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Patterns of hepatitis C virus RNA levels during acute infection: the InC3 study.

Hajarizadeh B, Grady B, Page K, Kim AY, McGovern BH, Cox AL, Rice TM, Sacks-Davis R, Bruneau J, Morris M, Amin J, Schinkel J, Applegate T, Maher L, Hellard M, Lloyd AR, Prins M, Dore GJ, Grebely J, InC3 Study Gro - PLoS ONE (2015)

Bottom Line: In the two groups with persistence, Interferon lambda 3 (IFNL3) CC genotype was independently associated with partial viral control compared to viral plateau (adjusted odds ratio [AOR]: 2.75; 95%CI: 1.08, 7.02).In the two groups with viral control, female sex was independently associated with spontaneous clearance compared to partial viral control (AOR: 2.86; 95%CI: 1.04, 7.83).IFNL3 CC genotype is associated with initial viral control, while female sex is associated with ultimate spontaneous clearance.

View Article: PubMed Central - PubMed

Affiliation: The Kirby Institute, UNSW Australia (University of New South Wales), Sydney, NSW, Australia.

ABSTRACT

Background: Understanding the patterns of HCV RNA levels during acute hepatitis C virus (HCV) infection provides insights into immunopathogenesis and is important for vaccine design. This study evaluated patterns of HCV RNA levels and associated factors among individuals with acute infection.

Methods: Data were from an international collaboration of nine prospective cohorts of acute HCV (InC3 Study). Participants with well-characterized acute HCV infection (detected within three months post-infection and interval between the peak and subsequent HCV RNA levels ≤ 120 days) were categorised by a priori-defined patterns of HCV RNA levels: i) spontaneous clearance, ii) partial viral control with persistence (≥ 1 log IU/mL decline in HCV RNA levels following peak) and iii) viral plateau with persistence (increase or <1 log IU/mL decline in HCV RNA levels following peak). Factors associated with HCV RNA patterns were assessed using multinomial logistic regression.

Results: Among 643 individuals with acute HCV, 162 with well-characterized acute HCV were identified: spontaneous clearance (32%), partial viral control with persistence (27%), and viral plateau with persistence (41%). HCV RNA levels reached a high viraemic phase within two months following infection, with higher levels in the spontaneous clearance and partial viral control groups, compared to the viral plateau group (median: 6.0, 6.2, 5.3 log IU/mL, respectively; P = 0.018). In the two groups with persistence, Interferon lambda 3 (IFNL3) CC genotype was independently associated with partial viral control compared to viral plateau (adjusted odds ratio [AOR]: 2.75; 95%CI: 1.08, 7.02). In the two groups with viral control, female sex was independently associated with spontaneous clearance compared to partial viral control (AOR: 2.86; 95%CI: 1.04, 7.83).

Conclusions: Among individuals with acute HCV, a spectrum of HCV RNA patterns is evident. IFNL3 CC genotype is associated with initial viral control, while female sex is associated with ultimate spontaneous clearance.

No MeSH data available.


Related in: MedlinePlus

Patterns of HCV RNA levels in individuals with well-characterized acute HCV infection in the InC3 study (total n = 162).(A) Monthly medians of HCV RNA levels, table underneath represents number of participants with available HCV RNA level measurements at each time point; (B) Fitted HCV RNA patterns, shaded areas represent the 95% confidence intervals.
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pone.0122232.g003: Patterns of HCV RNA levels in individuals with well-characterized acute HCV infection in the InC3 study (total n = 162).(A) Monthly medians of HCV RNA levels, table underneath represents number of participants with available HCV RNA level measurements at each time point; (B) Fitted HCV RNA patterns, shaded areas represent the 95% confidence intervals.

Mentions: Individuals with well-characterized acute HCV infection (n = 162) had a median of 4.5 HCV RNA tests (IQR: 3, 8), with a median of 33 days (IQR: 27, 68) between tests during the first 12 months following estimated date of HCV infection. Median interval from estimated date of infection to the first positive anti-HCV or HCV RNA test was 28 days (IQR: 28, 49). Spontaneous clearance was observed in 52 individuals. Among those with persistent infection (n = 110), 44 individuals demonstrated partial viral control with persistence (defined by ≥1 log IU/mL decline between the peak and the subsequent HCV RNA levels) and 66 individuals demonstrated viral plateau with persistence (defined by increase or <1 log IU/mL decline between the peak and the subsequent HCV RNA levels). HCV RNA levels among individuals with these three HCV RNA patterns are illustrated in Fig. 3.


