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Aim  The lack of potent innate immune responses during HCV infection might lead to a delay in initiating adaptive immune responses. Kupffer cells (KCs) and liver-infiltrating monocytes/macrophages (CD68 +  cells) are essential to establish effective anti-HCV responses. They express co-stimulatory molecules, CD80 and CD86. CD86 upregulation induces activator responses that are then potentially regulated by CD80. The relative levels of expression of CD80, CD86 and the inhibitory molecule, PD-L1, on CD68 +  cells modulate T cell activation. A few studies have explored CD80 and PD-L1 expression on KCs and infiltrating monocytes/macrophages in HCV-infected livers, and none investigated CD86 expression in these cells. These studies have identified these cells based on morphology only. We investigated the stimulatory/inhibitory profile of CD68 +  cells in HCV-infected livers based on the balance of CD80, CD86 and PD-L1 expression.    Methods  CD80, CD86 and PD-L1 expression by CD68 +  cells in the lobular and portal areas of the liver of chronic HCV-infected (n = 16) and control (n = 14) individuals was investigated using double staining immunohistochemistry.    Results  The count of CD68 +  KCs in the lobular areas of the HCV-infected livers was lower than that in the control ( p  = 0.041). The frequencies of CD68 + CD80 +  cells and CD68 + PD-L1 +  cells in both lobular and total areas of the liver were higher in HCV-infected patients compared with those in the control group ( p  = 0.001, 0.031 and 0.007 respectively). Moreover, in the lobular areas of the HCV-infected livers, the frequency of CD68 + CD80 +  cells was higher than that of CD68 + CD86 +  and CD68 + PD-L1 +  cells. In addition, the frequencies of CD68 + CD80 +  and CD68 + CD86 +  cells were higher in the lobular areas than the portal areas.    Conclusions  Our results show that CD68 +  cells have an inhibitory profile in the HCV-infected livers. This might help explain the delayed T cell response and viral persistence during HCV infection.

A Potential Inhibitory Profile of Liver CD68+ Cells during HCV Infection as Observed by an Increased CD80 and PD-L1 but Not CD86 Expression