CD4+ T cell restoration and control of hepatitis C virus replication after childbirth
Chronic hepatitis C virus (HCV) infection is characterized by persistent high-level viremia and defective cellular immunity, including a lack of functional HCV-specific CD4+ T cells. We previously described an exceptional period of viral control that occurs in some chronically infected women after childbirth. Here, we investigated whether reduced HCV replication after pregnancy is associated with recovery of CD4+ T cell immunity. Class II tetramer analysis revealed significantly greater frequencies of circulating HCV-specific CD4+ T cells at 3 months postpartum in women with concurrent declines in viremia compared with those with stable viremia. These HCV-specific CD4+ T cells had an effector-memory phenotype. Inhibitory coreceptor expression on these cells corresponded to the degree of viral control. Circulating CD4+ T cells produced IL-2 and IFN-γ after HCV antigen stimulation, demonstrating Th1 functionality. These data provide direct evidence that the profound loss of HCV-specific CD4+ T cell help that results in chronic infection is reversible following pregnancy, and this recovery of CD4+ T cells is associated with at least transient control of persistent viral replication.
Publication date: November 2020Source: European Journal of Obstetrics &Gynecology and Reproductive Biology, Volume 254Author(s): Silvano Piffer, Antonio Mazza, Laura Dell’Anna
Publication date: Available online 16 September 2020Source: European Journal of Obstetrics &Gynecology and Reproductive BiologyAuthor(s): Silvano Piffer, Antonio Mazza, Laura Dell’Anna
The study evaluates the trend over time and the results of serological screening for hepatitis C infection in pregnancy and obstetric and neonatal outcomes.
The treatment of hepatitis C virus (HCV) infection during pregnancy is mainly focused on maternal cure, with the secondary aim of also preventing vertical transmission to the fetus. Direct-acting antivirals (DAAs) are commonly being prescribed to nonpregnant patients, but a lack of data on the pharmacokinetics, safety, and efficacy of DAAs hampers their use in pregnant patients.1 It has been hypothesized that ribavirin-free maternal treatment regimens with DAAs could be appropriate if it can be shown that treatment during pregnancy does not cause reproductive toxic adverse effect.
This study aimed to determine the viral hepatitis in pregnant women attending antenatal clinic, AMTHI. Informed consent questionnaire was administered before blood collection via venipuncture. a total of 904 pregnant women plasma samples were tested for HBV, HCV, and HEV using ELISA kit. Data was analyzed using packages within SPSS software and P ≤ 0.05 was considered significant. Out of 904 samples analyzed, the overall prevalence of hepatitis infections among pregnant women attending antenatal clinic in AMTHI was 66(7.3%). High prevalence of the hepatitis infections was found among young women within the age grou...
(Abstracted from JAMA 2020;323(10):976–992)
PMID: 32732756 [PubMed - in process]
(University of Pittsburgh) Critics of the universal hepatitis C screening argue that it's wasteful to test pregnant women for a disease that can't be immediately treated, but results of a small phase I clinical trial suggest otherwise: pregnancy could be an excellent time to diagnose and cure hepatitis C infection.
Conclusion: The outbreak was due to HEV genotype 1A. The municipal water supply was contaminated and sanitary conditions and waste disposal were poor in the area. Boiling of drinking water, fixing the water supply pipes and frequent hand washing helped in controlling the outbreak.