Department of Environmental Medicine, Poznań University of Medical Sciences, 60-806 Poznań, Poland.
Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland.
Viruses. 2024 Aug 30;16(9):1386. doi: 10.3390/v16091386.
Elimination of hepatitis C virus (HCV) without the need for medical intervention, known as spontaneous clearance (SC), occurs at a significantly lower rate than in the case of hepatitis B virus infection and only in selected individuals, such as reportedly in Keith Richards, a guitarist of The Rolling Stones. The present paper provides an updated narrative review of the research devoted to the phenomenon in order to identify and discuss the demographic, lifestyle-related, clinical, viral genotype-related, and host genetic factors underpinning the SC occurrence. The body of evidence indicates that the likelihood of SC is decreased in older individuals, men, Black people, HIV-coinfected subjects, and intravenous drug and alcohol users. In turn, HBV coinfection and specific polymorphism of the genes encoding interferon lambda 3 (particularly at rs8099917) and interferon lambda 4 (particularly at rs12979860) and genes increase the odds of SC. Numerous other host-specific genetic factors could be implicated in SC, but the evidence is limited only to certain ethnic groups and often does not account for confounding variables. SC of HCV infection is a complex process arising from a combination of various factors, though a genetic component may play a leading role in some cases. Understanding factors influencing the likelihood of this phenomenon justifies better surveillance of high-risk groups, decreasing health inequities in particular ethnic groups, and may guide the development of a prophylactic vaccine, which at present is not available, or novel therapeutic strategies. Further research is needed to elucidate the exact mechanisms underlying SC and to explore potential interventions that could enhance this natural antiviral response.
HCV 病毒的消除（即无需医疗干预的自发性清除，简称 SC），其发生率远低于乙型肝炎病毒感染，且仅见于某些特定个体，如滚石乐队的吉他手基思·理查兹。本文对这一现象的研究进行了更新的叙述性综述，以确定和讨论支持 SC 发生的人口统计学、与生活方式相关的、临床的、病毒基因型相关的和宿主遗传因素。有证据表明，SC 的可能性在年龄较大的个体、男性、黑人、HIV 合并感染的受试者以及静脉内药物和酒精使用者中降低。相反，HBV 合并感染和编码干扰素 lambda 3（特别是 rs8099917）和干扰素 lambda 4（特别是 rs12979860）和 基因的特定多态性增加了 SC 的几率。许多其他宿主特异性遗传因素可能与 SC 有关，但证据仅局限于某些特定种族，且通常无法解释混杂变量。HCV 感染的 SC 是一个复杂的过程，由多种因素共同作用引起，尽管遗传因素在某些情况下可能起主导作用。了解影响这种现象发生几率的因素有助于更好地监测高危人群，减少特定种族的健康不平等，并可能指导预防性疫苗的开发，而目前这种疫苗尚未问世，或探索新的治疗策略。需要进一步的研究来阐明 SC 的确切机制，并探索可能增强这种天然抗病毒反应的潜在干预措施。
