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Abstract

Title: Correlates of spontaneous clearance of hepatitis C virus among people with hemophilia.
Author: Zhang M, Rosenberg PS, Brown DL, Preiss L, Konkle BA, Eyster ME, Goedert JJ
Journal: Blood
Year: 2005
Month: October

Abstract: People with hemophilia were formerly at very high risk of infection with hepatitis C virus (HCV). Approximately 20% of HCV-infected patients spontaneously clear the virus. To identify correlates of spontaneous clearance of HCV, we studied a cohort of HCV-infected hemophilic subjects without human immunodeficiency virus infection who had never been treated with interferon. Plasma HCV RNA was persistently undetectable in 192 (27.0%) of 712 HCV-seropositive subjects. In multivariate analyses, HCV clearance was more likely in subjects infected with HCV at younger age, especially with infection before age 2 (40.1%) compared to after age 15 years (14.9%, Ptrend< 0.0001), and with relatively recent infection, especially after 1983 (42.8%) compared to before 1969 (18.2%, Ptrend< 0.0001). HCV clearance was marginally reduced with African ancestry (19%) and greatly increased with chronic hepatitis B virus (HBV) infection (59.1%, P=0.0006). Resolved HBV infection, coagulopathy types and severity, types of clotting factor treatment, and gender were not associated with HCV clearance. In conclusion, hemophilic subjects co-infected with chronic HBV and those infected with HCV before age 2 or after 1983 were significantly more likely to spontaneously clear HCV viremia. These data highlight and clarify the importance of non-genetic determinants in spontaneous recovery from HCV infection.