Human leukocyte antigen class I-independent pathways may contribute to hepatitis B virus-induced liver disease after liver transplantation.
The proliferative response of peripheral blood lymphocytes to the HBcAg was compared with serological, molecular and immunohistochemical parameters of hepatitis B virus infection and with biochemical and histological parameters of liver disease in a patient who received a completely human leukocyte antigen class I-mismatched liver allograft for fulminant hepatitis. The proliferative response increased progressively after transplantation, as hepatitis B virus infection became reestablished in the hepatic allograft. Strikingly, the HBcAg-specific T cells suddenly disappeared from the peripheral blood immediately before the acute onset of a severe necroinflammatory liver disease in which more than 80% of the hepatocytes expressed HBcAg. These observations are compatible with the hypothesis that human leukocyte antigen class I-independent hepatitis B virus-specific T cells might play a previously unsuspected role in the pathogenesis of hepatitis B virus-induced liver disease.
Missale
G
G
Department of Molecular and Experimental Medicine, Scripps Research Institute, La Jolla, California 92037.
Brems
J J
JJ
Takiff
H
H
Pockros
P J
PJ
Chisari
F V
FV
D000328:Adult; D001483:Base Sequence; D016174:Hepacivirus / Q000276:immunology; D006508:Hepatitis Antibodies / Q000032:analysis; D006509:Hepatitis B / Q000276:immunology* / Q000503:physiopathology; D006512:Hepatitis B Core Antigens / Q000032:analysis*; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006513:Hepatitis B e Antigens / Q000032:analysis; D018937:Hepatitis C Antibodies; D015395:Histocompatibility Antigens Class I / Q000276:immunology*; D006650:Histocompatibility Testing; D006801:Humans; D016031:Liver Transplantation / Q000276:immunology* / Q000473:pathology; D008213:Lymphocyte Activation; D008297:Male; D008969:Molecular Sequence Data; D009838:Oligodeoxyribonucleotides; D016133:Polymerase Chain Reaction; D011183:Postoperative Complications / Q000276:immunology; D014184:Transplantation, Homologous / Q000276:immunology / Q000473:pathology
D006508:Hepatitis Antibodies; D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens; D018937:Hepatitis C Antibodies; D015395:Histocompatibility Antigens Class I; D009838:Oligodeoxyribonucleotides