Reuters Health Information (2004-07-02): Hepatitis C virus genotype 3 infection may resolve spontaneously
Hepatitis C virus genotype 3 infection may resolve spontaneously
Last Updated: 2004-07-02 11:15:38 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Infection with hepatitis C
virus (HCV) genotype 3 often clears spontaneously, sparing the patient
unnecessary treatment, German researchers report in the July issue of
the Journal of Medical Virology.
Early treatment of patients with acute HCV infection has been
advocated as an approach to preventing chronic infection, the authors
point out, but many patients may clear the virus spontaneously and thus
would not require treatment if they were identified beforehand.
As senior investigator Dr. Heiner Wedemeyer told Reuters Health,
"patients should be genotyped. Wait and see for genotype 3, treat
immediately for genotype 1."
Dr. Wedemeyer from Hannover Medical School and colleagues sought to
determine whether HCV genotype differences could lead to different
rates of spontaneous clearance of acute HCV infection. They studied
serum from 92 anti-HCV-positive men in a German prison.
HCV genotype 3 was significantly more common among subjects who were
HCV-negative than among those with HCV viremia, the authors report, and
the prevalence of genotype 3 was even higher after men who were HIV- or
hepatitis B-positive were excluded. Although acute HCV genotype 3
infection spontaneously resolved in many individuals, most patients
(63%) still developed chronic infection. This rate of chronic HCV was,
however, substantially lower than the rate of chronic HCV infection in
those with genotype 1 (93%).
"Considering the high sustained virological response rates of
pegylated interferons plus ribavirin combination therapy of chronic
hepatitis C in patients with genotypes 2 and 3," the authors conclude,
"different strategies for acute HCV infection may be appropriate for
different HCV genotypes."
"Chronicity of acute HCV genotype 1 infection evolves in the vast
majority of cases," Dr. Wedemeyer concluded. "However, unnecessary
treatment can be avoided in genotype 3 infection."
J Med Virol 2004;73:387-391.