title: Role of primary T-cell immunodeficiency and hepatitis B coinfection on spontaneous clearance of hepatitis C: The BC Hepatitis Testers Cohort.
abstract: T-cell host immune response against hepatitis C virus (HCV) has been suggested to play an important role in determining HCV infection outcome. However, data from human studies are not available. This study examined the effect of primary T-cell deficiency along with other factors on the spontaneous clearance of HCV in a large population-based cohort in British Columbia, Canada. The BC Hepatitis Testers Cohort includes all individuals tested for HCV in BC in 1990-2013 linked with data on their medical visits, hospitalizations and prescription drugs. HCV-positive individuals with at least one valid HCV PCR test on/after HCV diagnosis (n=46 783) were included in this study. To examine factors associated with the spontaneous clearance of HCV, multivariable logistic regression was fitted on the full sample, and Cox proportional hazards model on the HCV seroconverters. Spontaneous clearance was observed in 25.1% (n=11 737) of those tested for HCV. After adjusting for potential confounders, the odds of spontaneous clearance of HCV was lower in people with primary T-cell immunodeficiency (adjusted odds ratio [aOR]: 0.55, 95% CI: 0.32-0.94), and higher in females (aOR: 1.61, 95% CI: 1.54-1.68) and in those coinfected with HBV (aOR: 2.31, 95% CI: 1.93-2.77). Similar results were observed in HCV seroconverters except HBV coinfection was not significant. In conclusion, primary T-cell immunodeficiency is associated with a lower spontaneous clearance of HCV while female sex and coinfection with HBV are associated with a higher spontaneous clearance.
authors.affiliation: School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.|British Columbia Centre for Disease Control, Vancouver, BC, Canada.
authors.forename: N
authors.initials: N
authors.lastname: Islam
authors.affiliation: British Columbia Centre for Disease Control, Vancouver, BC, Canada.|Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Krajden
authors.affiliation: British Columbia Centre for Disease Control, Vancouver, BC, Canada.|Ontario HIV Treatment Network, Toronto, ON, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Gilbert
authors.affiliation: Department of Statistics, University of British Columbia, Vancouver, BC, Canada.
authors.forename: P
authors.initials: P
authors.lastname: Gustafson
authors.affiliation: British Columbia Centre for Disease Control, Vancouver, BC, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Yu
authors.affiliation: British Columbia Centre for Disease Control, Vancouver, BC, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Kuo
authors.affiliation: British Columbia Centre for Disease Control, Vancouver, BC, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Chong
authors.affiliation: British Columbia Centre for Disease Control, Vancouver, BC, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Alvarez
authors.affiliation: School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.|British Columbia Centre for Disease Control, Vancouver, BC, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Wong
authors.affiliation: School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.|British Columbia Centre for Disease Control, Vancouver, BC, Canada.
authors.forename: M W
authors.initials: MW
authors.lastname: Tyndall
authors.affiliation: School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.|British Columbia Centre for Disease Control, Vancouver, BC, Canada.
authors.forename: N Z
authors.initials: NZ
authors.lastname: Janjua
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001955:British Columbia; D060085:Coinfection / Q000821:virology*; D005260:Female; D016174:Hepacivirus / Q000302:isolation & purification*; D006509:Hepatitis B / Q000150:complications*; D006526:Hepatitis C / Q000821:virology*; D006801:Humans; D007153:Immunologic Deficiency Syndromes / Q000150:complications*; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D000081207:Primary Immunodeficiency Diseases; D012367:RNA, Viral / Q000097:blood; D055815:Young Adult
chemical_list: D012367:RNA, Viral
keywords: T-cell immunodeficiency; genotype; hepatitis B virus; hepatitis C virus; spontaneous resolution