Theme: Epidemiology & Public Health Research Year: 2019
Background: Many factors affect the outcome of HCV infection, including gender, age, ethnicity,
intravenous drug use, HIV-associated immune deficiency, and others. The strongest predictor of
spontaneous remission or treatment response is genetic and related to a specific polymorphism
(CC) in the IL28B gene (rs12979860). The allelic frequency varies widely with race being most
prevalent in East Asians and least prevalent in Africans and African-Americans. There are few
published data on Caribbean Hispanics but they suggest a lower allelic frequency than in East
Asians or Caucasians, though higher than in Africans or African-Americans. We determined the
prevalence of spontaneous remission in African-American and Hispanic people undergoing HCV
serotesting in non-medical settings in the Bronx, NY.
Method: HCV serotesting was performed using Orasure. Data were collected on demographics
and IV drug use. Informed consent, HIPAA authorization, and IRB approval was obtained.
Serotesting was followed by confirmation of active infection (quantifiable HCV RNA) in a clinical
laboratory.
Results: 68 subjects were studied: 49 men and 19 women; 46 Hispanic, 22 African American. All
admitted to prior IV drug use. Spontaneous remission was documented in 29 subjects (42.6%)
while a quantifiable viral load or successful treatment were found in 36 and 3, respectively.
Spontaneous remission was found in 43.5% of the Hispanic and 40.9% of the African-American
subjects.
Discussion: The spontaneous remission rates reported here are much higher than in studies
performed in inner city cohorts in the past. The reason is uncertain. We hypothesize that it is
associated with a higher allelic frequency of the CC genotype. If confirmed by further testing,
these data would suggest that epidemiologic studies using seropositivity alone may
overestimate the prevalence of active infection. Furthermore, the enrichment of people with
spontaneous remission may reflect the influence active HCV infection on cumulative mortality.