Spontaneous Viral Load Decline and Subsequent Clearance of Chronic Hepatitis C Virus in Postpartum Women Correlates With Favorable Interleukin-28B Gene Allele
Autor: | Ravi Jhaveri, Doa’a A. Saleh, Sahar A. Sharaf, Michelle Shardell, Mohamed D. Hashem, Samer S. El-Kamary, Fatma El-Mougy, Hesham Elghazaly, Lobna Abdelsalam |
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Rok vydání: | 2017 |
Předmět: |
Adult
0301 basic medicine Microbiology (medical) medicine.medical_specialty Time Factors Genotype Hepatitis C virus Remission Spontaneous Viremia medicine.disease_cause Gastroenterology 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Pregnancy Internal medicine Correspondence Humans Medicine Prospective Studies Pregnancy Complications Infectious Articles and Commentaries Alleles Polymorphism Genetic business.industry Interleukins Postpartum Period Odds ratio Hepatitis C Hepatitis C Antibodies Hepatitis C Chronic Viral Load medicine.disease 030104 developmental biology Infectious Diseases Immunology Cohort RNA Viral Female 030211 gastroenterology & hepatology Interferons business Viral load Postpartum period |
Zdroj: | Clin Infect Dis |
ISSN: | 1537-6591 1058-4838 |
Popis: | Background Postpartum hepatitis C viral (HCV) load decline followed by spontaneous clearance has been previously described. Herein we identify predictors for viral decline in a cohort of HCV-infected postpartum women. Methods Pregnant women at Cairo University were screened for anti-HCV antibodies and HCV RNA, and viremic women were tested for quantitative HCV RNA at 3, 6, 9, and 12 months postpartum. Spontaneous clearance was defined as undetectable viremia twice at least 6-months apart. Associations between viral load and demographic, obstetrical, HCV risk factors, and interleukin-28B gene (IL28B) polymorphism (rs12979860) were assessed. Results Of 2514 women, 97 (3.9%) had anti-HCV antibodies, 54 (2.1%) were viremic and of those, 52 (2.1%) agreed to IL28B testing. From pregnancy until 12 months postpartum, IL28B-CC allele women had a significant viral decline (P = .009). After adjusting, the IL28B-CC allele had a near significant difference compared to the CT allele (odds ratio [OR], 0.75; 95% confidence interval [CI], 0.75,1.00; P = .05), but not the TT allele (OR, 0.91; 95% CI, 0.61,1.38; P = .64). All 14/52 (26.9%) women who subsequently cleared were among the 15 with undetectable viremia at 12 months, making that time point a strong predictor of subsequent clearance (sensitivity = 100%, specificity = 97.4%, positive predictive value = 93.3%, negative predictive value = 100%). Conclusions IL28B-CC genotype and 12-month postpartum undetectable viremia were the best predictors for viral decline and subsequent clearance. These 2 predictors should influence clinical decision making. |
Databáze: | OpenAIRE |
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