Hepatitis C virus infection spontaneous clearance

Has it been underestimated?

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objectives: Hepatitis C virus (HCV) clearance rate (fclearance) is defined as the proportion of infected persons who will spontaneously clear their infection after acute infection. We aimed to estimate fclearance using a novel approach that avoids limitations in existing estimates, and to clarify the link between fclearance and HCV viremic rate—the latter being the proportion of RNA positivity among those antibody positive. Methods: A mathematical model was developed to describe HCV transmission. fclearance was estimated by fitting the model to probability-based and nationally representative population-based data for Egypt (Egypt 2008 and Egypt 2015) and USA (NHANES A and NHANES B). Uncertainty and sensitivity analyses were conducted. Results: fclearance was estimated at 39.9% (95% uncertainty interval (UI): 34.3%–46.4%) and 33.5% (95% UI: 29.2%–38.3%) for Egypt 2008 and Egypt 2015 data, respectively; and at 29.6% (23.0%–37.1%) and 39.9% (31.2%–51.0%) for NHANES A and NHANES B data, respectively. fclearance was found related to HCV viremic rate through (approximately) the formula fclearance = 1.16 (1 − HCV viremic rate). HCV viremic rate was higher with higher risk of HCV exposure. Robustness of results was demonstrated in uncertainty and sensitivity analyses. Conclusion: One-third of HCV-infected persons clear their infection spontaneously, higher than earlier estimates—the immune-system capacity to clear HCV infection may have been underestimated.

Original languageEnglish
Pages (from-to)60-66
Number of pages7
JournalInternational Journal of Infectious Diseases
Volume75
DOIs
Publication statusPublished - 1 Oct 2018

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Virus Diseases
Hepacivirus
Egypt
Nutrition Surveys
Uncertainty
Infection
Immune System
Theoretical Models
RNA
Antibodies

Keywords

  • Clearance rate
  • Epidemiology
  • Infectious disease transmission
  • Mathematical model
  • Viremic rate

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

@article{181f66ad54b2478d82c2250fcb3c1d38,
title = "Hepatitis C virus infection spontaneous clearance: Has it been underestimated?",
abstract = "Objectives: Hepatitis C virus (HCV) clearance rate (fclearance) is defined as the proportion of infected persons who will spontaneously clear their infection after acute infection. We aimed to estimate fclearance using a novel approach that avoids limitations in existing estimates, and to clarify the link between fclearance and HCV viremic rate—the latter being the proportion of RNA positivity among those antibody positive. Methods: A mathematical model was developed to describe HCV transmission. fclearance was estimated by fitting the model to probability-based and nationally representative population-based data for Egypt (Egypt 2008 and Egypt 2015) and USA (NHANES A and NHANES B). Uncertainty and sensitivity analyses were conducted. Results: fclearance was estimated at 39.9{\%} (95{\%} uncertainty interval (UI): 34.3{\%}–46.4{\%}) and 33.5{\%} (95{\%} UI: 29.2{\%}–38.3{\%}) for Egypt 2008 and Egypt 2015 data, respectively; and at 29.6{\%} (23.0{\%}–37.1{\%}) and 39.9{\%} (31.2{\%}–51.0{\%}) for NHANES A and NHANES B data, respectively. fclearance was found related to HCV viremic rate through (approximately) the formula fclearance = 1.16 (1 − HCV viremic rate). HCV viremic rate was higher with higher risk of HCV exposure. Robustness of results was demonstrated in uncertainty and sensitivity analyses. Conclusion: One-third of HCV-infected persons clear their infection spontaneously, higher than earlier estimates—the immune-system capacity to clear HCV infection may have been underestimated.",
keywords = "Clearance rate, Epidemiology, Infectious disease transmission, Mathematical model, Viremic rate",
author = "Houssein Ayoub and Hiam Chemaitelly and Ryosuke Omori and Laith Aburaddad",
year = "2018",
month = "10",
day = "1",
doi = "10.1016/j.ijid.2018.07.013",
language = "English",
volume = "75",
pages = "60--66",
journal = "International Journal of Infectious Diseases",
issn = "1201-9712",
publisher = "Elsevier",

}

TY - JOUR

T1 - Hepatitis C virus infection spontaneous clearance

T2 - Has it been underestimated?

AU - Ayoub, Houssein

AU - Chemaitelly, Hiam

AU - Omori, Ryosuke

AU - Aburaddad, Laith

PY - 2018/10/1

Y1 - 2018/10/1

N2 - Objectives: Hepatitis C virus (HCV) clearance rate (fclearance) is defined as the proportion of infected persons who will spontaneously clear their infection after acute infection. We aimed to estimate fclearance using a novel approach that avoids limitations in existing estimates, and to clarify the link between fclearance and HCV viremic rate—the latter being the proportion of RNA positivity among those antibody positive. Methods: A mathematical model was developed to describe HCV transmission. fclearance was estimated by fitting the model to probability-based and nationally representative population-based data for Egypt (Egypt 2008 and Egypt 2015) and USA (NHANES A and NHANES B). Uncertainty and sensitivity analyses were conducted. Results: fclearance was estimated at 39.9% (95% uncertainty interval (UI): 34.3%–46.4%) and 33.5% (95% UI: 29.2%–38.3%) for Egypt 2008 and Egypt 2015 data, respectively; and at 29.6% (23.0%–37.1%) and 39.9% (31.2%–51.0%) for NHANES A and NHANES B data, respectively. fclearance was found related to HCV viremic rate through (approximately) the formula fclearance = 1.16 (1 − HCV viremic rate). HCV viremic rate was higher with higher risk of HCV exposure. Robustness of results was demonstrated in uncertainty and sensitivity analyses. Conclusion: One-third of HCV-infected persons clear their infection spontaneously, higher than earlier estimates—the immune-system capacity to clear HCV infection may have been underestimated.

AB - Objectives: Hepatitis C virus (HCV) clearance rate (fclearance) is defined as the proportion of infected persons who will spontaneously clear their infection after acute infection. We aimed to estimate fclearance using a novel approach that avoids limitations in existing estimates, and to clarify the link between fclearance and HCV viremic rate—the latter being the proportion of RNA positivity among those antibody positive. Methods: A mathematical model was developed to describe HCV transmission. fclearance was estimated by fitting the model to probability-based and nationally representative population-based data for Egypt (Egypt 2008 and Egypt 2015) and USA (NHANES A and NHANES B). Uncertainty and sensitivity analyses were conducted. Results: fclearance was estimated at 39.9% (95% uncertainty interval (UI): 34.3%–46.4%) and 33.5% (95% UI: 29.2%–38.3%) for Egypt 2008 and Egypt 2015 data, respectively; and at 29.6% (23.0%–37.1%) and 39.9% (31.2%–51.0%) for NHANES A and NHANES B data, respectively. fclearance was found related to HCV viremic rate through (approximately) the formula fclearance = 1.16 (1 − HCV viremic rate). HCV viremic rate was higher with higher risk of HCV exposure. Robustness of results was demonstrated in uncertainty and sensitivity analyses. Conclusion: One-third of HCV-infected persons clear their infection spontaneously, higher than earlier estimates—the immune-system capacity to clear HCV infection may have been underestimated.

KW - Clearance rate

KW - Epidemiology

KW - Infectious disease transmission

KW - Mathematical model

KW - Viremic rate

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U2 - 10.1016/j.ijid.2018.07.013

DO - 10.1016/j.ijid.2018.07.013

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VL - 75

SP - 60

EP - 66

JO - International Journal of Infectious Diseases

JF - International Journal of Infectious Diseases

SN - 1201-9712

ER -