Hepatitis C virus-specific T-cell reactivity during interferon and ribavirin treatment in chronic hepatitis C

Background & Aims: The role of virus-specific T-helper lymphocyte reactivity in determining the therapeutic response in chronic hepatitis C virus (HCV) infection is not fully understood. Methods: We studied CD4^+ T lymphocyte proliferation together with interferon (IFN)-@c and interleukin (IL)-10 production from peripheral blood mononuclear cells in response to 4 HCV antigens (core, NS3, NS4, and NS5) in 25 patients with chronic hepatitis C undergoing antiviral therapy with IFN alone or in combination with ribavirin, prospectively, before, during, and after treatment. Results: HCV-specific T-cell reactivity was uncommon at baseline but increased markedly during antiviral therapy, peaking around treatment weeks 4-8. Resolution of hepatitis C viremia was significantly more likely in patients who developed HCV-specific T-cell proliferation with increased IFN-@c production. The main difference in T-cell reactivity of patients treated with IFN plus ribavirin was a significantly lower production of IL-10, whereas lymphocyte proliferation was similar to that in patients receiving IFN monotherapy. Conclusions: Treatment-induced control of hepatitis C viremia is associated with the development of HCV-specific T-cell responses with enhanced IFN-@c and low IL-10 production. The greater efficacy of combination therapy with IFN-@a plus ribavirin may be related to its ability to suppress HCV-specific IL-10 production. GASTROENTEROLOGY 2000;118:346-355