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1 April 2006

Volume 42, Number 7
Clinical Infectious Diseases 2006;42:945–952
© 2006 by the Infectious Diseases Society of America. All rights reserved.
1058-4838/2006/4207-0008$15.00
DOI: 10.1086/500938
MAJOR ARTICLE

High Rate of Spontaneous Negativity for Hepatitis C Virus RNA after Establishment of Chronic Infection in Alaska Natives

John D. Scott,1

Brian J. McMahon,3,4

Dana Bruden,3

Daniel Sullivan,2

Chriss Homan,4

Carol Christensen,4 and

David R. Gretch2

Departments of 1Medicine, Division of Allergy and Infectious Diseases, and 2Laboratory Medicine, Virology Division, University of Washington, Seattle, Washington; and 3Arctic Investigations Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, and 4Viral Hepatitis Program, Alaska Native Medical Center, Anchorage, Alaska

Background.Hepatitis C virus (HCV) leads to chronic infection in 70%–85% of exposed patients. Spontaneous clearance of the virus after chronic infection is believed to occur rarely.

Methods.Alaska Natives who tested positive for HCV antibodies were enrolled in a prospective study that began in 1994 and were followed up on a regular basis. Individuals who tested positive for HCV RNA on 3 separate dates, each of which were at least 1 year apart, were included. Being negative for the virus was defined as having at least 1 negative HCV RNA test result after chronic viremia had been established.

Results.Of the 815 patients enrolled in the cohort, 139 met entry criteria and were observed for a mean period of 7.0 years. Eleven (8%) of the persons had at least 1 test in which HCV RNA was undetectable; 7 were classified as having either possible or probable clearance of the virus, corresponding to an annualized clearance rate of 0.74% per person‐year (95% CI, 0.30%–1.53%). Of 9 patients who underwent subsequent HCV RNA testing, 5 (56%) had negative test results. A low HCV RNA level was significantly associated with spontaneous nondetectability of HCV RNA.

Conclusion.Spontaneous HCV RNA negativity during chronic HCV infection is a surprisingly frequent event and is associated with low HCV RNA titers. Knowledge of immunologic determinants of clearance may open up avenues of novel therapy.

Received 13 September 2005; accepted 18 November 2005; electronically published 28 February 2006.

  • (See the editorial commentary by Lauer and Kim on pages 953–4)

Reprints or correspondence: Dr. John Scott, Hepatitis and Liver Clinic, 325 Ninth Ave., Box 359938, Seattle, WA 98104 ().

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Citation-Full Text-PDF Version (50 kB)

  • Presented in part: 41st Annual Meeting of the Infectious Disease Society of America, San Diego, CA, October 2003 (poster 588).

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