title: Correlates of spontaneous clearance of hepatitis C virus in a Danish human immunodeficiency virus type 1 cohort.
abstract: BACKGROUND
  Around a quarter of individuals infected with hepatitis C virus (HCV) are spontaneously able to clear the virus. Correlates of spontaneous HCV clearance are not well established and the aim of this study was to characterize factors associated with spontaneous HCV clearance in a human immunodeficiency virus (HIV)-co-infected cohort.
  
  
  METHODS
  We analyzed 327 anti-HCV-positive HIV-1-infected patients using multivariate logistic regression. HCV clearance was defined as the presence of anti-HCV with undetectable HCV RNA from at least 2 measurements more than 6 months apart.
  
  
  RESULTS
  We included 327 HIV-1-infected individuals, predominantly of Caucasian race; 112 (34%) were females, 258 (79%) were injecting drug users (IDU), 25 (8%) were men who have sex with men (MSM), and 20 (6%) were hepatitis B surface antigen (HBsAg)-positive. Seventy-six (23%; 95% confidence interval (CI) 18-28) had cleared their HCV infection and 251 (77%; 95% CI 72-82) had a chronic infection. The clearance rate in HBsAg-positive individuals was 65%. Being female, HBsAg-positive, or belonging to HIV exposure groups IDU and MSM predicted higher HCV clearance rates (adjusted odds ratio (aOR) 1.8, 95% CI 1-3.2; aOR 7.6, 95% CI 2.7-21; aOR 5.2, 1.2-23.5; and aOR 10.2, 95% CI 1.8-58, respectively). Race, acquired immunodeficiency syndrome (AIDS), and antiretroviral therapy were not associated with HCV clearance.
  
  
  CONCLUSIONS
  The HCV clearance rate in this HIV-1 cohort was 23%. MSM and IDUs may have higher clearance rates due to their repeated exposure to low-dose HCV, leading to immune memory. Our data suggest an interaction of hepatitis B virus and HCV that influences the outcome of acute HCV infection.
authors: Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark. louisenygaardclausen@gmail.com
authors: Louise Nygaard
authors: LN
authors: Clausen
authors: Nina
authors: N
authors: Weis
authors: Kristian
authors: K
authors: Schønning
authors: Mogens
authors: M
authors: Fenger
authors: Henrik
authors: H
authors: Krarup
authors: Jens
authors: J
authors: Bukh
authors: Thomas
authors: T
authors: Benfield
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D055030:Drug Users; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology / Q000821:virology*; D015497:HIV-1; D016174:Hepacivirus; D006511:Hepatitis B Antigens / Q000032:analysis; D006526:Hepatitis C / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology / Q000821:virology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D012367:RNA, Viral / Q000097:blood; D019562:Viral Load
chemical_list: D044966:Anti-Retroviral Agents; D006511:Hepatitis B Antigens; D012367:RNA, Viral