Skip to main content
Log in

Immunopathology of hepatitis C

  • Published:
Springer Seminars in Immunopathology Aims and scope Submit manuscript

Abstract

Hepatitis C virus (HCV) infection becomes persistent in the majority of instances in the face of a Immoral and cellular immune response, and persistent HCV infection is associated with chronic hepatitis. In particular, cytotoxic T lymphocytes (CTL), crucial in the eradication of virus-infected cells, have been observed in the liver and the peripheral blood of chronically infected patients, suggesting that CTL cannot completely eliminate the virus, and may contribute to chronic liver injury. In this review, the potential host and the viral factors involved in the pathogenesis of chronic HCV infection will be discussed with emphasis on the HLA-A2 restricted peripheral blood CTL response and its relationship to liver disease and viral load.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Alter HJ (1995) To C or not to C: these are the questions. Blood 85:1681

    Google Scholar 

  2. Alter MJ, Margolis HS, Krawczynski K, Judson FN, Mares A, Alexander WJ, Hu PY, Miller JK, Gerber MA, Sampliner RE, Meeks EL, Beach MJ, the Sentinel Counties Chronic Non-A Non-B Hepatitis Study Team (1992) The natural history of community-acquired hepatitis C in the United States. N Engl J Med 327:1899

    Google Scholar 

  3. Autran B, Hadida F, Haas G (1996) Evolution and plasticity of CTL responses against HIV. Curr Opin Immunol 8:546

    Google Scholar 

  4. Bach N, Thung SN, Schaffner F (1992) The histological features of chronic hepatitis C and autoimmune chronic hepatitis: a comparative analysis. Hepatology 15:572

    Google Scholar 

  5. Ballardini G, Groff P, Pontisso P, Giostra F, Francesconi R, Lenzi M, Zauli D, Albeti A, Bianchi FB (1995) Hepatitis C virus (HCV) genotype, tissue HCV antigens, hepatocellular expression of HLA-A,B,C, and intercellular adhesion-1 molecules. J Clin Invest 95:2067

    Google Scholar 

  6. Barbatis C, Woods J, Morton JA, Fleming KA, McMichael A, McGee JO (1981) Immunohistochemical analysis of HLA (A,B,C) antigens in liver disease using a monoclonal antibody. Gut 22:985

    Google Scholar 

  7. Battegay M, Fikes J, Di Bisceglie AM, Wentworth PA, Sette A, Celis E, Ching W-M, Grakoui A, Rice CM, Kurokohchi K, Berzofsky JA, Hoofnagle JH, Feinstone SM, Akatsuka T (1995) Patients with chronic hepatitis C have circulating cytotoxic T cells which recognize hepatitis C virus-encoded peptides binding to HLA-A2.1 molecules. J Virol 69:2452

    Google Scholar 

  8. Bertoletti A, Ferrari C, Fiaccadori F, Penna A, Margolskee R, Schlicht HJ, Fowler P, Guilhot S, Chisari FV (1991) HLA class I-restricted human cytotoxic T cells recognize endogenously synthesized hepatitis B virus nucleocapsid antigen. Proc Natl Acad Sci USA 88:10445

    Google Scholar 

  9. Bertoletti A, Sette A, Chisari FV, Penna A, Levrero M, DeCarli M, Fiaccadori F, Ferrari C (1994) Natural variants of cytotoxic epitopes are T cell receptor antagonists for antiviral cytotoxic T cells. Nature 369:407

    Google Scholar 

  10. Botarelli P, Brunetto MR, Minutello MA, Calvo P, Unutmaz D, Weiner AJ, Chou Q-L, Shuster JR, Kuo G, Bonino F, Houghton M, Abrignani S (1993) T-lymphocyte response to hepatitis C virus in different clinical courses of infection. Gastroenterology 104:580

    Google Scholar 

  11. Bukh J, Miller RH, Purcell RH (1995) Genetic heterogeneity of hepatitis C virus: quasispecies and genotypes. Semin Liver Dis 15:41

