Persistent immune deficiency in patients with alcoholic hepatitis.
T-lymphocyte subset numbers, recall-antigen skin test responses and mitogen-induced lymphocyte proliferation assays were investigated in 12 patients with severe alcoholic hepatitis (AH). Serial studies of these parameters were obtained at intervals of 1 or 2 wk. Patients with AH had lower peripheral blood lymphocyte counts with corresponding decreases in T-cell subset numbers that were persistent in the serial evaluations. T8 cells were disproportionately decreased, with a significant resultant increase in the T4:T8 ratios. Compared with controls, AH patients had significantly smaller cutaneous responses to Candida albicans antigen (p less than 0.05) and mumps antigen (p less than 0.005). Fifty-eight percent of patients were anergic when tested with a battery of four antigens. Patients with AH had increased concanavalin A-, but not phytohemagglutinin-induced lymphocyte proliferative responses. These serial analyses confirm previous observations of cell-mediated immune dysfunction in patients with severe AH. Moreover, there is a persistence of these abnormalities for at least 6 wk after withdrawal from alcohol.
Mutchnick
M G
MG
Department of Medicine, Wayne State University School of Medicine, Detroit, Michigan.
Cohen
I A
IA
Elta
G H
GH
D006519:Hepatitis, Alcoholic / Q000097:blood / Q000276:immunology*; D006801:Humans; D007958:Leukocyte Count; D008213:Lymphocyte Activation / Q000276:immunology; D008875:Middle Aged; D012882:Skin Tests; D013601:T-Lymphocytes; D013997:Time Factors