Acute HCV

World Health Organisation targets and the Acute HCV UK Study

The World Health Organisation has committed to eliminating hepatitis C as a public health threat. One element of this commitment is to reduce the global incidence of hepatitis C infection by 90% by 2030. While there are very effective treatments for people who have been diagnosed, there is no vaccine to prevent infection (and thereby reduce incidence) in those at high risk.  

As part of the pathway towards designing an effective vaccine it is important to answer the following questions:

  • which parts of the virus (epitopes) induce a protective response?
  • which parts of the immune response drive spontaneous clearance?
  • which arms of the immune system are important in controlling infection?

The Acute HCV UK study is designed to provide answers to these questions by analysing the components of the protective immune response in people who have recently been infected with the hepatitis C virus.

It is unusual to diagnose infection soon after it is acquired, as most people do not exhibit symptoms until many years later, by which time they may already have cirrhosis or primary liver cancer.  More than 200 patients from Glasgow and London have now been recruited to the study following enhanced sentinel surveillance. Of these, around one in five spontaneously clear the infection in the presence of a protective immune response and do not require treatment.


Gartnaval Hospital Glasgow 

Research partner - Gartnavel General Hospital, Glasgow


 St Mary's Hospital, London

Research partner - St Mary's Hospital, London

A number of papers have been published involving CVR staff (mostly in collaboration with research partners) as a result of this study which is funded by Wellcome.  Publication of the initial B and T cell immunological analysis detailing the components of protective immunity found during early hepatitis C infection is expected during 2020.

Papers published to date with CVR involvement are listed below in order of publication (titles are hyperlinked).



1.Evidence for a widespread effect of interferon lambda 4 on hepatitis C virus diversity.

eLife 2019

2. Interpreting viral deep sequencing data with GLUE.

Viruses 2019

3. Highly Diverse Hepatitis C Strains Detected in Sub-Saharan Africa Have Unknown Susceptibility to Direct-Acting Antiviral Treatments.

Hepatology 2019

 4. GLUE: a flexible software system for virus sequence data.

BMC Bioinformatics 2018

 5. Quasispecies Changes with Distinctive Point Mutations in the Hepatitis C Virus Internal Ribosome Entry Site (IRES) Derived from PBMCs and Plasma.

Advanced Virology 2018

6. The benefits to patients of novel hepatitis C therapies are beyond reasonable doubt.

BMJ 2018

7. Comparison of Next-Generation Sequencing Technologies for Comprehensive Assessment of Full-Length Hepatitis C Viral Genomes.

Journal of Clinical Microbiology 2016

8. Tracking TCRbeta Sequence Clonotype Expansions during Antiviral Therapy Using High-Throughput Sequencing of the Hypervariable Region.

Frontiers in Immunology 2016

9. Broad Anti-Hepatitis C Virus (HCV) Antibody Responses Are Associated with Improved Clinical Disease Parameters in Chronic HCV Infection.

Journal of Virology 2016

10. Can Hepatitis C Virus (HCV) Direct-Acting Antiviral Treatment as Prevention Reverse the HCV Epidemic Among Men Who Have Sex With Men in the United Kingdom? Epidemiological and Modeling Insights.

Clinical Infectious Diseases 2016

11. Reduced healthcare utilization following successful hepatitis C virus treatment in HIV-co-infected patients with mild liver disease.

Journal of Viral Hepatitis 2016

12. Reply: To PMID 24797101.

Hepatology 2015

13. Next-generation sequencing sheds light on the natural history of hepatitis C infection in patients who fail treatment.

Hepatology 2015

14. Natural NS3 resistance polymorphisms occur frequently prior to treatment in HIV-positive patients with acute hepatitis C.

AIDS 2013

15. Mixed genotype hepatitis C infections and implications for treatment.

Hepatology 2014

16. Acute HCV/HIV coinfection is associated with cognitive dysfunction and cerebral metabolite disturbance, but not increased microglial cell activation.

PloS One 2012

17. The natural history of early hepatitis C virus evolution; lessons from a global outbreak in human immunodeficiency virus-1-infected individuals.

Journal of General Virology 2011

18. Predicting spontaneous clearance of acute hepatitis C virus in a large cohort of HIV-1-infected men.

Gut 2011

19. Dynamic coinfection with multiple viral subtypes in acute hepatitis C.

Journal of Infectious Diseases 2010

20. Does acute hepatitis C infection affect the central nervous system in HIV-1 infected individuals?

Journal of Viral Hepatitis 2010

21. Delayed anti-HCV antibody response in HIV-positive men acutely infected with HCV.

AIDS 2009

22. Diagnosing acute hepatitis C in HIV-infected patients: nucleic acid testing compared with antibody and antigen-antibody detecting methods.

Journal of Clinical Virology 2009

23. Epidemiology of hepatitis C virus infection in HIV-infected individuals.

Journal of Viral Hepatitis 2008

24. Increasing incidence of acute hepatitis C in individuals diagnosed with primary HIV in the United Kingdom.

AIDS 2008