    Google Scholar 

  12. Cacciarelli TV, Martinez OM, Gish RG, Villanueva JC, Krams SM (1996) Immunoregulatory cytokines in chronic hepatitis C virus infection: pre-and posttreatment with interferon alpha. Hepatology 24:6

    Google Scholar 

  13. Cerny A, McHutchison JG, Pasquinelli C, Brown ME, Brothers MA, Grabscheid B, Fowler P, Houghton M, Chisari FV (1995) Cytotoxic T lymphocyte response to hepatitis C virus-derived peptides containing the HLA A2.1 binding motif. J Clin Invest 95:521

    Google Scholar 

  14. Choo Q-L, Kuo G, Weiner AJ, Overby LR, Bradley DW, Houghton M (1989) Isolation of a cDNA clone derived from a blood-borne non-A, non-B viral hepatitis genome. Science 244:359

    Google Scholar 

  15. Davis GL, Balart LA, Schiff ER, Lindsay K, Bodenheimer HC, Perrillo RP, Carey W, Jacobson IM, Payne J, Dienstag JL, Van Thiel DH, Tamburro C, Lefkowitch J, Albrecht J, Meschievitz C, Ortego TJ, Gibas A (1989) Treatment of chronic hepatitis C with recombinant interferon alfa. N Engl J Med 321:1501

    Google Scholar 

  16. Di Bisceglie AM, Martin P, Kassianides C, Lisker-Melman M, Murray L, Waggoner J, Goodman Z, Banks SM, Hoofnagle JH (1989) Recombinant interferon alfa therapy for chronic hepatitis C. N Engl J Med 321:1506

    Google Scholar 

  17. Enomoto N, Sakuma I, Asahina Y, Kurosaki M, Murakami T, Yamamoto C, Izumi N, Marumo F, Sato C (1995) Comparison of full-length sequences of interferon-sensitive and resistant hepatitis C virus 1b. J Clin Invest 96:224

    Google Scholar 

  18. Enomoto N, Sakuma I, Asahina Y, Kurosaki M, Murakimi T, Yamamoto C, Ogura Y, Izumi N, Marumo F, Sato C (1996) Mutations in the nonstructural protein 5A gene and response to interferon in patients with chronic hepatitis C virus 1b infection. N Engl J Med 334:77

    Google Scholar 

  19. Erickson AL, Houghton M, Choo QL, Weiner AJ, Ralston R, Muchmore E, Walker CM (1993) Hepatitis C virus-specific CTL responses in the liver of chimpanzees with acute and chronic hepatitis C. J Immunol 151:4189

    Google Scholar 

  20. Esteban JI, Esteban R, Viladomiu L, Lopez-Talvera JC, Gonzalez A, Hernandez J (1989) Hepatitis C virus antibodies among risk groups in Spain. Lancet II:294

    Google Scholar 

  21. Falk K, Roetzschke O, Stevanovic S, Jung G, Rammensee H-G (1991) Allele-specific motifs revealed by sequencing of self-peptides eluted from MHC molecules. Nature 351:290

    Google Scholar 

  22. Farci P, Alter HJ, Govindarajan S, Wong DC, Engle R, Lesniewski RR, Mushahwar IK, Desai SM, Miller RH, Ogata N, Purcell RH (1992) Lack of protective immunity against reinfection with hepatitis C virus. Science 258:135

    Google Scholar 

  23. Feinstone SM, Mihalik KB, Kamimura T, Alter HJ, London WT, Purcell RH (1983) Inactivation of hepatitis B virus and non-A, non-B hepatitis by chloroform. Infect Immun 41:816

    Google Scholar 

  24. Ferrari C, Valli A, Galati L, Penna A, Scaccaglia P, Guiberti T, Schianchi C, Missale G, Marin MG, Fiaccadori F (1994) T-cell response to structural and nonstructural hepatitis C virus antigens in persistent and self-limited hepatitis C virus infections. Hepatology 19:286

