Open Access Research article

Antibody dynamics and spontaneous viral clearance in patients with acute hepatitis C infection in Rio de Janeiro, Brazil

Alexander M Strasak1, Arthur Y Kim2, Georg M Lauer3, Paulo S de Sousa4, Cleber F Ginuino4, Carlos A Fernandes5, Carlos E Velloso4, Adilson J de Almeida46, Jaqueline M de Oliveira7, Clara F Yoshida4, Julian Schulze zur Wiesch8, Gláucia Paranhos-Baccalá9, Stefan Lang10, Larry J Brant11, Hanno Ulmer1, Susanne Strohmaier1, Lalit Kaltenbach1, Elisabeth Lampe4 and Lia L Lewis-Ximenez4*

Author Affiliations

1 Department of Medical Statistics, Informatics and Health Economics, Innsbruck Medical University, Innsbruck, Austria

2 Division of Infectious Diseases, Massachusetts General Hospital and Harvard Medical School, Boston, USA

3 Gastrointestinal Unit, Massachusetts General Hospital and Harvard Medical School, Boston, USA

4 Viral Hepatitis Laboratory, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, Brazil

5 Hepatitis Division, Central Public Health Laboratory Noel Nutels, Rio de Janeiro, Brazil

6 Hematology Unit, Gaffrée & Guinle University Hospital, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil

7 Viral Technology Laboratory, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, Brazil

8 Medizinische Klinik I, Universitätsklinikum Eppendorf, Hamburg, Germany

9 Emerging Pathogens Laboratory, Fondation Merieux, Lyon, France

10 Institute of Statistics, University of Innsbruck, Innsbruck, Austria

11 Gerontology Research Center, National Institute on Aging, Baltimore, USA

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BMC Infectious Diseases 2011, 11:15  doi:10.1186/1471-2334-11-15

Published: 12 January 2011

Abstract

Background

The anti-HCV antibody response has not been well characterized during the early phase of HCV infection and little is known about its relationship to the clinical course during this period.

Methods

We analyzed serial anti-HCV antibodies longitudinally obtained from a prospective cohort of 65 patients with acute HCV infection by using a microparticle enzyme immunoassay AxSYM HCV 3.0 (Abbott Diagnostics) during the first 12 months from HCV acquisition in Rio de Janeiro, Brazil. Spontaneous viral clearance (SVC) was defined as undetectable HCV RNA in serum, in the absence of treatment, for three consecutive HCV PCR tests within 12-months of follow-up.

Results

Baseline antibody values were similar among patient groups with self-limiting HCV evolution (n = 34) and persistent viremia (n = 31) [median (interquartile range) signal/cut-off ratio (s/co) 78.7 (60.7-93.8) vs. 93.9 (67.8-111.9), p = 0.26]. During 12-months follow-up, patients with acute spontaneous resolving HCV infection showed significantly lower serial antibody response in comparison to individuals progressing to chronic infection [median (interquartile range) s/co 62.7 (35.2-85.0) vs. 98.4 (70.4-127.4), p < 0.0001]. In addition, patients with self-limiting HCV evolution exhibited an expeditious, sharp decline of serial antibody values after SVC in comparison to those measured before SVC [median (interquartile range) s/co 56.0 (25.4-79.3) vs. 79.4 (66.3-103.0), p < 0.0001].

Conclusion

Our findings indicate a rapid short-term decline of antibody values in patients with acute spontaneous resolving HCV infection.