title: The impact of illicit drug use on spontaneous hepatitis C clearance: experience from a large cohort population study.
abstract: OBJECTIVE
  Acute hepatitis C infection usually ends in chronic infection, while in a minority of patients it is spontaneously cleared. The current population-based study is performed on a large cohort in Golestan province of Iran to examine the demographic correlates of Spontaneous Hepatitis C Clearance.
  
  
  METHODS
  Serum samples used in this study had been stored in biorepository of Golestan Cohort Study. These samples were evaluated for anti hepatitis C Virus by third generation Enzyme-linked immunosorbent assay (ELISA). Subjects who tested positive were then invited and tested by Recombinant Immunoblot Assay (RIBA) and Ribonucleic Acid Polymerase Chain Reaction test (PCR). If tested positive for RIBA, subjects were recalled and the two tests were re-done after 6 months. Those subjects who again tested positive for RIBA but negative for PCR were marked as cases of spontaneous clearance.
  
  
  RESULTS
  49,338 serum samples were evaluated. The prevalence of Chronic Hepatitis C Virus (CHCV) infection based on PCR results was 0.31%. Among those who had acquired hepatitis C, the rate of SC was 38%. In multivariate analysis, illicit drug use both Injecting Use (OR = 3.271, 95% CI: 1.784-6.000, p-value<0.001) and Non-Injecting Use (OR = 1.901, 95% CI: 1.068-3.386, p-value = 0.029) were significant correlates of CHCV infection versus SC.
  
  
  CONCLUSIONS
  Illicit drug use whether intravenous or non-intravenous is the only significant correlate of CHCV, for which several underlying mechanisms can be postulated including repeated contacts with hepatitis C antigen.
authors: Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Tehran, Iran.
authors: Hossein
authors: H
authors: Poustchi
authors: Saeed
authors: S
authors: Esmaili
authors: Ashraf
authors: A
authors: Mohamadkhani
authors: Aghbibi
authors: A
authors: Nikmahzar
authors: Akram
authors: A
authors: Pourshams
authors: Sadaf G
authors: SG
authors: Sepanlou
authors: Shahin
authors: S
authors: Merat
authors: Reza
authors: R
authors: Malekzadeh
mesh_terms: D015331:Cohort Studies; D005260:Female; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology*; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012075:Remission, Spontaneous; D019966:Substance-Related Disorders