A case-control study of factors associated with resolution of hepatitis C viremia in former blood donors (CME).
A case-control study of factors associated with resolution of hepatitis C viremia in former blood donors (CME).
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DOI：
10.1111/j.1537-2995.2010.02634.x
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发表时间：
2010-07
期刊：
影响因子：
2.9
通讯作者：
Murphy EL
中科院分区：
文献类型：
--
作者：
Tobler LH;Bahrami SH;Kaidarova Z;Pitina L;Winkelman VK;Vanderpool SK;Guiltinan AM;Cooper S;Busch MP;Murphy EL
NAT is performed on blood collected in the United States allowing for the classification of HCV antibody positive donors into resolved and chronic hepatitis C infections. We report a case-control study of factors associated with HCV resolution. Blood donors with resolved (HCV Ab+, RNA- defined as “cases”) or chronic (HCV Ab+, RNA+ defined as “controls”) based on their index donation HCV test results were enrolled. Participants completed a risk factor, symptoms and treatment questionnaire followed by HCV antibody, RNA and liver biochemical testing. We enrolled 100 cases and 202 controls. In a multivariate logistic regression model, significant independent effects for spontaneous viral clearance were observed for African American (inverse) (OR = 0.11, 95% CI: 0.01-0.87), autologous blood donation (OR = 4.70, 95% CI: 2.02-10.94), alcohol intake (OR=2.39, 95% CI: 1.13-5.03), and transfusion prior to May 1990 (inverse) (OR = 0.36, 95% CI: 0.14-0.91). Cases admitting injection drug use (IDU) had shorter time since first injection than did controls. Forty-nine index RNA+ controls received antiviral therapy and 25 (51%) were RNA- at enrollment; surprisingly several RNA- cases received liver biopsies and/or antiviral treatment. We document the role donor screening plays in the identification, subsequent medical evaluation and treatment among individuals who presumable did not know they were at risk for HCV infection. Additionally, we confirmed race/ethnicity as a determinant of clearance and suggest infectious dose and route of infection may play a role in clearance.
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