Viral Host Interactions in Hepatitis C

描述（由申请人提供）：尽管对慢性丙型肝炎的发病机制知之甚少，但最近的研究表明，HCV与感染宿主之间发生的动态相互作用是病毒持续存在和疾病进展的关键决定因素。人类研究表明，HCV形成病毒准种的遗传进化，以及宿主CD4和CDS对HCV抗原的反应强度都与感染的持续性和慢性肝病的进展密切相关。然而，需要进行研究证实HCV演变与具有特定结果的个体患者的免疫应答之间的直接相互作用。本提案的总体目标是通过研究HCV基因进化与宿主免疫应答之间的关系，更好地了解丙型肝炎的发病机制，因为它们与感染的消退或持续以及慢性肝病的进展或非进展有关。我们将研究来自阿拉斯加原住民和美洲印第安人队列的受试者，利用可追溯到30多年前的血清库和过去8年中对约1000名受试者进行汇编的大型临床和病毒学数据库。HCV基因进化将在不同临床环境中宿主免疫应答的背景下进行研究。这些研究的结果将进一步加深我们对HCV持续存在和肝病进展机制的理解。

DESCRIPTION (provided by applicant): Although the pathogenesis of chronic hepatitis C is poorly understood, recent studies implicate the dynamic interactions which occur between HCV and the infected host as key determinants of viral persistence and disease progression. Studies in humans indicate that genetic evolution of HCV to form viral quasispecies, and the strength of host CD4 and CDS response against HCV antigens are both critically linked to persistence of infection and progression of chronic liver disease. However, research confirming a direct interplay between HCV evolution and the immune responses of individual patients with specific outcomes needs to be performed. The overall goal of this proposal is to gain a better understanding of the pathogenesis of hepatitis C by investigating the relationships between HCV genetic evolution and host immune responses as they relate to resolution or persistence of infection and progression or non- progression of chronic liver disease. We will study subjects from the Alaska Native and American Indian cohort, taking advantage of a serum bank which dates back over 30 years and a large clinical and virological database compiled on approximately 1000 subjects over the past 8 years. HCV genetic evolution will be studied in the context of host immune responses in different clinical settings. Results from these studies will further our understanding of the mechanisms of HCV persistence and liver disease progression.