimberly Page; William Osburn; Jennifer Evans; Judith A Hahn; Paula Lum; Alice Asher; Eric Delwart; Leslie Tobler; Andrea L Cox; Michael P Busch Journal: Clin Infect Dis Date: 2012-10-22 Impact factor: 9.079
Authors: E Riva; F Maggi; F Abbruzzese; F Bellomi; G Giannelli; A Picardi; C Scagnolari; A Folgori; E Spada; E Piccolella; F Dianzani; G Antonelli Journal: Med Microbiol Immunol Date: 2008-08-12 Impact factor: 3.402
Authors: Kimberly Page; Judith A Hahn; Jennifer Evans; Stephen Shiboski; Paula Lum; Eric Delwart; Leslie Tobler; William Andrews; Lia Avanesyan; Stewart Cooper; Michael P Busch Journal: J Infect Dis Date: 2009-10-15 Impact factor: 5.226