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Blood, 1 February 2006, Vol. 107, No. 3, pp. 892-897.
Prepublished online as a Blood First Edition Paper on October 4, 2005; DOI 10.1182/blood-2005-07-2781.


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Submitted July 13, 2005
Accepted September 19, 2005

Correlates of spontaneous clearance of hepatitis C virus among people with hemophilia

Mingdong Zhang, Philip S Rosenberg, Deborah L Brown, Liliana Preiss, Barbara A Konkle, M E Eyster, and James J Goedert*

Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA; Center for Emerging Infectious Diseases, Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
University of Texas Health Science Center, Houston, TX, USA
Research Triangle Institute, Rockville, MD, USA
Department of Medicine, Division of Hematology/Oncology, University of Pennsylvania, Philadelphia, PA, USA
Department of Medicine, Division of Hematology and Oncology, Pennsylvania State University College of Medicine, Hershey, PA, USA

* Corresponding author; email: goedertj{at}mail.nih.gov.

People with hemophilia were formerly at very high risk of infection with hepatitis C virus (HCV). Approximately 20% of HCV-infected patients spontaneously clear the virus. To identify correlates of spontaneous clearance of HCV, we studied a cohort of HCV-infected hemophilic subjects without human immunodeficiency virus infection who had never been treated with interferon. Plasma HCV RNA was persistently undetectable in 192 (27.0%) of 712 HCV-seropositive subjects. In multivariate analyses, HCV clearance was more likely in subjects infected with HCV at younger age, especially with infection before age 2 (40.1%) compared to after age 15 years (14.9%, Ptrend< 0.0001), and with relatively recent infection, especially after 1983 (42.8%) compared to before 1969 (18.2%, Ptrend< 0.0001). HCV clearance was marginally reduced with African ancestry (19%) and greatly increased with chronic hepatitis B virus (HBV) infection (59.1%, P=0.0006). Resolved HBV infection, coagulopathy types and severity, types of clotting factor treatment, and gender were not associated with HCV clearance. In conclusion, hemophilic subjects co-infected with chronic HBV and those infected with HCV before age 2 or after 1983 were significantly more likely to spontaneously clear HCV viremia. These data highlight and clarify the importance of non-genetic determinants in spontaneous recovery from HCV infection.


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This article has been cited by other articles:


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Am J EpidemiolHome page
J. J. Goedert, B. E. Chen, L. Preiss, L. M. Aledort, P. S. Rosenberg, and for the Second Multicenter Hemophilia Cohort Study
Reconstruction of the Hepatitis C Virus Epidemic in the US Hemophilia Population, 1940-1990
Am. J. Epidemiol., June 15, 2007; 165(12): 1443 - 1453.
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