    Google Scholar 

  25. Franco A, Ferrari C, Sette A, Chisari FV (1995) Viral mutations, T cell receptor antagonism and escape from the immune response. Curr Opin Immunol 7:524

    Google Scholar 

  26. Gretch DR, Bacchi CE, Corey L, Rosa CD, Lesniewski RR, Kowdley K, Gown A, Frank I, Perkins JD, Carithers RL (1995) Persistent hepatitis C virus infection after liver transplantation: clinical and virological features. Hepatology 22:1

    Google Scholar 

  27. Guidotti LG, Chisari FV (1996) To kill or to cure: options in host defense against viral infection. Curr Opin Immunol 8:478–483

    Google Scholar 

  28. Guidotti LG, Ishikawa T, Hobbs MV, Matzke B, Schreiber R, Chisari FV (1996) Intracellular inactivation of the hepatitis B virus by cytotoxic T lymphocytes. Immunity 4:25

    Google Scholar 

  29. He LF, Alling D, Popkin T, Shapiro M, Alter HJ, Purcell RH (1987) Determining the size of non-A, non-B hepatitis virus by filtration. J Infect Dis 156:636

    Google Scholar 

  30. Hijikata M, Shimizu YK, Kato H, Iwamoto A, Shih JW, Alter HJ, Purcell RP, Yoshikura H (1993) Equilibrium centrifugation studies of hepatitis C virus: evidence for circulating immune complexes. J Virol 67:1953

    Google Scholar 

  31. Hiramatsu N, Hayashi N, Haruna Y, Kasahara A, Fusamoto H, Mori C, Fuke I, Okayama H, Kamada T (1992) Immunohistochemical detection of hepatitis C virus-infected hepatocytes in chronic liver disease with monoclonal antibodies to core, envelope and NS3 regions of the hepatitis C virus genome. Hepatology 16:306

    Google Scholar 

  32. Hiramatsu N, Hayashi N, Katayama K, Mochizuki K, Kawanishi Y, Kasahara A, Fusamoto H, Kamada T (1994) Immunohistochemical detection of Fas antigen in liver tissue of patients with chronic hepatitis C. Hepatology 19:1354

    Google Scholar 

  33. Hiroishi K, Kita H, Kojima M, Okamoto H, Moriyama T, Kaneko T, Ishikawa T, Ohnishi S, Aikawa T, Tanaka N, Yazaki Y, Mitamura K, Imawari M (1997) Cytotoxic T lymphocyte response and viral load in hepatitis C virus infection. Hepatology 25:705

    Google Scholar 

  34. Hoffmann RM, Diepolder HM, Zachoval R, Zweibel F-M, Jung M-C, Scholz S, Nitschko H, Riethmuller G, Pape GR (1995) Mapping of immunodominant CD4+ T lymphocyte epitopes of hepatitis C virus and their relevance during the course of chronic infection. Hepatology 21:632

    Google Scholar 

  35. Hollinger FB (1990) Hepatitis B virus. In: Fields BN, et al (eds) Virology. Raven Press, New York, pp 2171–2236

    Google Scholar 

  36. Imawari M, Nomura M, Kaieda T, Moriyama T, Oshimi K, Nakamura I, Gunji T, Ohnishi S, Ishikawa T, Nakagama H, Takaku F (1989) Establishment of a human T-cell clone cytotoxic for both autologous and allogeneic hepatocytes from chronic hepatitis patients with type non-A, non-B virus. Proc Natl Acad Sci USA 86:2883

    Google Scholar 

  37. Kast WM, Brandt RMP, Sidney J, Drijfhout J-W, Kubo RT, Grey HM, Melief CJM, Sette A (1994) The role of HLA-A motifs in identification of potential CTL epitopes in human papillomavirus type 16 E6 and E7 proteins. J Immunol 152:3904

