Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Tehran, Iran.
PLoS One. 2011;6(8):e23830. doi: 10.1371/journal.pone.0023830. Epub 2011 Aug 24.
Acute hepatitis C infection usually ends in chronic infection, while in a minority of patients it is spontaneously cleared. The current population-based study is performed on a large cohort in Golestan province of Iran to examine the demographic correlates of Spontaneous Hepatitis C Clearance.
Serum samples used in this study had been stored in biorepository of Golestan Cohort Study. These samples were evaluated for anti hepatitis C Virus by third generation Enzyme-linked immunosorbent assay (ELISA). Subjects who tested positive were then invited and tested by Recombinant Immunoblot Assay (RIBA) and Ribonucleic Acid Polymerase Chain Reaction test (PCR). If tested positive for RIBA, subjects were recalled and the two tests were re-done after 6 months. Those subjects who again tested positive for RIBA but negative for PCR were marked as cases of spontaneous clearance.
49,338 serum samples were evaluated. The prevalence of Chronic Hepatitis C Virus (CHCV) infection based on PCR results was 0.31%. Among those who had acquired hepatitis C, the rate of SC was 38%. In multivariate analysis, illicit drug use both Injecting Use (OR = 3.271, 95% CI: 1.784-6.000, p-value<0.001) and Non-Injecting Use (OR = 1.901, 95% CI: 1.068-3.386, p-value = 0.029) were significant correlates of CHCV infection versus SC.
Illicit drug use whether intravenous or non-intravenous is the only significant correlate of CHCV, for which several underlying mechanisms can be postulated including repeated contacts with hepatitis C antigen.
急性丙型肝炎感染通常会导致慢性感染，而在少数患者中，它会被自发清除。本研究在伊朗戈勒斯坦省的一个大队列中进行，旨在研究自发清除丙型肝炎的人口统计学相关性。
本研究使用的血清样本储存在戈勒斯坦队列研究的生物库中。这些样本通过第三代酶联免疫吸附试验（ELISA）检测抗丙型肝炎病毒。对检测呈阳性的受试者进行重组免疫印迹分析（RIBA）和核糖核酸聚合酶链反应（PCR）检测。如果 RIBA 检测呈阳性，将召回受试者，并在 6 个月后重新进行这两项检测。如果 RIBA 再次呈阳性但 PCR 呈阴性的受试者被标记为自发清除病例。
评估了 49338 份血清样本。基于 PCR 结果，慢性丙型肝炎病毒（CHCV）感染的患病率为 0.31%。在感染丙型肝炎的人群中，自发清除率为 38%。在多变量分析中，使用非法药物，包括注射使用（OR=3.271，95%CI：1.784-6.000，p 值<0.001）和非注射使用（OR=1.901，95%CI：1.068-3.386，p 值=0.029）与 CHCV 感染与 SC 相比是显著相关的。
使用非法药物，无论是静脉内还是非静脉内，是 CHCV 的唯一显著相关因素，其背后的机制可能包括与丙型肝炎抗原的反复接触。
