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.
Similar content being viewed by others
References
Alter HJ (1995) To C or not to C: these are the questions. Blood 85:1681
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
Autran B, Hadida F, Haas G (1996) Evolution and plasticity of CTL responses against HIV. Curr Opin Immunol 8:546
Bach N, Thung SN, Schaffner F (1992) The histological features of chronic hepatitis C and autoimmune chronic hepatitis: a comparative analysis. Hepatology 15:572
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
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
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
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
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
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
Bukh J, Miller RH, Purcell RH (1995) Genetic heterogeneity of hepatitis C virus: quasispecies and genotypes. Semin Liver Dis 15:41
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
Guidotti LG, Chisari FV (1996) To kill or to cure: options in host defense against viral infection. Curr Opin Immunol 8:478–483
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
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
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
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
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
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
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
Hollinger FB (1990) Hepatitis B virus. In: Fields BN, et al (eds) Virology. Raven Press, New York, pp 2171–2236
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
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
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
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
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
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
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
Koup RA (1994) Virus escape from CTL recognition. J Exp Med 180:779
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
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
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
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
Matsuura Y, Miyamura T (1993) The molecular biology of hepatitis C virus. Semin Virol 4:297
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
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
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
Nagata S (1996) Fas ligand and immune evasion. Nature Med 2:1306
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
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
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
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
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
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
Pereira BJG, Milford EL, Kirkman RL, Levey AS (1991) Transmission of hepatitis C virus by organ transplantation. N Engl J Med 325:454
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
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
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
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
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
Resnick RH, Koff R (1993) Hepatitis C-related hepatocellular carcinoma. Prevalence and significance. Arch Intern Med 153:1672
Rickinson AB, Lee SP, Steven NM (1996) Cytotoxic T lymphocyte responses to Epstein-Barr virus. Curr Opin Immunol 8:492
Scheuer P, Ashrafzadeh P, Sherlock S, Brown D, Dusheiko GM (1992) The pathology of hepatitis C. Hepatology 15:567
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
Smith GL (1996) Virus proteins that bind cytokines, chemokines or interferons. Curr Opin Immunol 8:467
Spriggs MK (1996) One step ahead of the game: viral immunomodulatory molecules. Ann Rev Immunol 14:101
Stevens CE, Taylor CE, Pindyk J, Choo Q-L, Bradley DW, Kuo G, Houghton M (1990) Epidemiology of hepatitis C virus. JAMA 263:49
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
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
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
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
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
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
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
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
Author information
Authors and Affiliations
Rights 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
Issue Date:
DOI: https://doi.org/10.1007/BF00945025