title: Female sex and IL28B, a synergism for spontaneous viral clearance in hepatitis C virus (HCV) seroconverters from a community-based cohort.
abstract: OBJECTIVE
  Since acute hepatitis C virus (HCV) infection is often asymptomatic, it is difficult to examine the rate and determinants of spontaneous clearance. Consequently, these studies are subject to bias, which can potentially lead to biased rates of viral clearance and risk estimates. We evaluated determinants of spontaneous HCV clearance among HCV seroconverters identified in a unique community-based cohort.
  
  
  METHODS
  Subjects were 106 drug users with documented dates of HCV seroconversion from the Amsterdam Cohort Study. Logistic regression was used to examine sociodemographic, behavioral, clinical, viral and host determinants, measured around acute infection, of HCV clearance.
  
  
  RESULTS
  The spontaneous viral clearance rate was 33.0% (95% confidence interval (CI) 24.2-42.8). In univariate analyses female sex and fever were significantly associated with spontaneous clearance. The favorable genotypes for rs12979860 (CC) and rs8099917 (TT) were associated with spontaneous clearance, although borderline significant. In multivariate analysis, females with the favorable genotype for rs12979860 (CC) had an increased odds to spontaneously clear HCV infection (adjusted OR 6.62, 95% 2.69-26.13), whereas females with the unfavorable genotype were as likely as men with the favorable and unfavorable genotype to clear HCV. Chronic Hepatitis B infection and absence of HIV coinfection around HCV seroconversion also favor HCV clearance.
  
  
  CONCLUSIONS
  This study shows that co-infection with HIV and HBV and genetic variation in the IL28B region play an important role in spontaneous clearance of HCV. Our findings suggest a possible synergistic interaction between female sex and IL28B in spontaneous clearance of HCV.
authors: Cluster Infectious Diseases, Department of Research, Center for Infection and Immunity Amsterdam (CINIMA), Public Health Service, Amsterdam, The Netherlands.
authors: Charlotte H B S
authors: CH
authors: van den Berg
authors: Bart P X
authors: BP
authors: Grady
authors: Janke
authors: J
authors: Schinkel
authors: Thijs
authors: T
authors: van de Laar
authors: Richard
authors: R
authors: Molenkamp
authors: Robin
authors: R
authors: van Houdt
authors: Roel A
authors: RA
authors: Coutinho
authors: Debbie
authors: D
authors: van Baarle
authors: Maria
authors: M
authors: Prins
mesh_terms: D000208:Acute Disease / Q000453:epidemiology; D000328:Adult; D058345:Asymptomatic Infections / Q000453:epidemiology; D001519:Behavior; D015331:Cohort Studies; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000472:pathogenicity*; D006526:Hepatitis C / Q000150:complications / Q000453:epidemiology* / Q000235:genetics* / Q000821:virology; D006801:Humans; D007372:Interferons; D007378:Interleukins / Q000235:genetics*; D008297:Male; D015999:Multivariate Analysis; D012075:Remission, Spontaneous; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D017678:Sex Distribution; D000095022:Interferon Lambda
chemical_list: D007372:Interferons; D007378:Interleukins; C000624353:interferon-lambda, human; D000095022:Interferon Lambda