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A case‐control study of factors associated with resolution of hepatitis C viremia in former blood donors (CME)
Author(s) -
Tobler Leslie H.,
Bahrami Shrein H.,
Kaidarova Zhanna,
Pitina Lubov,
Winkelman Valarie K.,
Vanderpool Sandra K.,
Guiltinan Anne M.,
Cooper Stewart,
Busch Michael P.,
Murphy Edward L.
Publication year - 2010
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/j.1537-2995.2010.02634.x
Subject(s) - medicine , viremia , hepatitis c virus , odds ratio , nucleic acid test , antibody , logistic regression , immunology , gastroenterology , hepatitis c , confidence interval , viral load , virus , disease , covid-19 , infectious disease (medical specialty)
BACKGROUND: Nucleic acid testing (NAT) is performed on blood collected in the United States allowing for the classification of hepatitis C virus (HCV) antibody–positive donors into resolved and chronic hepatitis C infections. We report a case‐control study of factors associated with HCV resolution. STUDY DESIGN AND METHODS: Blood donors with resolved (HCV antibody positive, RNA negative defined as “cases”) or chronic (HCV antibody positive, RNA positive defined as “controls”) based on their index donation HCV test results were enrolled. Participants completed a risk factor, symptoms, and treatment questionnaire followed by HCV antibody, HCV RNA, and liver biochemical testing. RESULTS: We enrolled 100 cases and 202 controls. In a multivariate logistic regression model, significant independent effects for spontaneous viral clearance were observed for African American (inverse; odds ratio [OR], 0.11; 95% confidence interval [CI], 0.01‐0.87), autologous blood donation (OR, 4.70; 95% CI, 2.02‐10.94), alcohol intake (OR, 2.39; 95% CI, 1.13‐5.03), and transfusion before May 1990 (inverse; OR, 0.36; 95% CI, 0.14‐0.91). Cases admitting injection drug use had shorter time since first injection than did controls. Forty‐nine index RNA positive controls received antiviral therapy and 25 (51%) were RNA negative at enrollment; surprisingly several RNA‐negative cases received liver biopsies and/or antiviral treatment. CONCLUSIONS: We document the role donor screening plays in the identification, subsequent medical evaluation, and treatment among individuals who presumably did not know that they were at risk for HCV infection. Additionally, we confirmed race/ethnicity as a determinant of clearance and suggest infectious dose and route of infection may play a role in clearance.