title: Hepatitis C virus infection and spontaneous clearance in HTLV-1 and HIV co-infected patients in Salvador, Bahia, Brazil.
abstract: BACKGROUND
  While 20-40% of patients with hepatitis C virus (HCV) monoinfection will spontaneously clear the virus, less is known regarding clearance with coinfections. HCV, human immunodeficiency virus (HIV), and human T-cell lymphotrophic virus 1 and 2 (HTLV-1/2) coinfection occurs due to shared routes of transmission and is prevalent in Brazil.
  
  
  OBJECTIVE
  To compare the proportion of patients who have spontaneously cleared HCV in patients with HCV monoinfection to patients coinfected by HCV/HIV, or HCV/HIV/HTLV-1.
  
  
  METHODS
  Using medical records from two clinics in Salvador, Brazil, including demographic data and serological markers of HCV, HIV and HTLV-I/II, cross-sectional data was obtained from 197 patients. Patients who were anti-HCV positive and HCV RNA negative, and who did not receive HCV treatment were defined as having cleared infection.
  
  
  RESULTS
  Nineteen patients (9.5%) showed evidence of spontaneous HCV clearance; with clearance in 9 of 108 (8.3%) patients in the HCV monoinfected group, 5 of 68 (7.4%) patients with HCV/HIV, and 5 of 21 (23.8%) patients with HCV/HIV/HTLV. Demographic data were not associated with HCV clearance status. Patients coinfected with both HIV and HTLV-1 had increased odds (5.50; 95% CI 1.00, 30.17) of spontaneous clearance of HCV compared with patients who were HIV negative or of unknown HIV status.
  
  
  CONCLUSIONS
  Our study found that patients coinfected with HIV and HTLV-1 were more likely to spontaneously clear hepatitis C virus than patients with HIV/HCV or HCV alone. The effects of HTLV coinfection on the immune response of such patients may be associated with these findings.
authors.affiliation: School of Medicine, University of California San Francisco, San Francisco, USA.
authors.forename: Chloe
authors.initials: C
authors.lastname: Le Marchand
authors.affiliation: Department of Infectious Disease, Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil.
authors.forename: Fabianna
authors.initials: F
authors.lastname: Bahia
authors.affiliation: Division of Epidemiology, Biostatistics and Preventive Medicine, University of New Mexico Health Sciences Center, Albuquerque, USA.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Page
authors.affiliation: Department of Infectious Disease, Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil. Electronic address: crbrites@gmail.com.
authors.forename: Carlos
authors.initials: C
authors.lastname: Brites
mesh_terms: D000328:Adult; D001938:Brazil; D060085:Coinfection / Q000821:virology*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications*; D015490:HTLV-I Infections / Q000150:complications*; D006526:Hepatitis C / Q000150:complications* / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012367:RNA, Viral; D017201:Virus Shedding
chemical_list: D012367:RNA, Viral
keywords: Brazil; HIV; HTLV-1; Hepatitis C; Spontaneous HCV clearance