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Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Gastroenterology 2014 ; 147 (4): 870-881.e8 Nephropedia Template TP
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Signatures of Protective Memory Immune Responses During HCV Reinfection #MMPMID25038432
Gastroenterology 2014[Oct]; 147 (4): 870-881.e8 PMID25038432show ga
Background & Aims: Development of a vaccine against hepatitis C virus (HCV) has been hindered by our limited understanding of immune correlates of protection during real-life exposure to the virus. We studied the immune response during HCV reinfection. Methods: We analyzed blood samples from participants in the Montreal Acute Hepatitis C Injection Drug User Cohort Study who were re-infected with HCV from 2009 and 2012. Five patients spontaneously resolved their second infection while 4 developed chronic infections. We monitored the phenotypic and functional dynamics of HCV-specific memory responses of T cells from all subjects, during natural re-exposure and reinfection. Results: Populations of CD4+ and CD8+ T cells with HCV-specific polyfunctional memory were expanded in all 5 individuals who resolved 2 successive HCV infections. We detected CD127hi HCV-specific memory CD8+ T cells prior to reinfection regardless of a subject?s ability to clear subsequent infections. Protection against viral persistence was associated with the expansion of a CD127neg, PD1lo effector memory T cells at the peak of the response. We also observed broadening of T-cell response, indicating generation of de novo T-cell responses. The 4 individuals who failed to clear their subsequent infection had limited expansion of HCV-specific CD4+ and CD8+ memory T cells and expressed variable levels of the exhaustion marker PD1 on HCV-specific CD8+ T cells. Dominant epitope regions of HCV strains isolated from patients with persistent reinfection had sequence variations that were not recognized by the pre-existing memory T cells. Conclusions: Protection from persistent HCV reinfection depends on the magnitude, breadth, and quality of the HCV-specific memory T-cell response. Sequence homology among viruses, and ability of T cells to recognize multiple strains of HCV, are critical determinants of protective memory.