A case of spontaneous HCV clearancein a patient with decompensatedHCV-related liver cirrhosis

Authors

  • Vasyl Kopcha I. Horbachevsky Ternopil National Medical University
  • Oksana Kadubets 2Тернопільська міська комунальна лікарня швидкої допомоги

DOI:

https://doi.org/10.11603/1681-2727.2026.3.16493

Keywords:

HCV, chronic hepatitis C, decompensated liver cirrhosis, spontaneous HCV clearance, immune response, PD-1/PD-L1

Abstract

Spontaneous clearance of hepatitis C virus (HCV) in chronic infection is an extremely rare phenomenon, particularly in patients with decompensated liver cirrhosis. This article reviews current literature data regarding the possible mechanisms of spontaneous HCV clearance, including the role of T-cell immune response, the PD-1/PD-L1 signaling pathway, immune reconstitution, and the impact of splenectomy.

We present a clinical case of a 51-year-old female patient with HCV-associated decompensated liver cirrhosis, portal hypertension, ascites, and pancytopenia who repeatedly refused antiviral therapy with direct-acting antivirals. During follow-up, a gradual decline in viral load was observed, from 8.98×106 IU/mL to a level close to the assay detection limit, followed by complete disappearance of HCV RNA confirmed by three consecutive negative PCR tests without any etiological treatment. The authors discuss possible mechanisms underlying this phenomenon, including immunological changes and progressive reduction in the number of functioning hepatocytes in advanced cirrhosis. Despite the possibility of spontaneous HCV elimination in exceptional cases, direct-acting antivirals remain the treatment of choice for patients with chronic hepatitis C and decompensated liver cirrhosis.

Author Biographies

  • Vasyl Kopcha, I. Horbachevsky Ternopil National Medical University

    MD, DSc, Professor of the Infectious Diseases and Epidemiology, Skin and Venereal Diseases Department

  • Oksana Kadubets, 2Тернопільська міська комунальна лікарня швидкої допомоги

    Infectious Disease Physician, Head of the Infectious Diseases Department

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Published

2026-09-30

Issue

No. 3 (2026)

Section

Brief reports

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Copyright (c) 2026 Василь Копча, Оксана Кадубець

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How to Cite

A case of spontaneous HCV clearancein a patient with decompensatedHCV-related liver cirrhosis. (2026). Infectious Diseases – Infektsiyni Khvoroby, 3, 77-81. https://doi.org/10.11603/1681-2727.2026.3.16493