E. initial Jirillo, N. M. Pellegrino, G. Piazzolla, D. Caccavo and S. Antonaci Pages 169 - 180 ( 12 )
Hepatitis C virus (HCV) is responsible for most cases of posttransfusion hepatitis and sporadic or community-acquired non-A, non-B hepatitis. Different generations of enzyme-linked immunosorbent assay have been generated for detecting antibodies to HCV epitopes. HCV-RNA quantitative analysis has been developed by means of polymerase chain reaction technique. This approach is the only reliable method for HCV-RNA tissue localization, being helpful in early diagnosis. HCV infected liver is characterized by an inflammatory infiltrate including CD4positive, CD8positive, and B lymphocytes. Evidence has been provided that in HCV patients CD8positive cell response is associated with low level of viraemia and higher level of disease activity. CD4positive T cells exhibit specificity for the core antigen, also correlating with disease activity and viraemia. Costimulatory molecules, cytokines, oxygen radicals, the complex Fas - Fas-ligand and soluble class I HLA structures are discussed as putative cofactors involved in disease evolution. Various forms of interferon (IFN)-alpha have been evaluated for the treatment of patients with HCV infection. Initial enthusiasm has been attenuated by the evidence of a low sustained virological response rate and the constant side effects of IFN-alpha therapy in patients with chronic HCV disease. Among possible markers for predicting therapeutic outcome in HCV-positive individuals, anti-core antibodies correlate positively with response to IFN-alpha administration, as well as reduction of interleukin-2 serum levels has been detected in patients with a good therapeutic response. Association between HCV infection and autoimmune phenomena, also in relation to IFN-alpha therapy has been reported. Finally, results of the combined treatment with IFN-alpha/ribavirin are illustrated.
Hepatitis C Virus Infection,Immune Responsiveness,Interferon,HCV RNA,CD4 CD8 B lymphocytes,viraemia,fas ligand,IFN,HIV,cDNA clone,nonstructural NS domains,NS proteins NS2 NS5,HCV transmission,immunosorbent assay ELISA,enzyme linked,host immune response,Granulocyte macrophage colony,interferon IFN,interleukin,CTLs,Intraheptic B lymphocytes,recombinant vaccinia viruses VV,Innate Immunity,Arachidonic acid metabolites,soluble mediators,cytokines,ICAM 1,MHC CD80 CD86,TH1,TH2
, , , , Department of Clinical Medicine, Immunology and Infectious Disease, University of Bari,Bari, Italy, and 2 Scientific Institute for Gastroenterology, Castellana Grotte, Bari, Italy.