Document Type
Article
Publication Date
9-2013
Abstract
BACKGROUND: T-cell responses have been described in seronegative patients who test negative for hepatitis C virus (HCV) RNA despite frequent HCV exposure. However, the cross-sectional design of those studies did not clarify whether T cells were indeed induced by low-level HCV exposure without seroconversion or whether they resulted from regular acute infection with subsequent antibody loss.
METHODS: Over a 10-year period, our longitudinal study recruited 72 healthcare workers with documented HCV exposure. We studied viremia and antibody and T-cell responses longitudinally for 6 months.
RESULTS: All healthcare workers remained negative for HCV RNA and antibodies. However, 48% developed proliferative T-cell response and 42% developed responses in interferon-gamma enzyme-linked immunosorbent spot assays, with 29 healthy HCV-unexposed controls used to define assay cutoffs. The response prevalence was associated with the transmission risk score. T-cell responses peaked at week 4 and returned to baseline by week 12 after exposure. They predominantly targeted nonstructural HCV proteins, which are not part of the HCV particle and thus must have been synthesized in infected cells.
CONCLUSIONS: Subclinical transmission of HCV occurs frequently, resulting in infection and synthesis of nonstructural proteins despite undetectable systemic viremia. T-cell responses are more sensitive indicators of this low-level HCV exposure than antibodies.
Recommended Citation
Heller, Theo; Werner, Jens Martin; Rahman, Fareed; Mizukoshi, Eishiro; Sobao, Yuji; Gordon, Ann Marie; Sheets, Arlene; Sherker, Averell H.; Kessler, Ellen; Bean, Kathleen S.; Herrine, Steven K.; Stevens, M'lou; Schmitt, James; and Rehermann, Barbara, "Occupational exposure to hepatitis C virus: early T-cell responses in the absence of seroconversion in a longitudinal cohort study." (2013). Division of Gastroenterology and Hepatology Faculty Papers. Paper 80.
https://jdc.jefferson.edu/gastro_hepfp/80
Creative Commons License
This work is licensed under a
Creative Commons Public Domain Dedication 1.0 License.
PubMed ID
23801608
Language
English
Comments
This article is the authors’ final published version in The Journal of Infectious Diseases, Volume 208, Issue 6, September 2013, Pages 1020–1025.
The published version is available at https://doi.org/10.1093/infdis/jit270. Copyright © Heller et al.