    Google Scholar 

  38. Kita H, Moriyama T, Kaneko T, Harase I, Nomura M, Miura H, Nakamura I, Yazaki Y, Imawari M (1993) HLA-B44-restricted cytotoxic T lymphocytes recognizing an epitope on hepatitis C virus nucleocapsid protein. Hepatology 18:1039

    Google Scholar 

  39. Kiyosawa K, Akahane Y, Nagata A, Koike Y, Furuta S (1982) Significance of blood transfusion in non-A, non-B chronic liver disease in Japan. Vox Sang 43:45

    Google Scholar 

  40. Klenerman P, Rowland-Jones S, McAdams S, Edwards J, Daenke S, Lalloo D, Koppe B, Rosenberg W, Boyd D, Edwards A, Giangrande P, Phillips RE, McMichael AJ (1994) Cytotoxic T-cell activity antagonized by naturally occurring HIV-1 Gag variants. Nature 369:403

    Google Scholar 

  41. Koike K, Moriya K, Ishibashi K, Matsuura Y, Suzuki T, Saito I, Iino S, Kurokawa K, Miyamura T (1995) Expression of hepatitis C virus envelope proteins in transgenic mice. J Gen Virol 76:3031

    Google Scholar 

  42. Kolykhalov AA, Feinstone SM, Rice CM (1996) Identification of a highly conserved sequence element at the 3′ terminus of hepatitis C virus genome RNA. J Virol 70:3363

    Google Scholar 

  43. Koup RA (1994) Virus escape from CTL recognition. J Exp Med 180:779

    Google Scholar 

  44. Koziel MJ, Dudley D, Wong JT, Dienstag J, Houghton M, Ralston R, Walker BD (1992) Intrahepatic cytotoxic T lymphocytes specific for hepatitis C virus in persons with chronic hepatitis. J Immunol 149:3339

    Google Scholar 

  45. Koziel MJ, Dudley D, Afdhal N, Choo Q-L, Houghton M, Ralston R, Walker BD (1993) Hepatitis C virus (HCV)-specific cytoxic T lymphocytes recognize epitopes in the core and envelope proteins of HCV. J Virol 67:7522

    Google Scholar 

  46. Koziel MJ, Dudley D, Afdhal N, Grakoui A, Rice CM, Choo Q-L, Houghton M, Walker BD (1995) HLA class I-restricted cytotoxic T lymphocytes specific for hepatitis C virus. Identification of multiple epitopes and characterization of patterns of cytokine release. J Clin Invest 96:2311

    Google Scholar 

  47. Kuo G, Choo Q-L, Alter HJ, Gitnick GI, Redeker AG, Purcell RH, Miyamura T, Dienstag JL, Alter MJ, Syevens CE, Tegtmeier GE, Bonino F, Colombo M, Lee WS, Kuo C, Berger K, Shuster JR, Overby LR, Bradley DW, Houghton MA (1989) An assay for circulating antibodies to a major etiologic virus of human non-A, non-B hepatitis. Science 244:362

    Google Scholar 

  48. Matsuura Y, Miyamura T (1993) The molecular biology of hepatitis C virus. Semin Virol 4:297

    Google Scholar 

  49. Missale G, Bertoni R, Lamonaca V, Valli A, Massari M, Mori C, Rumi MG, Houghton M, Fiaccadori F, Ferrari C (1996) Differential clinical behaviors of acute hepatitis C virus infection are associated with different vigor of the anti-viral cell-mediated immune response. J Clin Invest 98:706

    Google Scholar 

  50. Mita E, Hayashi N, Iio S, Takehara T, Hijioka T, Kasahara A, Fusamoto H, Kamada T (1994) Role of Fas ligand in apoptosis induced by hepatitis C virus infection. Biochem Biophys Res Commun 204:468

