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ANTIBODY DYNAMICS AND SPONTANEOUS VIRAL CLEARANCE IN PATIENTS WITH ACUTE HEPATITIS C INFECTION IN RIO DE JANEIRO, BRAZIL
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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.
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