Watanabe Hisayoshi, Saito Takafumi, Shinzawa Haruhide, Okumoto Kazuo, Hattori Etsuko, Adachi Tohru, Takeda Tadashi, Sugahara Kazuhiko, Ito Jun-itsu, Saito Koji, Togashi Hitoshi, Suzuki Ryosuke, Hayashi Masahiro, Miyamura Tatsuo, Matsuura Yoshiharu, Kawata Sumio
Second Department of Internal Medicine, Yamagata University School of Medicine, Yamagata, Japan.
J Med Virol. 2003 Sep;71(1):56-61. doi: 10.1002/jmv.10448.
The natural course of hepatitis C virus (HCV) infection has not been fully elucidated. To investigate whether HCV is spontaneously eliminated in chronic carriers, a long-term population-based cohort study was conducted on 435 chronic HCV carriers. Individual characteristics, serum HCV RNA, and liver function tests were analyzed, and ultra sonography (US) was performed in all subjects. Subjects were followed up for 7.2 +/- 2.4 years (mean +/- SD). Serum HCV RNA was spontaneously eliminated in 16/435 (3.7%) individuals during this period; thus, the incidence of spontaneous elimination of serum HCV RNA was 0.5%/year/person. Multivariate analysis revealed that both a low value of ZTT and no US finding of chronic liver disease were associated with spontaneous viral elimination in HCV carriers. Three of these 16 individuals had chronic hepatitis, and 13 of them had normal ALT levels. When the neutralization of binding (NOB) assay that evaluates inhibition of the HCV envelope-2 protein binding to human cells was examined using sera from these 16 individuals, the NOB antibody was detected in only 3 cases with chronic hepatitis. These results suggest that serum HCV RNA is spontaneously eliminated in chronic HCV carriers in a population, and that the development of NOB antibody is associated with a natural resolution of chronic hepatitis in the minority of them.
丙型肝炎病毒（HCV）感染的自然病程尚未完全阐明。为了研究慢性携带者中HCV是否会自发清除，我们对435名慢性HCV携带者进行了一项基于人群的长期队列研究。分析了个体特征、血清HCV RNA和肝功能检查结果，并对所有受试者进行了超声检查（US）。对受试者进行了7.2±2.4年（平均±标准差）的随访。在此期间，16/435（3.7%）的个体血清HCV RNA自发清除；因此，血清HCV RNA自发清除的发生率为0.5%/年/人。多变量分析显示，ZTT值较低以及超声检查未发现慢性肝病均与HCV携带者的病毒自发清除有关。这16名个体中有3例患有慢性肝炎，13例ALT水平正常。当使用这16名个体的血清检测评估HCV包膜-2蛋白与人细胞结合抑制作用的结合中和（NOB）试验时，仅在3例慢性肝炎患者中检测到NOB抗体。这些结果表明，人群中慢性HCV携带者的血清HCV RNA会自发清除，并且在少数患者中，NOB抗体的产生与慢性肝炎的自然缓解有关。
