Micallef J M, Kaldor J M, Dore G J
National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales, Darlinghurst, Sydney, NSW, Australia.
J Viral Hepat. 2006 Jan;13(1):34-41. doi: 10.1111/j.1365-2893.2005.00651.x.
A large number of studies have reported on spontaneous viral clearance rates in acute hepatitis C infection, however most have been small, and reported rates have varied quite widely. To improve the precision of the estimated rate of spontaneous viral clearance, a systematic review was conducted of longitudinal studies. Factors associated with viral clearance were also examined. Inclusion criteria for studies were: longitudinal assessment from time of acute hepatitis C; hepatitis C virus RNA analysis as determinant of viral clearance; untreated for acute hepatitis C. Information on study population, and factors that may influence viral clearance were extracted from each study. Viral clearance was defined among individuals with at least 6 months follow-up following acute hepatitis C. The number of subjects with viral clearance was expressed as a proportion for each study and a weighted mean for proportion was calculated. A total of 31 studies were examined. Study populations included nine studies of post-transfusion hepatitis, 19 of acute clinical hepatitis, and three of sero-incident cases. In total, data was available for 675 subjects and the mean study population was 22 (range 4-67). The proportion with viral clearance ranged from 0.0 to 0.8, with a weighted mean of 0.26 (95% CI 0.22-0.29). Factors associated with viral clearance were female gender and acute clinical hepatitis C study population. Further studies are required to more clearly define predictors of clearance and guide therapeutic intervention strategies.
大量研究报告了急性丙型肝炎感染的病毒自发清除率，然而大多数研究规模较小，报告的清除率差异也很大。为提高病毒自发清除率估计的准确性，对纵向研究进行了系统评价。还研究了与病毒清除相关的因素。纳入研究的标准为：自急性丙型肝炎起进行纵向评估；以丙型肝炎病毒RNA分析作为病毒清除的决定因素；未接受急性丙型肝炎治疗。从每项研究中提取有关研究人群以及可能影响病毒清除的因素的信息。病毒清除定义为急性丙型肝炎后至少随访6个月的个体。将病毒清除的受试者数量表示为每项研究的比例，并计算比例的加权平均值。共审查了31项研究。研究人群包括9项输血后肝炎研究、19项急性临床肝炎研究和3项血清感染病例研究。总共获得了675名受试者的数据，平均研究人群为22人（范围4 - 67人）。病毒清除的比例范围为0.0至0.8，加权平均值为0.26（95%置信区间0.22 - 0.29）。与病毒清除相关的因素为女性性别和急性临床丙型肝炎研究人群。需要进一步研究以更明确地确定清除的预测因素并指导治疗干预策略。
