The Effects of Female Sex, Viral Genotype, and IL28B Genotype on Spontaneous Clearance of Acute Hepatitis C Virus Infection

被引：299

作者：

Grebely, Jason ^{[1
]}

Page, Kimberly ^{[2
]}

Sacks-Davis, Rachel ^{[3
,4
]}

van der Loeff, Maarten Schim ^{[5
,6
]}

Rice, Thomas M. ^{[2
]}

Bruneau, Julie ^{[7
]}

Morris, Meghan D. ^{[2
]}

Hajarizadeh, Behzad ^{[1
]}

Amin, Janaki ^{[1
]}

Cox, Andrea L. ^{[8
]}

Kim, Arthur Y. ^{[9
]}

McGovern, Barbara H. ^{[10
,11
]}

Schinkel, Janke ^{[12
]}

George, Jacob ^{[13
,14
]}

Shoukry, Naglaa H. ^{[7
]}

Lauer, Georg M. ^{[9
]}

Maher, Lisa ^{[1
]}

Lloyd, Andrew R. ^{[15
]}

Hellard, Margaret ^{[3
,4
]}

Dore, Gregory J. ^{[1
]}

Prins, Maria ^{[5
,6
]}

机构：

[1] Univ New S Wales, Kirby Inst, Sydney, NSW 2052, Australia

[2] Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA

[3] Burnet Inst, Melbourne, Vic, Australia

[4] Monash Univ, Dept Epidemiol & Prevent Med, Melbourne, Vic 3004, Australia

[5] GGD Publ Hlth Serv Amsterdam, Amsterdam, Netherlands

[6] Univ Amsterdam, Acad Med Ctr, Dept Internal Med, Div Infect Dis Trop Med & AIDS,Ctr Infect & Immun, NL-1105 AZ Amsterdam, Netherlands

[7] Univ Montreal, CRCHUM, Montreal, PQ, Canada

[8] Johns Hopkins Med Inst, Dept Med, Baltimore, MD 21205 USA

[9] Harvard Univ, Sch Med, Boston, MA USA

[10] Tufts Med Sch, Boston, MA USA

[11] Abbvie, Chicago, IL USA

[12] Univ Amsterdam, Acad Med Ctr, Ctr Infect & Immun Amsterdam, Dept Med Microbiol, NL-1105 AZ Amsterdam, Netherlands

[13] Univ Sydney, Westmead Millennium Inst, Storr Liver Unit, Sydney, NSW 2006, Australia

[14] Westmead Hosp, Sydney, NSW, Australia

[15] Univ New S Wales, Sch Med Sci, Inflammat & Infect Res Ctr, Sydney, NSW 2052, Australia

来源：

HEPATOLOGY | 2014年 / 59卷 / 01期

基金：

澳大利亚国家健康与医学研究理事会; 英国医学研究理事会;

关键词：

SINGLE-SOURCE OUTBREAK; IMMUNE-RESPONSES; DRUG-USERS; COHORT;

D O I：

10.1002/hep.26639

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Although 20%-40% of persons with acute hepatitis C virus (HCV) infection demonstrate spontaneous clearance, the time course and factors associated with clearance remain poorly understood. We investigated the time to spontaneous clearance and predictors among participants with acute HCV using Cox proportional hazards analyses. Data for this analysis were drawn from an international collaboration of nine prospective cohorts evaluating outcomes after acute HCV infection. Among 632 participants with acute HCV, 35% were female, 82% were Caucasian, 49% had interleukin-28 (IL28)B CC genotype (rs12979860), 96% had injected drugs ever, 47% were infected with HCV genotype 1, and 7% had human immunodeficiency virus (HIV) coinfection. Twenty-eight percent were HCV antibody negative/RNA positive at the time of acute HCV detection (early acute HCV). During follow-up, spontaneous clearance occurred in 173 of 632, and at 1 year after infection, 25% (95% confidence interval [CI]: 21, 29) had cleared virus. Among those with clearance, the median time to clearance was 16.5 weeks (IQR: 10.5, 33.4), with 34%, 67%, and 83% demonstrating clearance at 3, 6, and 12 months. Adjusting for age, factors independently associated with time to spontaneous clearance included female sex (adjusted hazards ratio [AHR]: 2.16; 95% CI: 1.48, 3.18), IL28B CC genotype (versus CT/TT; AHR, 2.26; 95% CI: 1.52, 3.34), and HCV genotype 1 (versus non-genotype 1; AHR: 1.56; 95% CI: 1.06, 2.30). The effect of IL28B genotype and HCV genotype on spontaneous clearance was greater among females, compared to males. Conclusions: Female sex, favorable IL28B genotype, and HCV genotype 1 are independent predictors of spontaneous clearance. Further research is required to elucidate the observed sex-based differences in HCV control. (Hepatology 2014;58:109-120)

引用

页码：109 / 120

页数：12

共 32 条

[1] Early Interferon Therapy for Hepatitis C Virus Infection Rescues Polyfunctional, Long-Lived CD8+ Memory T Cells [J].