Veille documentaire MTPH

Médecine du travail du personnel hospitalier

Occupational exposure to hepatitis C virus: early T-cell responses in the absence of seroconversion in a longitudinal cohort study

Auteur Theo Heller
Auteur Jens Martin Werner
Auteur Fareed Rahman
Auteur Eishiro Mizukoshi
Auteur Yuji Sobao
Auteur Ann Marie Gordon
Auteur Arlene Sheets
Auteur Averell H Sherker
Auteur Ellen Kessler
Auteur Kathleen S Bean
Auteur Steven K Herrine
Auteur M’lou Stevens
Auteur James Schmitt
Auteur Barbara Rehermann
Volume 208
Numéro 6
Pages 1020-1025
Publication The Journal of infectious diseases
ISSN 1537-6613
Date Sep 2013
Extra PMID: 23801608
Abrév. de revue J. Infect. Dis.
DOI 10.1093/infdis/jit270
Catalogue de bibl. NCBI PubMed
Langue eng
Résumé 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.

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doi:10.1093/infdis/jit270

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