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The impact of HBV‐DNA fluctuations on virus‐specific CD8+ T cells in HBeAg+ chronic hepatitis B patients treated with a steroid and lamivudine
Author(s) -
Gotto J.,
Webster G. J. M.,
Brown D.,
Jenkins J.,
Dusheiko G. M.,
Bertoletti A.
Publication year - 2006
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/j.1365-2893.2005.00716.x
Subject(s) - lamivudine , hbeag , virology , chronic hepatitis , hepatitis b virus , medicine , virus , immunology , hbsag
Summary. Restoration of anti‐viral immune response may be a requisite for sustained virological response to treatment in chronic hepatitis B patients. Over a 13‐month period, we examined the dynamics of hepatitis B virus (HBV)‐specific CD8+ cells in six human leucocyte antigen (HLA)‐A2+ hepatitis B e antigen (HBeAg)+ ‘immunotolerant’ chronic hepatitis B patients treated sequentially with corticosteroid and lamivudine. Our results show that the combination treatment did not result in a sustained restoration of anti‐viral specific CD8+ cells in five of the six patients studied. However, HBV‐specific CD8+ cells, despite being severely compromised, were not totally deleted. Paradoxically, steroid treatment was not associated with inhibition but with a minimal increase of the HBV‐specific CD8 response, and we observed that nucleocapsid‐specific CD8 responses were not rescued by stable and prolonged inhibition but became detectable after rapid rebounds of HBV replication. In most patients, the transient and minimal restoration of HBV‐specific immunity was not associated with clinical benefits. Our results describe a dynamic relationship between HBV‐specific CD8+ cells and HBV‐DNA values, that could potentially be used for a better design of HBV treatment in HBeAg+ ‘immunotolerant’ chronic hepatitis B patients.