Spontaneous HCV clearance: an association with gender, age, viral genotypes, infection transmission routes, and markers of HBV and HIV


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Aim. To determine the rate of spontaneous recovery depending on gender, age, prior icteric hepatitis, infection transmission routes, HCV genotype, markers of HBV and HIV.
Subjects and methods. A humoral immunity response to core antigen and nonstructural viral proteins was assessed in patients with HCV clearance and in a group of patients with chronic hepatitis C (CHC). Two hundred and thirty-eight anti-HCV positive patients were examined. Spontaneous viral clearance (SVC) was diagnosed in 27 (12.1%) patients; a false-positive anti-HCV reaction was seen in 15. The spontaneous recovery group comprised young patients with a female predominance: 66 versus 41.9% in the CHC group. Results. 25.2% of the examinees with SVC had a history of the icteric form of acute viral hepatitis. There were no significant differences between HCV genotype and disease outcome. The markers of retrospectively sustained HBV infection were more detectable in the spontaneous recovery group: anti-HBc 48.1% and anti-HBs 14.8%; these were 32.6 and 8.7%, respectively. HIV co-infection reduced the likelihood of recovery. The determination of antibodies to nonstructural viral proteins could state their rare identification in patients with spontaneous HCV clearance (anti-NS3 HCV, 100%; SVC, 42.3%; NS4 HBC, 95.5%; SVC, 30.8%; p < 0.0001). AntiNS5 was only in 15.4% of the recovered patients and in 89.8% of the patients with chronic infections (p < 0.0001).
Conclusion. Rare detection of anti-NS5 may serve as an additional serological marker indicating to spontaneous HCV clearance in anti-HCV positive patients.

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