Clearance of Hepatitis C Viremia Associated with Cellular Immunity in the Absence of Seroconversion in the Hepatitis C Incidence and Transmission in Prisons Study Cohort

Understanding the earliest virological and immunological events in acute hepatitis C virus (HCV) infection may provide insight into the determinants of protective immunity. Four cases of HCV viremia with subsequent viral clearance, but without biochemical hepatitis or anti-HCV seroconversion, are re...

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Bibliographic Details
Published in:The Journal of infectious diseases 2004-05, Vol.189 (10), p.1846-1855
Main Authors: Post, Jeffrey J., Pan, Yong, Freeman, Anthony J., Harvey, Charles E., White, Peter A., Palladinetti, Patricia, Haber, Paul S., Marinos, George, Levy, Michael H., Kaldor, John M., Dolan, Kate A., Ffrench, Rosemary A., Lloyd, Andrew R., Rawlinson, William D.
Format: Article
Language:English
Subjects:
Adult
Antibodies
Biological and medical sciences
CD4-Positive T-Lymphocytes - immunology
Cell Division
Cohort Studies
Enzyme-Linked Immunosorbent Assay
Flow Cytometry
Fundamental and applied biological sciences. Psychology
Hepacivirus
Hepacivirus - genetics
Hepacivirus - immunology
Hepatitis
Hepatitis Antibodies - blood
Hepatitis C
Hepatitis C - epidemiology
Hepatitis C - immunology
Hepatitis C - transmission
Hepatitis C - virology
Hepatitis C virus
Human viral diseases
Humans
Incidence
Infections
Infectious diseases
Interferon-gamma - blood
Longitudinal Studies
Lymphocytes
Male
Medical sciences
Microbiology
New South Wales - epidemiology
Prisoners
Prisons
Reverse Transcriptase Polymerase Chain Reaction
RNA, Viral - blood
T lymphocytes
T-Lymphocytes, Cytotoxic - pathology
Viral diseases
Viral hepatitis
Viremia
Viremia - epidemiology
Viremia - immunology
Viremia - transmission
Viremia - virology
Viruses
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Summary:Understanding the earliest virological and immunological events in acute hepatitis C virus (HCV) infection may provide insight into the determinants of protective immunity. Four cases of HCV viremia with subsequent viral clearance, but without biochemical hepatitis or anti-HCV seroconversion, are reported from a prospective cohort study of prison inmates. Two of the subjects who developed sustained viremia were assessed for production of interferon (IFN)-γ, by use of the enzyme-linked immunospot (ELISPOT) method and by assessment of HCV cytotoxic T lymphocyte (CTL) activity, CD4 lymphocyte proliferative responses, HCV load, and genotype. After 2-6 months of viremia, all 4 subjects cleared serum HCV RNA. Specific cellular responses were detected in both of the subjects who were assessed, and production of IFN-γ was demonstrated in one subject. All subjects had weak, but consistent, serological reactivity against HCV nonstructural proteins on immunoblot testing, despite repeatedly nonreactive HCV ELISA tests. These cases highlight the potential for cellular immune responses against HCV to facilitate viral clearance, responses that may model those required for effective HCV vaccination.
ISSN:0022-1899
1537-6613
DOI:10.1086/383279