    Google Scholar 

  51. Moriyama T, Guilhot S, Klopchin K, Moss B, Pinkert CA, Palmiter RD, Brinster RL, Kanagawa O, Chisari FV (1990) Immunobiology and pathogenesis of hepatocellular injury in hepatitis B virus transgenic mice. Science 248:361

    Google Scholar 

  52. Nagata S (1996) Fas ligand and immune evasion. Nature Med 2:1306

    Google Scholar 

  53. Napoli J, Bishop GA, McGuinness PH, Painter DM, McCaughan GW (1996) Progressive liver injury in chronic hepatitis C infection correlates with increased intrahepatic expression of Th 1-associated cytokines. Hepatology 24:759

    Google Scholar 

  54. Nayersina R, Folwer P, Guilhot S, Missale G, Cerny A, Schlicht H-J, Vitiello A, Chesnut R, Person JL, Redeker AG, Chisari FV (1993) HLA A2 restricted cytotoxic T lymphocyte responses to multiple hepatitis B surface antigen epitopes during hepatitis B virus infection. J Immunol 150:4659

    Google Scholar 

  55. Nouri-Aria KT, Sallie R, Mizokami M, Portmann BC, Williams R (1995) Intrahepatic expression of hepatitis C virus antigens in chronic liver disease. J Pathol 175:77

    Google Scholar 

  56. Nowak MA, May RM, Phillips RE, Rowland-Jones S, Lalloo DG, McAdams S, Klenerman P, Koppe B, Sigmund K, Bangham CRM (1995) Antigenic oscillations and shifting immunodominance in HIV-1 infections. Nature 375:606

    Google Scholar 

  57. Ogata N, Alter HJ, Miller RH, Purcell RH (1991) Nucleotide sequence and mutation rate of the H strain of hepatitis C virus. Proc Natl Acad Sci USA 88:3392

    Google Scholar 

  58. Pasquinelli C, Shoenberger JM, Chang J-S, Chang K-M, Selby M, Berger K, Lesniewski R, Houghton M, Chisari FV (1997) Hepatitis C virus core and E2 protein expression in transgenic mice. Hepatology 25:719

    Google Scholar 

  59. Pereira BJG, Milford EL, Kirkman RL, Levey AS (1991) Transmission of hepatitis C virus by organ transplantation. N Engl J Med 325:454

    Google Scholar 

  60. Peters CJ, Buchmeier M, Rollin PE, Ksiazek TG (1996) Arenaviruses. In: Fields BN, Knipe DM, Howley PM (eds) Fields Virology. Lippincott-Raven Press, Philadelphia, pp. 1521

    Google Scholar 

  61. Rehermann B, Person J, Redeker A, Fowler P, Brown M, Moss B, Sette A, Chisari FV (1995) The cytotoxic T lymphocyte response to multiple hepatitis B virus polymerase epitopes during and after acute viral hepatitis. J Exp Med 181:1047

    Google Scholar 

  62. Rehermann B, Chang K-M, McHutchison JG, Kokka R, Houghton M, Chisari FV (1996) Quantitative analysis of the peripheral blood cytotoxic T lymphocyte response in patients with chronic hepatitis C virus infection. J Clin Invest 98:1432

    Google Scholar 

  63. Rehermann B, Chang K-M, McHutchison JG, Kokka R, Houghton M, Rice CM, Chisari FV (1996) Differential cytotoxic T lymphocyte responsiveness to the hepatitis B and C viruses in chronically infected patients. J Virol 70:7092

    Google Scholar 

  64. Rehermann B, Lau D, Hoofnagle JH, Chisari FV (1996) Cytotoxic T lymphocyte responsiveness after resolution of chronic hepatitis B virus infection. J Clin Invest 97:1655

    Google Scholar 

  65. Resnick RH, Koff R (1993) Hepatitis C-related hepatocellular carcinoma. Prevalence and significance. Arch Intern Med 153:1672

