The dynamics of T-lymphocyte responses during combination therapy for chronic hepatitis C virus infection.

Hepatitis C virus (HCV) readily sets up a persistent infection and is a major cause of liver disease worldwide. Interferon alfa and ribavirin therapy lead to sustained clearance of virus in 31% to 64% of patients with type 1 and non-type 1 genotypes, respectively. It is not clear to what extent thes...

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Main Authors: Barnes, E, Harcourt, G, Brown, D, Lucas, M, Phillips, R, Dusheiko, G, Klenerman, P
Format: Journal article
Language:English
Published: 2002
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author Barnes, E
Harcourt, G
Brown, D
Lucas, M
Phillips, R
Dusheiko, G
Klenerman, P
author_facet Barnes, E
Harcourt, G
Brown, D
Lucas, M
Phillips, R
Dusheiko, G
Klenerman, P
author_sort Barnes, E
collection OXFORD
description Hepatitis C virus (HCV) readily sets up a persistent infection and is a major cause of liver disease worldwide. Interferon alfa and ribavirin therapy lead to sustained clearance of virus in 31% to 64% of patients with type 1 and non-type 1 genotypes, respectively. It is not clear to what extent these drugs act directly to reduce HCV replication, or indirectly via host immune responses, and what evoked immune responses are associated with clinical outcome. We have examined prospectively 15 patients with chronic HCV infection before, during, and after combination therapy. Quantitative assays for HCV antigen-specific CD4+ and CD8+ T-cell responses, and flow cytometric assays for analysis of the phenotype of T cells, in addition to viral sequencing of core protein, were performed throughout the treatment and follow-up period over 18 months. We found enhancement of proliferative T-cell responses during therapy. Proliferative responses are strikingly heterogeneous in terms of specificity, kinetics, and magnitude. Proliferative responses are often not associated with interferon-gamma release. T-cell responses are rarely sustained irrespective of treatment outcome and this is not due to the evolution of new immune escape variants. T-cell responses tend to peak late in the course of treatment. In conclusion, combination therapy for HCV has a transient effect on host virus-specific T cells in the blood. Induction of sustained T-cell responses may require additional immune modulation later in therapy.
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spelling oxford-uuid:057f005d-35b3-441e-8a9a-7a65f1658af42022-03-26T08:57:26ZThe dynamics of T-lymphocyte responses during combination therapy for chronic hepatitis C virus infection.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:057f005d-35b3-441e-8a9a-7a65f1658af4EnglishSymplectic Elements at Oxford2002Barnes, EHarcourt, GBrown, DLucas, MPhillips, RDusheiko, GKlenerman, PHepatitis C virus (HCV) readily sets up a persistent infection and is a major cause of liver disease worldwide. Interferon alfa and ribavirin therapy lead to sustained clearance of virus in 31% to 64% of patients with type 1 and non-type 1 genotypes, respectively. It is not clear to what extent these drugs act directly to reduce HCV replication, or indirectly via host immune responses, and what evoked immune responses are associated with clinical outcome. We have examined prospectively 15 patients with chronic HCV infection before, during, and after combination therapy. Quantitative assays for HCV antigen-specific CD4+ and CD8+ T-cell responses, and flow cytometric assays for analysis of the phenotype of T cells, in addition to viral sequencing of core protein, were performed throughout the treatment and follow-up period over 18 months. We found enhancement of proliferative T-cell responses during therapy. Proliferative responses are strikingly heterogeneous in terms of specificity, kinetics, and magnitude. Proliferative responses are often not associated with interferon-gamma release. T-cell responses are rarely sustained irrespective of treatment outcome and this is not due to the evolution of new immune escape variants. T-cell responses tend to peak late in the course of treatment. In conclusion, combination therapy for HCV has a transient effect on host virus-specific T cells in the blood. Induction of sustained T-cell responses may require additional immune modulation later in therapy.
spellingShingle Barnes, E
Harcourt, G
Brown, D
Lucas, M
Phillips, R
Dusheiko, G
Klenerman, P
The dynamics of T-lymphocyte responses during combination therapy for chronic hepatitis C virus infection.
title The dynamics of T-lymphocyte responses during combination therapy for chronic hepatitis C virus infection.
title_full The dynamics of T-lymphocyte responses during combination therapy for chronic hepatitis C virus infection.
title_fullStr The dynamics of T-lymphocyte responses during combination therapy for chronic hepatitis C virus infection.
title_full_unstemmed The dynamics of T-lymphocyte responses during combination therapy for chronic hepatitis C virus infection.
title_short The dynamics of T-lymphocyte responses during combination therapy for chronic hepatitis C virus infection.
title_sort dynamics of t lymphocyte responses during combination therapy for chronic hepatitis c virus infection
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