Hepatitis C virus: host, environmental and viral factors promoting spontaneous clearance

Abstract

Hepatitis C virus (HCV) is a pathogenic entity which determines inflammation and liver damage through complex immune mechanisms. Although progress has been made in managing the disease course, chronic infection still remains a significant cause of morbidity and mortality to this day. Because both acute and chronic infection are often asymptomatic, chronic infection is frequently diagnosed when its complications have developed. In a small proportion of cases, the chronic infection does not develop, the immune system managing to cleanse the body from this silent pathogen in the absence of specific treatment, a process called spontaneous viral clearance, which occurs rarely, in about 20-30 % of cases. A competent immune response that manages to eliminate the virus from the organism was associated with IL-28B genetic polymorphism, female gender, young age, which often lead to clinical manifestations of acute hepatitis after initial exposure. Environmental factors such as limited viral exposure also play an important role. These factors and the mechanisms underlying spontaneous clearance are not fully understood but their action is complementary. In this paper, we review the concept of spontaneous clearance of HCV and assess the factors that have been associated with this clinical outcome of the infection.

Keywords

• hepatitis c
• liver disease
• spontaneous clearance