Spontaneous resolution of chronic hepatitis C virus infection after antiviral treatment and relapse

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• 作者：Potthoff ; Andrej ; Sarhaddar ; Jasmin ; Wiegand ; Johannes ; Lichtinghagen ; Ralf ; Sarrazin ; Christoph ; et. al.
• 关键词：Hepatitis C infection ; Relapse ; IL-8 ; Clearance ; T cells
• 刊名：Hepatology Research
• 出版年：2005
• 出版时间：January, 2005
• 年：2005
• 卷：31
• 期：1
• 页码：18-23
• 全文大小：241 K

文摘

Clearance of acute hepatitis C virus (HCV) infection is associated with strong and multi-specific cellular immune responses which are often weak in chronic hepatitis C. We here report a case of spontaneous and sustained resolution of chronic hepatitis C virus infection in the absence of apparent HCV-specific immunity. The patient received standard antiviral therapy for chronic HCV infection and was HCV-RNA negative at the end of treatment but relapsed between follow-up week 4 and 12. Surprisingly, from follow-up week 28 on, he persistently was HCV-RNA negative in serum, even when being tested with the highly sensitive TMA-assay (cut-off 5–10 IU/ml). ALT levels were within the normal range throughout follow-up. Virus-specific CD4+ T cell responses were prospectively analysed during the relapse period and during spontaneous resolution by interferon-gamma ELISPOT assays. Importantly, no HCV-specific cellular immune responses were detectable at any time-point. The patient suffered from an acute respiratory tract infection before HCV clearance and serum IL-8 levels were significantly increased during this period.

Thus, spontaneous resolution of hepatitis C after antiviral treatment and relapse may occur even in the absence of hepatitis flares and apparent HCV-specific immune responses in single cases. The role of heterologous infections for HCV clearance requires further investigation.