13 Dec Hepatitis C: Factors Associated with Spontaneous Clearance
MedicalResearch.com Interview with:
Dr. Jason Grebely PhD
The Kirby Institute
University of South Wales, Australia
MedicalResearch.com: What are the main findings of the study?
Dr. Grebely: Although 20%-40% of persons with acute hepatitis C virus (HCV) infection demonstrate spontaneous clearance, the time course and factors associated with clearance remain poorly understood. This study investigated the time to spontaneous clearance and predictors among participants with acute HCV. Female sex, favorable IL28B genotype, and HCV genotype 1 were identified to be independent predictors of spontaneous clearance. This study provides important insights into factors affecting HCV viral control and offers guidance in clinical decision-making for the treatment of acute HCV infection.
MedicalResearch.com: Were any of the findings unexpected?
Dr. Grebely: Perhaps most interesting finding is a differential effect of sex on spontaneous HCV clearance, with the effects of IL28B and HCV genotype greater in females as compared to males. Taken together, these results are striking and suggestive of the potential role of sex in modifying factors important in HCV clearance. Mechanisms behind the association of female sex and clearance may be linked to sex-based differences in immunity. Females have a lower burden of infections, a higher prevalence of several autoimmune diseases and an increased number and magnitude of immune and inflammatory responses, as compared to males. The prevailing hypothesis to explain immunological differences between males and females is that sex steroids bind to specific receptors expressed in lymphoid tissue cells, macrophages, dendritic cells and lymphocytes, thereby influencing the function of immune cells. However, despite considerable research demonstrating differences in immune function between females and males, there are little data on sex-based differences in immune profiles in those with HCV.
MedicalResearch.com: What should clinicians and patients take away from your report?
Dr. Grebely: Males with the unfavourable IL28B genotype should perhaps be offered more immediate HCV therapy during the acute phase of HCV infection, given they have a low likelihood of HCV clearance, but higher response to therapy during the acute phase as compared to the chronic phase of infection.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Dr. Grebely: Further studies should focus on mechanisms explaining differences in clearance between males and females as this may contain important information for understanding HCV viral control.
Citation:
The effects of female sex, viral genotype, and IL28B genotype on spontaneous clearance of acute hepatitis C virus infection
Grebely J, Page K, Sacks-Davis R, van der Loeff MS, Rice TM, Bruneau J, Morris MD, Hajarizadeh B, Amin J, Cox AL, Kim AY, McGovern BH, Schinkel J, George J, Shoukry NH, Lauer GM, Maher L, Lloyd AR, Hellard M, Dore GJ, Prins M; the InC3 Study Group.
The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
Hepatology. 2013 Aug 2. doi: 10.1002/hep.26639. [Epub ahead of print]
Last Updated on December 13, 2013 by Marie Benz MD FAAD