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Factors associated with spontaneous clearance of hepatitis C virus among illicit drug users Grebely, Jason; Raffa, Jesse Daniel; Lai, Calvin; Krajden, Mel; Conway, Brian; Tyndall, Mark

Abstract

BACKGROUND: Spontaneous clearance of hepatitis C virus (HCV) occurs in approximately 25% of individuals. METHODS: To better understand the characteristics associated with clearance, the present study evaluated HCV clearance in a community-based cohort study. The Community Health and Safety Evaluation project recruited 3553 individuals via community organizations and door-to-door canvassing of a random sample of single occupancy hotels in the community to monitor uptake of health services and to estimate the incidence of communicable infections. Cohort data were linked with longitudinal laboratory databases, including HCV antibody and polymerase chain reaction assay results. RESULTS: Overall, 762 individuals had HCV antibody and RNA testing performed between 1999 and 2005. Spontaneous HCV clearance was observed in 179 individuals (23.5%), while HCV persistence was observed in 583 individuals (76.5%). The ability to develop protective immunity against HCV, as demonstrated by viral clearance, occurred more often in individuals of Aboriginal ethnicity (adjusted OR [AOR] 2.9, 95% CI 2.0 to 4.3; P<0.001) and female individuals (AOR 1.6, 95% CI 1.1 to 2.4; P=0.01). The rate of spontaneous HCV clearance was reduced in individuals using any type of illicit drugs (AOR 0.54, 95% CI 0.29 to 1.00; P=0.05) and those with HIV coinfection (AOR 0.58, 95% CI 0.38 to 0.88; P=0.01). Of 218 HIV-infected subjects, 48 of 51 (94%) in whom the order of HCV and HIV infection was established were infected with HCV a median of 2.4 years (range 0.2 to 10 years) before becoming infected with HIV. CONCLUSIONS: Aboriginal ethnicity and female sex were associated with increased rates of HCV clearance, while HIV coinfection and illicit drug use were associated with increased HCV persistence.

Item Metadata

Title
Factors associated with spontaneous clearance of hepatitis C virus among illicit drug users
Creator
Grebely, Jason; Raffa, Jesse Daniel; Lai, Calvin; Krajden, Mel; Conway, Brian; Tyndall, Mark
Contributor
British Columbia Centre for Excellence in HIV/AIDS; BC Centre for Disease Control
Date Issued
2007-07
Description
BACKGROUND: Spontaneous clearance of hepatitis C virus (HCV) occurs in approximately 25% of individuals. METHODS: To better understand the characteristics associated with clearance, the present study evaluated HCV clearance in a community-based cohort study. The Community Health and Safety Evaluation project recruited 3553 individuals via community organizations and door-to-door canvassing of a random sample of single occupancy hotels in the community to monitor uptake of health services and to estimate the incidence of communicable infections. Cohort data were linked with longitudinal laboratory databases, including HCV antibody and polymerase chain reaction assay results. RESULTS: Overall, 762 individuals had HCV antibody and RNA testing performed between 1999 and 2005. Spontaneous HCV clearance was observed in 179 individuals (23.5%), while HCV persistence was observed in 583 individuals (76.5%). The ability to develop protective immunity against HCV, as demonstrated by viral clearance, occurred more often in individuals of Aboriginal ethnicity (adjusted OR [AOR] 2.9, 95% CI 2.0 to 4.3; P<0.001) and female individuals (AOR 1.6, 95% CI 1.1 to 2.4; P=0.01). The rate of spontaneous HCV clearance was reduced in individuals using any type of illicit drugs (AOR 0.54, 95% CI 0.29 to 1.00; P=0.05) and those with HIV coinfection (AOR 0.58, 95% CI 0.38 to 0.88; P=0.01). Of 218 HIV-infected subjects, 48 of 51 (94%) in whom the order of HCV and HIV infection was established were infected with HCV a median of 2.4 years (range 0.2 to 10 years) before becoming infected with HIV. CONCLUSIONS: Aboriginal ethnicity and female sex were associated with increased rates of HCV clearance, while HIV coinfection and illicit drug use were associated with increased HCV persistence.
Subject
Aboriginal ethnicity; Female; Hepatitis C virus; HIV; Injection drug use
Geographic Location
Downtown-Eastside (Vancouver, B.C.)
Genre
Article
Type
Text
Language
eng
Date Available
2017-01-21
Provider
Vancouver : University of British Columbia Library
Rights
Attribution-NonCommercial-NoDerivatives 4.0 International
DOI
10.14288/1.0339808
URI
http://hdl.handle.net/2429/59736
Affiliation
Medicine, Faculty of; Science, Faculty of; Other UBC; Anesthesiology, Pharmacology and Therapeutics, Department of; Medicine, Department of; Statistics, Department of
Citation
Grebely J, Raffa JD, Lai C, Krajden M, Conway B, Tyndall MW.Factors associated with spontaneous clearance of hepatitis C virus among illicit drug users. Can J Gastroenterol. 2007 Jul;21(7):447-51
Peer Review Status
Reviewed
Scholarly Level
Faculty; Researcher; Graduate
Copyright Holder
Jason Grebely
Rights URI
http://creativecommons.org/licenses/by-nc-nd/4.0/
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Attribution-NonCommercial-NoDerivatives 4.0 International