Produção Nacional
Revisado por pares
Prospective Follow‐Up of Patients with Acute Hepatitis C Virus Infection in Brazil
2010; Oxford University Press; Volume: 50; Issue: 9 Linguagem: Inglês
10.1086/651599
ISSN1537-6591
AutoresLia Laura Lewis‐Ximenez, Georg M. Lauer, Julian Schulze zur Wiesch, Paulo Sérgio Fonseca de Sousa, Cleber F. Ginuino, Gláucia Paranhos‐Baccalà, Hanno Ulmer, Karl Pfeiffer, Hans H. Goebel, João Luiz Pereira, Jaqueline Mendes Oliveira, Clara Fumiko Tachibana Yoshida, Elisabeth Lampe, Carlos Eduardo Pereira Velloso, Marcelo Alves Pinto, Henrique Sergio Coelho, Adílson José de Almeida, Carlos Augusto Fernandes, Arthur Y. Kim, Alexander Strasak,
Tópico(s)Liver Disease Diagnosis and Treatment
ResumoThe natural outcome of infection with hepatitis C virus (HCV) varies substantially among individuals. However, little is known about host and viral factors associated with a self-limiting or chronic evolution of HCV infection.From 1 January 2001 through 31 December 2008, a consecutive series of 65 patients from Rio de Janeiro, Brazil, with a well-documented diagnosis of acute HCV infection, acquired via various routes, were enrolled in this study. Patients were prospectively followed up for a median of 40 months after the estimated date of HCV infection with serial measurements of serum alanine aminotransferase, HCV RNA, and anti-HCV antibodies. Spontaneous viral clearance (SVC) was defined as undetectable levels of HCV RNA in serum, in the absence of treatment, for 3 consecutive HCV polymerase chain reaction tests within the first 6 months of follow-up. Cox proportional hazards regression was used to identify host and viral predictors of SVC.The cumulative rate of SVC was 44.6% (95% confidence interval, 32.3%-57.5%). Compared with chronic HCV evolution, patients with self-limiting disease had significantly lower peak levels of anti-HCV antibodies (median, 109.0 vs 86.7 optical density-to-cutoff ratio [od/co]; P<.02), experienced disease symptoms more frequently (69.4% vs 100%; P<.001), and had lower viral load at first clinical presentation (median, 4.3 vs 0.0 log copies; P=.01). In multivariate analyses, low peak anti-HCV level ( or =93.5 od/co) was 2.62 (95% confidence interval, 1.11-6.19; P=.03).Our data suggest that low levels of anti-HCV antibodies during the acute phase of HCV infection are independently related to spontaneous viral clearance.
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