Lack of variant specific CD8+ T-cell response against mutant and pre-existing variants leads to outgrowth of particular clones in acute hepatitis C.
BACKGROUND
CTL escape mutations have been described during acute hepatitis C in patients who developed chronic disease later on. Our aim was to investigate the mutual relationship between HCV specific CD8+ T cells and evolution of the viral sequence during early acute HCV infection.


RESULTS
We sequenced multiple clones of NS3 1406 epitope in 4 HLA-A*02 patients with acute hepatitis C genotype 1b infection. Pentamers specific for the variants were used to monitor the corresponding CD8+ T cell response. We observed outgrowth of mutations, which induced only a weak and thus potentially insufficient CD8+ T cell response. In one patient we observed outgrowth of variant epitopes with similarities to a different genotype rather than de novo mutations most probably due to a lack of responsiveness to these likely pre-existing variants. We could show that in acute hepatitis C CTL escape mutations occur much earlier than demonstrated in previous studies.


CONCLUSIONS
The adaption of the virus to a new host is characterized by a high and rapid variability in epitopes under CD8+ T cell immune pressure. This adaption takes place during the very early phase of acute infection and strikingly some sequences were reduced below the limit of detection at some time points but were detected at high frequency again at later time points. Independent of the observed variability, HCV-specific CD8+ T cell responses decline and no adaption to different or new antigens during the course of infection could be detected.
Department of Internal Medicine II, Klinikum Großhadern, University of Munich, Marchioninistrasse 15, Munich, 81377, Germany. Norbert.Gruener@med.uni-muenchen.de.
Axel
A
Ulsenheimer
Gláucia
G
Paranhos-Baccalà
Florence
F
Komurian-Pradel
Bijan
B
Raziorrouh
Peter
P
Kurktschiev
Helmut M
HM
Diepolder
Reinhart
R
Zachoval
Michael
M
Spannagl
Maria-Christina
MC
Jung
Norbert H
NH
Gruener
D000220:Adaptation, Biological; D000328:Adult; D000956:Antigens, Viral / Q000235:genetics / Q000276:immunology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology*; D004252:DNA Mutational Analysis; D005260:Female; D016174:Hepacivirus / Q000235:genetics* / Q000276:immunology* / Q000302:isolation & purification; D006526:Hepatitis C / Q000276:immunology* / Q000821:virology*; D006801:Humans; D057131:Immune Evasion; D008297:Male; D008875:Middle Aged; D009154:Mutation; D017422:Sequence Analysis, DNA
D000956:Antigens, Viral