Spontaneous control of primary hepatitis C virus infection and immunity against persistent reinfection.
Spontaneous control of primary hepatitis C virus infection and immunity against persistent reinfection.
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DOI：
10.1053/j.gastro.2009.09.017
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发表时间：
2010-01
期刊：
影响因子：
29.4
通讯作者：
Cox AL
中科院分区：
文献类型：
--
作者：
Osburn WO;Fisher BE;Dowd KA;Urban G;Liu L;Ray SC;Thomas DL;Cox AL
我们对初次丙型肝炎病毒（HCV）感染得到控制后持续暴露于丙型肝炎病毒（HCV）的患者进行随访，以确定初次控制是否可以预防未来的持续感染。对22名清除原发性丙型肝炎病毒血症至少60天的活跃注射吸毒者（IDU）进行每月监测。再感染定义为检测到新的丙型肝炎病毒感染。根据再感染后病毒血症的程度和持续时间以及t细胞和中和抗体（nAb）反应的产生来评估保护作用，在先前自发控制原发性HCV感染的11名idu（50%）中发生了再感染。虽然大约25%的原发性感染患者出现病毒清除，但在83%的再感染患者中观察到自发病毒清除。与同一受试者的初次感染相比，再次感染期间的病毒血症持续时间和最高水平显著降低。与慢性感染相反，再感染与t细胞反应广度的显著增加有关。在急性感染期间，60%的再感染者检测到针对异源病毒假颗粒的nab；在进展为慢性感染的患者中很少检测到交叉反应性nab。HCV再感染与病毒血症的程度和持续时间的减少（与初次感染相比）、细胞免疫反应的扩大以及交叉反应性体液反应的产生有关。这些发现与适应性免疫的发展是一致的，适应性免疫不是消毒，而是预防慢性疾病。
We followed persons with ongoing hepatitis C virus (HCV) exposure following control of an initial HCV infection to determine whether primary control conferred protection against future persistent infections. Twenty-two active injection drug users (IDU) who had cleared a primary hepatitis C viremia for at least 60 days were monitored monthly. Reinfection was defined as the detection of a new hepatitis C virus infection. Protection was assessed based on the magnitude and duration of viremia following reinfection and generation of T-cell and neutralizing antibody (nAb) responses Reinfection occurred in 11 IDUs (50%) who previously spontaneously controlled primary HCV infection. Although viral clearance occurs in approximately 25% of patients with primary infections, spontaneous viral clearance was observed in 83% of reinfected patients. The duration and maximum level of viremia during subsequent episodes of reinfection were significantly decreased, compared with those of the primary infection in the same subjects. In contrast to chronic infection, reinfection was associated with a significant increase in the breadth of T-cell responses. During acute infection, nAbs against heterologous viral pseudoparticles were detected in 60% of reinfected subjects; cross-reactive nAbs are rarely detected in patients who progress to chronic infection. HCV reinfection is associated with a reduction in the magnitude and duration of viremia (compared with the initial infection), broadened cellular immune responses, and the generation of cross-reactive humoral responses. These findings are consistent with the development of adaptive immunity that is not sterilizing but protects against chronic disease.
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影响因子：
82.9
作者：
Folgori, A;Capone, S;Nicosia, A
通讯作者：
Nicosia, A
影响因子：
13.5
作者：
Grebely, Jason;Conway, Brian;Tyndall, Mark W.
通讯作者：
Tyndall, Mark W.
影响因子：
13.8
作者：
Jeanmougin, F;Thompson, JD;Gibson, TJ
通讯作者：
Gibson, TJ
影响因子：
6.4
作者：
Prince, AM;Brotman, B;Shata, MT
通讯作者：
Shata, MT
影响因子：
29.4
作者：
Dowd KA;Netski DM;Wang XH;Cox AL;Ray SC
通讯作者：
Ray SC