ROLE OF THE IMMUNE-RESPONSE IN VIRAL-HEPATITIS, HEPATOCELLULAR-CARCINOMA, AND ALCOHOLIC HEPATITIS

Viral infections, malignant transformation, and xenobiotics may elicit immune responses capable of mediating tissue injury. Accumulating evi dence indicates that immune responses against viral antigens expressed by infected hepatocytes may mediate hepatocellular necrosis during he patitis B or C viral infections. Recent studies have clarified the rol e of T cells, cytokines, and both major histocompatibility complex and adhesion molecules during hepatitis B and C infections. Additional st udies have assessed the impact of hepatitis B virus mutants on the imm une response and the ability of the hepatitis B virus to alter the phe notype of infected hepatocytes. Emerging data also indicate that hepat itis C infection may play a role in autoimmune reactions. New observat ions have further defined a relationship between the development of he patocellular carcinoma and the immune response. In addition, continuin g investigations have emphasized the importance of the immune response in the pathogenesis of alcoholic hepatitis. Further understanding of these immune mechanisms may lead to innovative therapeutic strategies.