Influence of alcohol use, race, and viral coinfections on spontaneous HCV clearance in a US veteran population
Influence of alcohol use, race, and viral coinfections on spontaneous HCV clearance in a US veteran population
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DOI：
10.1002/hep.20384
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发表时间：
2004-10-01
期刊：
影响因子：
13.5
通讯作者：
Chang, KM
中科院分区：
文献类型：
--
作者：
Piasecki, BA;Lewis, JD;Chang, KM
丙型肝炎病毒（HCV）在原发感染期间在15%至45%的个体中自发清除。为了明确酒精、种族、HBV或HIV合并感染在HCV自然清除中的作用，我们在203例HCV自发恢复受试者（既往未接受抗病毒治疗的HCV Ab（+）/RNA（-）受试者）和293例慢性HCV感染患者（HCV Ab（+）/RNA（+））中检查了这些参数。受试者是从2000年1月至2002年7月在费城退伍军人事务医疗中心检测HCV RNA的1,454名HCV抗体血清阳性的美国退伍军人中确定的。在单变量分析中，酒精使用障碍（比值比[OR] 0.52; 95%CI，0.31-0.85; P= 0.006）和黑人（OR 0.65; 95%CI，0.44-0.96; P= 0.024）均与HCV自发清除可能性降低相关。在调整种族、HIV感染、年龄和酒精使用障碍的多变量分析中，酒精仍然与HCV清除率降低密切相关（OR 0.49; 95%CI，0.30- 0.81; P= 0.005）。相比之下，黑人种族与病毒清除之间的关联不再具有统计学显著性（校正OR 0.72; 95% CI，0.48-1.09; P= 0.125）。HIV合并感染与HCV清除率呈负相关（OR 0.37; 95%CI，0.16-0.83; P= 0.016），而HBV合并感染与HCV清除率呈正相关（未校正OR 5.0; 95%CI，1.26-28.6; P= 0.008）。总之，HCV自发清除的可能性可能受到酒精和病毒合并感染的影响。
Hepatitis C virus (HCV) is spontaneously cleared in 15% to 45% of individuals during primary infection. To define the role of alcohol, race, and HBV or HIV coinfections in natural HCV clearance, we examined these parameters in 203 spontaneously HCV-recovered subjects (HCV Ab(+)/RNA(-) subjects without prior antiviral therapy) and 293 chronically HCV-infected patients (HCV Ab(+)/RNA(+)). Subjects were identified from 1,454 HCV antibody-seropositive US veterans tested for HCV RNA between January 2000 and July 2002 at the Philadelphia Veterans Affairs Medical Center. In univariate analysis, alcohol use disorder (odds ratio [OR] 0.52; 95% CI, 0.31-0.85; P=.006) and black race (OR 0.65; 95% CI, 0.44-0.96; P=.024) were both associated with decreased likelihood of spontaneous HCV clearance. In multivariate analyses adjusting for race, HIV infection, age, and alcohol use disorder, alcohol remained strongly associated with reduced HCV clearance (OR 0.49; 95% CI, 0.30-0.8 1; P=.005). In contrast, the association between black race and viral clearance was no longer statistically significant (adjusted OR 0.72; 95% CI, 0.48-1.09; P=.125). HIV coinfection was negatively associated with HCV clearance (OR 0.37; 95% CI, 0.16-0.83; P=.016), while HBV coinfection was positively associated with HCV clearance (unadjusted OR 5.0; 95% CI, 1.26-28.6; P=.008). In conclusion, the likelihood of spontaneous clearance of HCV may be influenced by alcohol and viral coinfections.