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High spontaneous clearance of symptomatic iatrogenic acute hepatitis C genotype 4 infection
Author(s) -
Hashem Mohamed,
Zaghla Hassan,
Zakaria Zainab,
Allam Walaa R.,
Sameea Eman Abdel,
Mikhail Nabiel N.,
Sobhy Maha,
Galal Iman F.,
Mokhtar Yasser,
Hamdy Shimaa,
Galal Gehan,
Abdelwahab Sayed F.,
Waked Imam
Publication year - 2018
Publication title -
journal of medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.782
H-Index - 121
eISSN - 1096-9071
pISSN - 0146-6615
DOI - 10.1002/jmv.25270
Subject(s) - medicine , ribavirin , hepatitis c virus , viremia , genotype , gastroenterology , clearance , hepacivirus , hepatitis c , viral load , virus , immunology , virology , biology , biochemistry , urology , gene
Acute hepatitis C (AHC) infection resolves spontaneously in 15% to 40% of patients. Factors favoring spontaneous viral clearance remain undefined. In this study, predictors of spontaneous viral clearance in patients with symptomatic AHC were investigated. Epidemiological, clinical, and virologic parameters were also examined. Patients with symptomatic AHC were enrolled and followed up prospectively. The patients were followed up every 2 weeks in the first month and then monthly for the following 5 months, with a follow‐up visit 6 months after the last hepatitis C virus (HCV)‐RNA negative sample for those who had cleared the virus. Interleukin (IL)‐28B.rs12979860 single‐nucleotide polymorphism and HCV genotype were tested at baseline. HCV‐RNA was tested during each visit. Patients who remained RNA‐positive at 24 weeks were treated with pegylated interferon plus ribavirin for 24 weeks. A total of 30 patients, mostly with iatrogenically acquired AHC genotype 4 infections completed 6‐months’ follow‐up, to either spontaneous clearance or start of treatment. The mean age of the patients was 37 ± 13 years. In total, 67% of patients were females, and the mean incubation period was 7.6 ± 3.5 weeks. Viral clearance occurred spontaneously in 19 (63.3%) patients. The average time to clearance was 24.3 ± 9.6 weeks. A total of 11 patients received therapy, and 8 (72.7%) cleared the virus and had a sustained virologic response to the treatment 24 weeks after the therapy. A total of three patients were treatment nonresponders. IL28B. rs12979860 CC genotype, female gender, and viremia level were not associated with self‐limiting AHC in this cohort. In conclusion, patients with symptomatic AHC genotype 4 infection caused by an iatrogenic exposure had higher rates of spontaneous resolution than previously reported. Predicting spontaneous viral clearance after iatrogenic AHC exposure was not possible in this population.