Evidence for factors to better predict spontaneous clearance (SC) of acute hepatitis C in HIV-1-infected MSM1

Given the emerging epidemic of primary hepatitis C infection (PHCV) in HIV-infected MSM in Europe, Australia and USA, researchers in London have conducted a prospective, longitudinal, cohort study to investigate factors that may predict spontaneous clearance of HCV. A positive HCV-RNA-PCR, occurring within 6 months of a preceding negative PCR or antibody test, was used to diagnose 112 MSM with PHCV. Retrospective testing was performed on stored samples to confirm PHCV where necessary. Ten men were also confirmed to have primary HIV infection at the time of diagnosis.

Plasma and peripheral blood mononuclear cells were obtained at monthly intervals for 3 months and at 3-monthly intervals thereafter, for a median of 45 months (IQR=29–69) for HCV-RNA, liver function tests and CD4 quantification. A sub-study group of 10 SCs and 40 progressors also had samples for HCV phylogenetics taken at multiple time points to assess baseline and subsequent quasi-species variance.

Fifteen per cent spontaneously cleared their PHCV. …