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VIRAL HEPATITIS IN 2018

Host–pathogen interactions in chronic HBV infection and transplantation of HCV-positive organs

Nature Reviews Gastroenterology & Hepatology volume 16, pages 77–78 (2019)Cite this article

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HBV and HCV infections continue to be major global health problems, causing over 1 million deaths annually. Key studies this year investigated the innate and adaptive immune responses in different clinical scenarios in HBV infection, whereas others evaluated the merits of transplanting HCV-infected organs into uninfected recipients.

Key advances

  • HBV is able to act as a ‘stealth virus’ and evade the innate immune response1,2,3.

  • Factors associated with hepatitis flares after stopping antiviral therapy could eventually serve as biomarkers to predict who can safely stop treatment5,6.

  • Transmission of HCV can occur through liver transplantation despite absence of measurable viraemia in HCV-antibody positive donors, highlighting the need for close follow-up of patients receiving these organs7.

  • Organ transplantation from HCV-infected donors to HCV-uninfected recipients is safe but early and possibly even pre-emptive treatment is important to reduce the risk of relapse or severe initial infection8,9.

Whether HBV activates innate immunity or suppresses innate antiviral signalling continues to be debated. The confusion stems from HBV antigen overexpression using in vitro transfection systems or commercially available HBV antigens of varying quality and questionable purity. Further complicating our understanding are the differences between the innate immune responses of mice and humans.

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Fig. 1: HBV and innate immune sensors.

References

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Authors and Affiliations

  1. Toronto Centre for Liver Disease, Toronto General Hospital Research Institute, University Health Network, Toronto, Canada

    Jordan J. Feld & Adam J. Gehring

  2. Institute for Medical Science, University of Toronto, Toronto, Canada

    Jordan J. Feld & Adam J. Gehring

  3. Department of Immunology, University of Toronto, Toronto, Canada

    Adam J. Gehring

Authors
  1. Jordan J. Feld
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  2. Adam J. Gehring
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Correspondence to Jordan J. Feld.

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Competing interests

J.J.F. has received research support from Abbvie, Gilead, Janssen and Merck and honoraria for scientific consulting from Contravir, Enanta and Roche. A.J.G. has acted as a consultant for Aicuris, Arbutus, Roche and SpringBank Pharmaceuticals and has received research funding from Janssen & Gilead.

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Feld, J.J., Gehring, A.J. Host–pathogen interactions in chronic HBV infection and transplantation of HCV-positive organs. Nat Rev Gastroenterol Hepatol 16, 77–78 (2019). https://doi.org/10.1038/s41575-018-0101-y

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  • DOI: https://doi.org/10.1038/s41575-018-0101-y

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