IMMUNORESPONSIVENESS IN CHRONIC HEPATITIS-C PATIENTS - CORRELATION BETWEEN TISSUE AND SERUM FINDINGS

In the present study, intrahepatic CD8+ lymphocyte infiltrates as well as HLA class I and CD54 (ICAM-1) antigen expression at both tissue an d serum levels were evaluated in 54 untreated patients with chronic he patitis C stratified on the basis of histological diagnosis (Chronic P ersistent Hepatitis/Chronic Lobular Hepatitis -CPH/CLH- and Chronic Ac tive Hepatitis -CAH-: 22 and 32 subjects, respectively). The relations hips between soluble HLA-I (sHLA-I) and ICAM-1 (sICAM-1) serum levels and their membrane-bound counterparts, CD8+ liver infiltration and ser um alanine aminotransferase (ALT) were also studied. A strong HLA-I an d CD54 tissue expression, associated to the presence of CD8+ cell infi ltrates in necro-inflammatory areas, and elevated sHLA-I and sICAM-1 s erum amounts were observed in all patients. At the same time, no diffe rence Was found at tissue level between the two groups of patients wit h respect to the mean scores of HLA-I and CD54 expression, while CAH s ubjects displayed a significantly higher CD8 periportal and lobular re activity in comparison to the other subset. Serological assays outline d higher:values of circulating HLA-I molecules in CPH/CLH patients and higher sICAM-1 levels in the CAH group. Finally, a negative correlati on was found between sHLA-I and ACT in CAH subjects while, in all pati ents, sICAM-1 positively correlated with both CD8 tissue infiltration and ALT. Our findings confirm the occurrence of an immune activation s tatus during chronic hepatitis C and suggest that sHLA-I molecules mig ht play a down-modulating role on immunoresponsiveness of these patien ts.