eprintid: 10146916
rev_number: 9
eprint_status: archive
userid: 699
dir: disk0/10/14/69/16
datestamp: 2022-04-21 12:16:33
lastmod: 2022-04-21 12:16:33
status_changed: 2022-04-21 12:16:33
type: article
metadata_visibility: show
sword_depositor: 699
creators_name: Ades, AE
creators_name: Gordon, Fabiana
creators_name: Scott, Karen
creators_name: Collins, Intira Jeannie
creators_name: Thorne, Claire
creators_name: Pembrey, Lucy
creators_name: Chappell, Elizabeth
creators_name: Mariné-Barjoan, Eugènia
creators_name: Butler, Karina
creators_name: Indolfi, Giuseppe
creators_name: Gibb, Diana M
creators_name: Judd, Ali
title: Spontaneous Clearance Of Vertically Acquired Hepatitis C Infection: Implications For Testing And Treatment
ispublished: inpress
divisions: UCL
divisions: J38
divisions: D65
divisions: B02
keywords: HCV, Hepatitis C virus, over-treatment, spontaneous clearance, vertical transmission
note: © The Author(s) 2022. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/).
abstract: BACKGROUND: Current guidelines recommend that infants born to women with hepatitis C (HCV) viremia are screened for HCV antibody at age 18 months, and if positive, referred for RNA testing at 3 years to confirm chronic infection. This policy is based in part on analyses suggesting 25%-40% of vertically acquired HCV infections clear spontaneously within 4-5 years. METHODS: Data on 179 infants with HCV RNA and/or anti-HCV evidence of vertically acquired infection in three prospective European cohorts were investigated. Ages at clearance of infection were estimated taking account of interval censoring and delayed entry. We also investigated clearance in initially HCV RNA negative infants in whom RNA was not detectable until after 6 weeks. RESULTS: Clearance rates are initially high then decline slowly. Apparently, many infections clear before they can be confirmed. An estimated 65.9% (50.1-81.6) of confirmed infections cleared by 5 years, at a median 12.4 (7.1-18.9) months. If treatment began at age 6 months, 18 months or 3 years, at least 59.0% (42.0-76.9), 39.7% (17.9-65.9), and 20.9% (4.6-44.8) of those treated would clear without treatment. In seven (6.6%) confirmed infections, RNA was not detectable until after 6 weeks, and in 2 (1.9%) not until after 6 months. However, all such cases subsequently cleared. CONCLUSIONS: Most confirmed infection clears by age 3 years. Treatment before age 3, if it was available, would avoid loss to follow-up, but would result in substantial over-treatment.
date: 2022-04-09
date_type: published
publisher: Oxford University Press (OUP)
official_url: https://doi.org/10.1093/cid/ciac255
oa_status: green
full_text_type: other
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 1949791
doi: 10.1093/cid/ciac255
medium: Print-Electronic
pii: 6565752
lyricists_name: Gibb, Diana
lyricists_name: Thorne, Claire
lyricists_id: MGIBB48
actors_name: Gibb, Diana
actors_name: Payne, Roxanne
actors_id: MGIBB48
actors_id: RPAYN74
actors_role: owner
actors_role: impersonator
full_text_status: public
publication: Clinical Infectious Diseases
event_location: United States
citation:        Ades, AE;    Gordon, Fabiana;    Scott, Karen;    Collins, Intira Jeannie;    Thorne, Claire;    Pembrey, Lucy;    Chappell, Elizabeth;                     ... Judd, Ali; + view all <#>        Ades, AE;  Gordon, Fabiana;  Scott, Karen;  Collins, Intira Jeannie;  Thorne, Claire;  Pembrey, Lucy;  Chappell, Elizabeth;  Mariné-Barjoan, Eugènia;  Butler, Karina;  Indolfi, Giuseppe;  Gibb, Diana M;  Judd, Ali;   - view fewer <#>    (2022)    Spontaneous Clearance Of Vertically Acquired Hepatitis C Infection: Implications For Testing And Treatment.                   Clinical Infectious Diseases        10.1093/cid/ciac255 <https://doi.org/10.1093/cid%2Fciac255>.    (In press).    Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/10146916/7/Gibb_Spontaneous%20Clearance%20Of%20Vertically%20Acquired%20Hepatitis%20C%20Infection.pdf