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Occasional Spontaneous Clearance Of Chronic Hepatitis C Virus In Hiv-infected Individuals

Stenkvist et al., 2014Other/Unknown

Stenkvist, J., Nyström, J., Falconer, K., Sönnerborg, A., & Weiland, O. (2014). Occasional spontaneous clearance of chronic hepatitis C virus in HIV-infected individuals. Journal of hepatology, 61(4), 957–961. https://doi.org/10.1016/j.jhep.2014.06.014

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Abstract

The IL28B genotype has been found to have a strong influence on spontaneous clearance of acute HCV both in HCV mono- and HIV/ the HCV co-infected patients. Spontaneous clearance of chronic HCV without HCV treatment is rare. Here, we report on three chronic HCV cases co-infected with HIV with spontaneous clearance of their HCV infection, all with the IL28B CC genotype. These cases were derived from a surveillance of the total HIV/HCV co-infected cohort in Sweden (n =4 66). The estimated frequency of spontaneous clearance of chronic HCV infection in our cohort was calculated to be 0.6-4.7%. Our cases lend some support to the initiation of ART prior to HCV treatment in HIV/HCV co-infected patients. Furthermore, HCV-RNA testing should be recommended immediately before initiation of HCV treatment, to find the subset of HIV/HCV co-infected patients with IL28B CC that may have cleared their chronic infection spontaneously.

Case Details

Disease Location

Liver

Personal Characteristics

A 48-year-old woman with HIV diagnosed 1985 and HCV genotype 2b in 1997

Clinical Characteristics

HCV-RNA was repeatedly positive between 2001 and 2004 with fluctuating HCV-RNA between 4290 and 171,000 iu/ml had been on art since 1996 with a low CD4+ t-cell count of 170 x 109/l

Remission Characteristics

At the time of spontaneous HCV-RNA clearance in 2005 patient was on lopinavir/ritonavir, stavudine and tenofovir, and the CD4+ t-cell count was 880 x 109 /l. After this HCV-RNA has been repeatedly negative in serum during 18 months

Treatment & Mechanisms

Proposed Remission Mechanisms

Immune related

Clinical Treatment

Lopinavir/ritonavir, stavudine and tenofovir,