title: Differential cytotoxic T-lymphocyte responsiveness to the hepatitis B and C viruses in chronically infected patients.
abstract: Cytotoxic T lymphocytes (CTL) are thought to control hepatitis B virus (HBV) infection, since they are readily detectable in patients who clear the virus whereas they are hard to detect during chronic HBV infection. In chronic hepatitis C virus (HCV) infection, however, the virus persists in the face of a CTL response. Indeed, most infected patients respond to one or more HCV-1 (genotype 1a)-derived CTL epitopes in the core, NS3, and NS4 proteins, and the CTL response is equally strong in patients infected by different HCV genotypes, suggesting broad cross-reactivity. To examine the effect of the HCV-specific CTL response in patients with chronic hepatitis C on viral load and disease activity, we quantitated the strength of the multispecific CTL response against 10 independent epitopes within the HCV polyprotein. We could not detect a linear correlation between the CTL response and viral load or disease activity in these patients. However, the CTL response was stronger in the subgroup of patients whose HCV RNA was below the detection threshold of the HCV branched- chain DNA assay than in branched-chain-DNA-positive patients. These results suggest that the HCV-specific CTL response may be able to control viral load to some extent in chronically infected patients, and they indicate that prospective studies in acutely infected patients who successfully clear HCV should be performed to more precisely define the relationship between CTL responsiveness, viral clearance, and disease severity in this infection.
authors.affiliation: Department of Molecular and Experimental Medicine, The Scripps Research Institute, La Jolla, California 92037, USA.
authors.forename: B
authors.initials: B
authors.lastname: Rehermann
authors.forename: K M
authors.initials: KM
authors.lastname: Chang
authors.forename: J
authors.initials: J
authors.lastname: McHutchinson
authors.forename: R
authors.initials: R
authors.lastname: Kokka
authors.forename: M
authors.initials: M
authors.lastname: Houghton
authors.forename: C M
authors.initials: CM
authors.lastname: Rice
authors.forename: F V
authors.initials: FV
authors.lastname: Chisari
mesh_terms: D000328:Adult; D002908:Chronic Disease; D005260:Female; D016174:Hepacivirus / Q000276:immunology*; D006509:Hepatitis B / Q000276:immunology*; D006515:Hepatitis B virus / Q000276:immunology*; D006526:Hepatitis C / Q000276:immunology*; D006801:Humans; D016130:Immunophenotyping; D008297:Male; D008875:Middle Aged; D016176:T-Lymphocyte Subsets / Q000276:immunology*; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology / Q000821:virology*; D019562:Viral Load