Lascar, RM;
(2006)
Impact of human immunodeficiency virus on hepatitis B-specific immune responses.
Doctoral thesis , UCL (University College London).
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Abstract
Prior infection with hepatitis B virus (HBV) is a common occurrence in HIV infected subjects and an increasing cause of morbidity and mortality. The CD8 T cell response is crucial for the long-term control of the virus in patients resolving acute hepatitis B. I first examined the effect of HIV related immunodepletion on HBV-specific immune responses in patients who resolved HBV. A cross-sectional study showed a reduction in HBV-specific CD8 responses in HBV immune patients with HIV infection compared to those without. Longitudinal study of a subgroup of patients examined whether this attrition could be reversed by effective antiretroviral therapy. The introduction of highly active antiretroviral therapy (HAART) resulted in recovery of some HBV-specific CD8 and CD4 responses, in association with restoration of CD4 counts. These data provided a mechanism for the observed impairment of HBV control in the setting of HIV infection and support the ability of HAART to reconstitute functionally active responses. I also studied the HBV-specific cellular immune responses in HIV negative patients who resolved acute hepatitis B without symptoms, a group which has never been studied immunologically, but represents a significant proportion of hepatitis cases acquired in adulthood. In the last chapter I focused on the chronic hepatitis B carriers co-infected with HIV and the impact of HIV and HBV treatment. I showed that reconstitution of some HBV-specific T cell responses can also occur in HIV-positive patients after a reduction in HBV load. This potential to recover T cell responses provides support for the addition of anti-HBV therapy in the treatment of co-infected patients.
| Type: | Thesis (Doctoral) |
|---|---|
| Title: | Impact of human immunodeficiency virus on hepatitis B-specific immune responses |
| Identifier: | PQ ETD:593265 |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Thesis digitised by ProQuest. Third party copyright material has been removed from the ethesis. Images identifying individuals have been redacted or partially redacted to protect their identity. |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1445941 |
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