    Google Scholar 

  66. Rickinson AB, Lee SP, Steven NM (1996) Cytotoxic T lymphocyte responses to Epstein-Barr virus. Curr Opin Immunol 8:492

    Google Scholar 

  67. Scheuer P, Ashrafzadeh P, Sherlock S, Brown D, Dusheiko GM (1992) The pathology of hepatitis C. Hepatology 15:567

    Google Scholar 

  68. Shimizu YK, Hijikata M, Iwamoto A, Alter HJ, Purcell RH, Yoshikura H (1994) Neutralizing antibodies against hepatitis C virus and the emergence of neutralization escape mutant viruses. J Virol 68:1494

    Google Scholar 

  69. Smith GL (1996) Virus proteins that bind cytokines, chemokines or interferons. Curr Opin Immunol 8:467

    Google Scholar 

  70. Spriggs MK (1996) One step ahead of the game: viral immunomodulatory molecules. Ann Rev Immunol 14:101

    Google Scholar 

  71. Stevens CE, Taylor CE, Pindyk J, Choo Q-L, Bradley DW, Kuo G, Houghton M (1990) Epidemiology of hepatitis C virus. JAMA 263:49

    Google Scholar 

  72. Strand S, Hofmann WJ, Hug H, Muller M, Otto G, Strand D, Mariani SM, Stremmel W, Krammer PH, Galle PR (1996) Lymphocyte apoptosis induced by CD95 (APO-1/Fas) ligand-expressing tumor cells — A mechanism of immune evasion? Nature Med 2:1361

    Google Scholar 

  73. Tanaka T, Kato N, Cho M-J, Sugiyama K, Shimotohno K (1996) Structure of the 3′ terminus of the hepatitis C virus genome. J Virol 70:3307

    Google Scholar 

  74. Thomssen R, Bonk S, Propfe C, Heermann K-H, Kochel HG, Uy A (1992) Association of hepatitis C virus in human sera with B-lipoprotein. Med Microbiol Immunol 181:293

    Google Scholar 

  75. Weiner AJ, Geysen HM, Christopherson C, Hall JE, Mason TJ, Saracco G, Bonino F, Crawford K, Marion CD, Crawford KA, Brunetto M, Barr PJ, Miyamura T, McHutchison JG, Houghton M (1992) Evidence for immune selection of hepatitis C virus (HCV) putative envelope glycoprotein variants: potential role in chronic HCV infection. Proc Natl Acad Sci USA 89:3468

    Google Scholar 

  76. Weiner A, Erickson AL, Kansopon J, Crawford K, Muchmore E, Hughes AL, Houghton M, Walker CM (1995) Persistent hepatitis C virus infection in a chimpanzee is associated with emergence of a cytotoxic T lymphocyte escape variant. Proc Natl Acad Sci USA 92:2755

    Google Scholar 

  77. Wong D, Koziel M, Dudley D, Afdhal N, Rice C, Houghton M, Walker B (1996) Hepatitis C virus-specific cytotoxic T lymphocytes from liver and peripheral blood. Abstracts of the IX Triennial International Symposium on Viral Hepatitis and Liver Disease, Italy, 1996, CpA, Rome, abstr. no. 38

  78. Yoo JY, Howard R, Waggoner JG, Hoofnagle JH (1987) Peroxidase-anti-peroxidase detection of hepatitis B surface and core antigen in liver biopsy specimens from patients with chronic type B hepatitis. J Med Virol 23:273

    Google Scholar 

  79. Yuasa T, Ishikawa G, Manabe S, Sekiguchi S, Takeuchi K, Miyamura T (1991) The particle size of hepatitis C virus estimated by filtration through microporous regenerated cellulose fibre. J Gen Virol 72:2021

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Chang, KM., Rehermann, B. & Chisari, F.V. Immunopathology of hepatitis C. Springer Semin Immunopathol 19, 57–68 (1997). https://doi.org/10.1007/BF00945025

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00945025

Keywords

Navigation