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Experimental evidence indicates that <jats:styled-content style=\"fixed-case\">LVP<\/jats:styled-content>s have decreased susceptibility to antibody\u2010mediated neutralisation and higher infectivity. This study tested the hypothesis that <jats:styled-content style=\"fixed-case\">LVP<\/jats:styled-content>s are required to establish persistent infection, and conversely, low levels of <jats:styled-content style=\"fixed-case\">LVP<\/jats:styled-content> in recent <jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content> infection increase the probability of spontaneous <jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content> clearance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">LVP<\/jats:styled-content> in non\u2010fasting plasma was measured using the concentration of <jats:styled-content style=\"fixed-case\">HCV RNA<\/jats:styled-content> bound to large &gt;100 n<jats:sc>m<\/jats:sc> sized lipoproteins after <jats:italic>ex vivo<\/jats:italic> addition of a lipid emulsion, that represented the maximum concentration of <jats:styled-content style=\"fixed-case\">LVP<\/jats:styled-content> (maxi\u2010<jats:styled-content style=\"fixed-case\">LVP<\/jats:styled-content>). This method correlated with <jats:styled-content style=\"fixed-case\">LVP<\/jats:styled-content> in fasting plasma measured using iodixanol density gradient ultracentrifugation. Maxi\u2010<jats:styled-content style=\"fixed-case\">LVP<\/jats:styled-content> was measured in a cohort of 180 <jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content> participants with recent <jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content> infection and detectable <jats:styled-content style=\"fixed-case\">HCV RNA<\/jats:styled-content> from the Australian Trial in Acute Hepatitis C (<jats:styled-content style=\"fixed-case\">ATAHC<\/jats:styled-content>) and Hepatitis C Incidence and Transmission Study in prison (<jats:styled-content style=\"fixed-case\">HITS<\/jats:styled-content>\u2010p) cohorts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Spontaneous clearance occurred in 15% (27 of 180) of individuals. In adjusted analyses, low plasma maxi\u2010<jats:styled-content style=\"fixed-case\">LVP<\/jats:styled-content> level was independently associated with spontaneous <jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content> clearance (\u2264827 IU\/ml; adjusted odds ratio 3.98, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 1.02, 15.51, <jats:italic>P<\/jats:italic> = 0.047), after adjusting for interferon lambda\u20103 rs8099917 genotype, estimated duration of <jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content> infection and total <jats:styled-content style=\"fixed-case\">HCV RNA<\/jats:styled-content> level.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Maxi\u2010<jats:styled-content style=\"fixed-case\">LVP<\/jats:styled-content> is a biomarker for the maximum concentration of <jats:styled-content style=\"fixed-case\">LVP<\/jats:styled-content> in non\u2010fasting samples. Low maxi\u2010<jats:styled-content style=\"fixed-case\">LVP<\/jats:styled-content> level is an independent predictor of spontaneous clearance of acute <jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.13176","type":"journal-article","created":{"date-parts":[[2016,5,25]],"date-time":"2016-05-25T22:22:53Z","timestamp":1464214973000},"page":"1774-1782","source":"Crossref","is-referenced-by-count":9,"title":["Maximum levels of hepatitis C virus lipoviral particles are associated with early and persistent infection"],"prefix":"10.1111","volume":"36","author":[{"given":"David A.","family":"Sheridan","sequence":"first","affiliation":[{"name":"Storr Liver Centre Westmead Millennium Institute and Westmead Hospital University of Sydney Sydney NSW Australia"},{"name":"Institute of Cellular Medicine Newcastle University Newcastle upon Tyne UK"},{"name":"Institute of Translational and Stratified Medicine Plymouth University Peninsula Schools of Medicine &amp; Dentistry Plymouth UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Behzad","family":"Hajarizadeh","sequence":"additional","affiliation":[{"name":"The Kirby Institute UNSW Australia Kensington NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fiona I.","family":"Fenwick","sequence":"additional","affiliation":[{"name":"Institute of Cellular Medicine Newcastle University Newcastle upon Tyne UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gail V.","family":"Matthews","sequence":"additional","affiliation":[{"name":"The Kirby Institute UNSW Australia Kensington NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tanya","family":"Applegate","sequence":"additional","affiliation":[{"name":"The Kirby Institute UNSW Australia Kensington NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Douglas","sequence":"additional","affiliation":[{"name":"Storr Liver Centre Westmead Millennium Institute and Westmead Hospital University of Sydney Sydney NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dermot","family":"Neely","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry Newcastle upon Tyne Hospitals NHS Foundation Trust Newcastle upon Tyne UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bev","family":"Askew","sequence":"additional","affiliation":[{"name":"HB Innovations Ltd Newcastle upon Tyne UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory J.","family":"Dore","sequence":"additional","affiliation":[{"name":"The Kirby Institute UNSW Australia Kensington NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew 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