BACKGROUND & AIMS: Immune responses during the first few months of acute hepatitis C virus (HCV) infection seem crucial for viral control, but the relationship of these responses to natural history is poorly characterized. METHODS: This prospective study investigated the HCV-specific CD4(+) and cytokine responses in patients with acute HCV hepatitis with or without Schistosoma mansoni coinfection, a parasitic infection with T helper (Th) 2 immune bias. HCV-specific CD4(+) proliferative responses and cytokine production in peripheral blood mononuclear cells were correlated with liver biopsy results at 6 months and at the end of follow-up. RESULTS: Whereas 5 of 15 patients with HCV alone recovered from acute HCV, all (17 of 17) patients with S. mansoni coinfection progressed to histologically proven chronic hepatitis. Coinfected patients had either absent or transient weak HCV-specific CD4(+) responses with Th0/Th2 cytokine production. The magnitude of the HCV-specific CD4(+) response at week 12 was inversely correlated with the fibrosis progression rate in chronically infected patients. CONCLUSIONS: Patients with acute hepatitis C and schistosomiasis coinfection cannot clear viremia and show rapid progression once chronic infection is established. This rapid progression is associated with a strong Th2 response in peripheral immune responses, suggesting that early development of vigorous Th1 responses not only facilitates clearance but delays disease progression.
BACKGROUND & AIMS: Immune responses during the first few months of acute hepatitis C virus (HCV) infection seem crucial for viral control, but the relationship of these responses to natural history is poorly characterized. METHODS: This prospective study investigated the HCV-specific CD4(+) and cytokine responses in patients with acute HCV hepatitis with or without Schistosoma mansoni coinfection, a parasitic infection with T helper (Th) 2 immune bias. HCV-specific CD4(+) proliferative responses and cytokine production in peripheral blood mononuclear cells were correlated with liver biopsy results at 6 months and at the end of follow-up. RESULTS: Whereas 5 of 15 patients with HCV alone recovered from acute HCV, all (17 of 17) patients with S. mansoni coinfection progressed to histologically proven chronic hepatitis. Coinfectedpatients had either absent or transient weak HCV-specific CD4(+) responses with Th0/Th2 cytokine production. The magnitude of the HCV-specific CD4(+) response at week 12 was inversely correlated with the fibrosis progression rate in chronically infectedpatients. CONCLUSIONS:Patients with acute hepatitis C and schistosomiasis coinfection cannot clear viremia and show rapid progression once chronic infection is established. This rapid progression is associated with a strong Th2 response in peripheral immune responses, suggesting that early development of vigorous Th1 responses not only facilitates clearance but delays disease progression.
Authors: I Bakr; C Rekacewicz; M El Hosseiny; S Ismail; M El Daly; S El-Kafrawy; G Esmat; M A Hamid; M K Mohamed; A Fontanet Journal: Gut Date: 2006-01-24 Impact factor: 23.059
Authors: Kathleen R Page; Anne E Jedlicka; Benjamin Fakheri; Gregory S Noland; Anup K Kesavan; Alan L Scott; Nirbhay Kumar; Yukari C Manabe Journal: Infect Immun Date: 2005-12 Impact factor: 3.441
Authors: David E Kaplan; Fusao Ikeda; Yun Li; Nobuhiro Nakamoto; Sutharsan Ganesan; Mary E Valiga; Frederick A Nunes; K Rajender Reddy; Kyong-Mi Chang Journal: J Hepatol Date: 2008-03-07 Impact factor: 25.083
Authors: E Spada; A Mele; A Berton; L Ruggeri; L Ferrigno; A R Garbuglia; M P Perrone; G Girelli; P Del Porto; E Piccolella; M U Mondelli; P Amoroso; R Cortese; A Nicosia; A Vitelli; A Folgori Journal: Gut Date: 2004-11 Impact factor: 23.059