- D3.537 - Immunologic and other factors influencing clearance of viral hepatitis infections

Georgia has implemented a national hepatitis C elimination program since 2015, and a hepatitis B elimination program began in 2024. Most hepatitis C virus (HCV) infections become persistent, whereas about 15 to 30 percent resolve spontaneously without progressing to chronic hepatitis C. In contrast, 90 to 95 percent of hepatitis B virus (HBV) infections resolve, with only a small fraction progressing to chronic HBV infection.

We analyzed subsets of cohorts of patients with HCV and HBV identified through the national elimination programs and tested within the Clinic NeoLab network, a major service provider for these programs in Georgia. The goal was to assess associations between genetic, immunological, behavioral, and demographic factors and spontaneous viral clearance. Spontaneous HCV clearance was defined as a reactive anti HCV antibody result followed by no detectable HCV RNA or core antigen, with no history of HCV treatment. Spontaneous HBV clearance was defined as reactivity to anti HBc antibodies in the absence of hepatitis B surface antigen (HBsAg). Antigen and antibody testing was performed by ELISA. Viral genetic material, CCR5 delta 32 mutation, and IL28 gene polymorphisms were assessed by PCR. Chi square tests and logistic regression were used for statistical analyses.

For HCV, spontaneous clearance was positively associated with female sex, younger age, and IL28 gene polymorphisms (non CC variants). Lower clearance was observed among people living with HIV and among those with a history of exposure to penitentiary settings. For HBV, clearance was associated with female sex, no or low alcohol consumption, and the CCR5 delta 32 mutation.

Identifying immunologic, genetic and behavioral factors linked to clearance of HCV and HBV can improve understanding of host defense mechanisms and support the development of more effective therapeutic and prevention approaches aimed at reducing viral persistence.