title: Hepatitis B virus-specific CD4 T cell immunity after liver transplantation for chronic hepatitis B.
abstract: Cellular immunity plays an important role in the long-term control of hepatitis B virus (HBV) infection. We studied the changes in HBV-specific CD4 T cell immunity after orthotopic liver transplantation (OLT) for chronic hepatitis B under antiviral prophylaxis. T cell proliferation and interferon-gamma production in response to in vitro challenge with HBV-encoded antigens were tested in 40 OLT recipients without HBV recurrence and in 12 OLT recipients with HBV recurrence more than 1 year after transplantation, and they were compared to 40 subjects with chronic HBV infection and to 23 subjects with self-limited HBV infection. The frequency and magnitude of the HBV-specific CD4 T cell response were significantly lower in 40 OLT recipients with HBV clearance, but the T cell reactivity to mitogen (phytohemagglutinin) and recall antigen (tetanus toxoid) was maintained. In the 12 OLT recipients with HBV recurrence, however, the HBV-specific T cell immunity was enhanced to a level comparable to that of patients with chronic hepatitis B, and the level was dependent on the serum viral load. In conclusion, HBV-specific CD4 T cell immunity is antigen-driven and evanesces with viral clearance, hence providing a favorable milieu for reactivation once prophylaxis is withdrawn. The cellular immunity in recipients with recurrence is not significantly different from that of individuals with chronic hepatitis B.
authors.affiliation: Department of Hepatobiliary Surgery, General Hospital of PLA, Beijing, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Luo
authors.forename: Chung Mau
authors.initials: CM
authors.lastname: Lo
authors.forename: Cindy K
authors.initials: CK
authors.lastname: Cheung
authors.forename: George K
authors.initials: GK
authors.lastname: Lau
authors.forename: John
authors.initials: J
authors.lastname: Wong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D004279:DNA, Viral / Q000097:blood; D005260:Female; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000276:immunology*; D019694:Hepatitis B, Chronic / Q000276:immunology*; D006801:Humans; D007111:Immunity, Cellular; D007136:Immunoglobulins / Q000627:therapeutic use*; D007371:Interferon-gamma / Q000378:metabolism; D016031:Liver Transplantation / Q000276:immunology*; D008213:Lymphocyte Activation; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D013601:T-Lymphocytes / Q000276:immunology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D007136:Immunoglobulins; D007371:Interferon-gamma; C045213:hepatitis B hyperimmune globulin