Patterns of hepatitis C virus RNA levels during acute infection: the InC3 study.

Hajarizadeh B, Grady B, Page K, Kim AY, McGovern BH, Cox AL, Rice TM, Sacks-Davis R, Bruneau J, Morris M, Amin J, Schinkel J, Applegate T, Maher L, Hellard M, Lloyd AR, Prins M, Dore GJ, Grebely J, InC3 Study Gro - PLoS ONE (2015)

Patterns of HCV RNA levels in individuals with well-characterized acute HCV infection in the InC3 study (total n = 162).(A) Monthly medians of HCV RNA levels, table underneath represents number of participants with available HCV RNA level measurements at each time point; (B) Fitted HCV RNA patterns, shaded areas represent the 95% confidence intervals.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4383375&req=5

pone.0122232.g003: Patterns of HCV RNA levels in individuals with well-characterized acute HCV infection in the InC3 study (total n = 162).(A) Monthly medians of HCV RNA levels, table underneath represents number of participants with available HCV RNA level measurements at each time point; (B) Fitted HCV RNA patterns, shaded areas represent the 95% confidence intervals.
Mentions: Individuals with well-characterized acute HCV infection (n = 162) had a median of 4.5 HCV RNA tests (IQR: 3, 8), with a median of 33 days (IQR: 27, 68) between tests during the first 12 months following estimated date of HCV infection. Median interval from estimated date of infection to the first positive anti-HCV or HCV RNA test was 28 days (IQR: 28, 49). Spontaneous clearance was observed in 52 individuals. Among those with persistent infection (n = 110), 44 individuals demonstrated partial viral control with persistence (defined by ≥1 log IU/mL decline between the peak and the subsequent HCV RNA levels) and 66 individuals demonstrated viral plateau with persistence (defined by increase or <1 log IU/mL decline between the peak and the subsequent HCV RNA levels). HCV RNA levels among individuals with these three HCV RNA patterns are illustrated in Fig. 3.

Bottom Line: In the two groups with persistence, Interferon lambda 3 (IFNL3) CC genotype was independently associated with partial viral control compared to viral plateau (adjusted odds ratio [AOR]: 2.75; 95%CI: 1.08, 7.02).In the two groups with viral control, female sex was independently associated with spontaneous clearance compared to partial viral control (AOR: 2.86; 95%CI: 1.04, 7.83).IFNL3 CC genotype is associated with initial viral control, while female sex is associated with ultimate spontaneous clearance.

View Article: PubMed Central - PubMed

Affiliation: The Kirby Institute, UNSW Australia (University of New South Wales), Sydney, NSW, Australia.

ABSTRACT

Background: Understanding the patterns of HCV RNA levels during acute hepatitis C virus (HCV) infection provides insights into immunopathogenesis and is important for vaccine design. This study evaluated patterns of HCV RNA levels and associated factors among individuals with acute infection.

Methods: Data were from an international collaboration of nine prospective cohorts of acute HCV (InC3 Study). Participants with well-characterized acute HCV infection (detected within three months post-infection and interval between the peak and subsequent HCV RNA levels ≤ 120 days) were categorised by a priori-defined patterns of HCV RNA levels: i) spontaneous clearance, ii) partial viral control with persistence (≥ 1 log IU/mL decline in HCV RNA levels following peak) and iii) viral plateau with persistence (increase or <1 log IU/mL decline in HCV RNA levels following peak). Factors associated with HCV RNA patterns were assessed using multinomial logistic regression.

Results: Among 643 individuals with acute HCV, 162 with well-characterized acute HCV were identified: spontaneous clearance (32%), partial viral control with persistence (27%), and viral plateau with persistence (41%). HCV RNA levels reached a high viraemic phase within two months following infection, with higher levels in the spontaneous clearance and partial viral control groups, compared to the viral plateau group (median: 6.0, 6.2, 5.3 log IU/mL, respectively; P = 0.018). In the two groups with persistence, Interferon lambda 3 (IFNL3) CC genotype was independently associated with partial viral control compared to viral plateau (adjusted odds ratio [AOR]: 2.75; 95%CI: 1.08, 7.02). In the two groups with viral control, female sex was independently associated with spontaneous clearance compared to partial viral control (AOR: 2.86; 95%CI: 1.04, 7.83).

Conclusions: Among individuals with acute HCV, a spectrum of HCV RNA patterns is evident. IFNL3 CC genotype is associated with initial viral control, while female sex is associated with ultimate spontaneous clearance.

No MeSH data available.


Related in: MedlinePlus