Acute hepatitis C in a contemporary US cohort: modes of acquisition and factors influencing viral clearance.

Abstract

BACKGROUND
Acute hepatitis C virus (HCV) infection is often asymptomatic; thus, its epidemiology and natural history are difficult to define.
METHODS
Acute HCV infection was identified on the basis of HCV seroconversion within 1 year (n=45), new anti-HCV seropositivity with clinical acute hepatitis (n=21), or HCV strain sequencing after an iatrogenic exposure (n=1). Risk factors were assessed with a baseline questionnaire, and participants were followed up prospectively with serial measurement of viral loads.
RESULTS
Of 67 persons with acute HCV infection, most were asymptomatic (64%) and injection drug users (66%). Thirteen had an unknown mode of transmission; of these, 11 reported high-risk sexual behavior. Ten acquired acute HCV infection within 3 months of an iatrogenic exposure; 3 had confirmed iatrogenic infection, and 4 had no other risk factors identified. The spontaneous viral clearance rate after 6 months of infection was 18% (95% confidence interval, 11%-31%). The rate of viral clearance varied significantly by sex (34% vs. 3% for women vs. men; P<.001).
CONCLUSIONS
High-risk sexual or iatrogenic exposures may be important contemporary risk factors for HCV infection. The spontaneous viral clearance rate (18%) in this contemporary study was similar to that reported for past studies of transfusion-associated HCV infection. Women were more likely to clear acute HCV infection than men.

Links

Publisher Full Text

Authors

Wang CC, Krantz E, Klarquist J, Krows M, McBride L, Scott EP, Shaw-Stiffel T, Weston SJ, Thiede H, Wald A, Rosen HR

Institution

Department of Medicine, Division of Infectious Diseases, University of Washington, 325 Ninth Avenue, Seattle, WA 98104, USA. chiaw@u.washington.edu

Source

The Journal of infectious diseases 196:10 2007 Nov 15 pg 1474-82

MeSH

Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
Antibodies, Viral
Cohort Studies
Disease Transmission, Infectious
Female
Hepacivirus
Hepatitis C
Humans
Immunoglobulin M
Male
Middle Aged
Polymerase Chain Reaction
Questionnaires
RNA, Viral
Risk Factors
Sex Factors
Sexual Behavior
United States
Viral Load
Viremia

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

18008226