Predictors of spontaneous viral clearance and outcomes of acute hepatitis C
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Background/Aims: This study evaluated the predictors of spontaneous viral clearance (SVC), as defined by twoconsecutive undetectable hepatitis C virus (HCV) RNA tests performed ≥12 weeks apart, and the outcomes of acutehepatitis C (AHC) demonstrating SVC or treatment-induced viral clearance. Methods: Thirty-two patients with AHC were followed for 12-16 weeks without administering antiviral therapy. Results: HCV RNA was undetectable at least once in 14 of the 32 patients. SVC occurred in 12 patients (37.5%), amongwhom relapse occurred in 4. SVC was exhibited in 8 of the 11 patients exhibiting undetectable HCV RNA within 12 weeks. HCV RNA reappeared in three patients (including two patients with SVC) exhibiting undetectable HCV RNA after 12weeks. SVC was more frequent in patients with low viremia than in those with high viremia (55.6% vs. 14.3%; P =0.02),and in patients with HCV genotype non-1b than in those with HCV genotype 1b (57.1% vs. 22.2%; P=0.04). SVC was morecommon in patients with a ≥2 log reduction of HCV RNA at 4 weeks than in those with a smaller reduction (90% vs. 9.1%,P<0.001). A sustained viral response was achieved in all patients (n=18 ) receiving antiviral therapy. Conclusions: Baseline levels of HCV RNA and genotype non-1b were independent predictors for SVC. A ≥2 log reductionof HCV RNA at 4 weeks was a follow-up predictor for SVC. Undetectable HCV RNA occurring after 12 weeks was notsustained. All patients receiving antiviral therapy achieved a sustained viral response. Antiviral therapy should beinitiated in patients with detectable HCV RNA at 12 weeks after the diagnosis.
Abstract
Background/Aims: This study evaluated the predictors of spontaneous viral clearance (SVC), as defined by twoconsecutive undetectable hepatitis C virus (HCV) RNA tests performed ≥12 weeks apart, and the outcomes of acutehepatitis C (AHC) demonstrating SVC or treatment-induced viral clearance. Methods: Thirty-two patients with AHC were followed for 12-16 weeks without administering antiviral therapy. Results: HCV RNA was undetectable at least once in 14 of the 32 patients. SVC occurred in 12 patients (37.5%), amongwhom relapse occurred in 4. SVC was exhibited in 8 of the 11 patients exhibiting undetectable HCV RNA within 12 weeks. HCV RNA reappeared in three patients (including two patients with SVC) exhibiting undetectable HCV RNA after 12weeks. SVC was more frequent in patients with low viremia than in those with high viremia (55.6% vs. 14.3%; P =0.02),and in patients with HCV genotype non-1b than in those with HCV genotype 1b (57.1% vs. 22.2%; P=0.04). SVC was morecommon in patients with a ≥2 log reduction of HCV RNA at 4 weeks than in those with a smaller reduction (90% vs. 9.1%,P<0.001). A sustained viral response was achieved in all patients (n=18 ) receiving antiviral therapy. Conclusions: Baseline levels of HCV RNA and genotype non-1b were independent predictors for SVC. A ≥2 log reductionof HCV RNA at 4 weeks was a follow-up predictor for SVC. Undetectable HCV RNA occurring after 12 weeks was notsustained. All patients receiving antiviral therapy achieved a sustained viral response. Antiviral therapy should beinitiated in patients with detectable HCV RNA at 12 weeks after the diagnosis.
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