The immune response induced by hepatitis B virus principal antigens.

Hepatitis B virus (HBV) infection occurs primarily in hepatocytes in the liver with release of infectious virions and non-infectious empty surface antigen particles into the bloodstream. HBV replication is non-cytopathic. Transient infections run a course of several months, and chronic infections are often life-long. Chronic infections can lead to liver failure with cirrhosis and hepatocellular carcinoma. It is generally accepted that neutralizing anti-HBs antibodies plays a key role in recovery from HBV infection by containing the spread of infection in the infected host and facilitating the removal and destruction of viral particles. However, the immune response initiated by the T-cell response to viral antigens is also important for viral clearance and disease pathogenesis in HBV infection. The three structural forms of the viral proteins, the HBsAg, the particulate HBcAg, and the nonparticulate HBeAg, may preferentially elicit different Th cell subsets. The different IgG subclass profiles of anti-HBs, anti-HBc, and anti-HBe in different HBV infection status were revealed. Moreover, the different IgG subclass profiles in chronic carriers did not change with different ALT and AST levels and may reflect the difference between stimulating antigens, immune response, and the stages of viral disease and provide the basis for the use of vaccines and prophylactic treatments for individuals at high risk of human HBV infection. This review elucidates the detailed understanding of the immune responses induced during transient and persistent infection, and the development of immunotherapy and immunodiagnosis in patients with HBV infection, and possible means of reducing the liver damage.

[1]  D. Subirá,et al.  Hepatitis B virus–specific T‐cell proliferation and cytokine secretion in chronic hepatitis B e antibody–positive patients treated with ribavirin and interferon alfa , 2001 .

[2]  F. Chisari,et al.  Class I-restricted cytotoxic T lymphocytes are directly cytopathic for their target cells in vivo. , 1994, Journal of immunology.

[3]  C. Yurdaydın,et al.  Circulating IL-2, IL-10 and TNF-alpha in chronic hepatitis B: their relations to HBeAg status and the activity of liver disease. , 2000, Hepato-gastroenterology.

[4]  T. Maruyama,et al.  Role of T-cell tolerance in the persistence of hepatitis B virus infection. , 1993, Journal of immunotherapy with emphasis on tumor immunology : official journal of the Society for Biological Therapy.

[5]  D. Häussinger,et al.  Long-term follow-up of HBeAg-positive patients treated with interferon alfa for chronic hepatitis B. , 1996, The New England journal of medicine.

[6]  M. Vecchi,et al.  Primary biliary cirrhosis is associated with specific changes in liver IgG-bearing cell subpopulations. , 1995, Journal of hepatology.

[7]  Y. Ilan Immune downregulation leads to upregulation of an antiviral response: a lesson from the hepatitis B virus. , 2002, Microbes and infection.

[8]  L. Fainboim,et al.  Association of chronic active hepatitis and HLA B35 in patients with hepatitis B virus. , 2008, Tissue antigens.

[9]  J C Imperial,et al.  Natural history of chronic hepatitis B and C , 1999, Journal of gastroenterology and hepatology.

[10]  G. Pape,et al.  Immunology of hepatitis B infection. , 2002, The Lancet. Infectious diseases.

[11]  M. Pignatelli,et al.  Viruses and immune reactions in the liver. , 1985, Scandinavian journal of gastroenterology. Supplement.

[12]  O. Weiland,et al.  The antiviral compound ribavirin modulates the T helper (Th) 1/Th2 subset balance in hepatitis B and C virus-specific immune responses. , 1998, The Journal of general virology.

[13]  J. Summers,et al.  Replication of the genome of a hepatitis B-like virus by reverse transcription of an RNA intermediate , 1982, Cell.

[14]  Xinchun Chen,et al.  Recombinant hepatitis B core antigen carrying preS1 epitopes induce immune response against chronic HBV infection. , 2004, Vaccine.

[15]  F. Schödel,et al.  The hepatitis B virus core and e antigens elicit different Th cell subsets: antigen structure can affect Th cell phenotype , 1997, Journal of virology.

[16]  O. Zinder,et al.  Natural killer cell activity in post-necrotic cirrhotic patients as related to hepatitis-B virus infection and plasma zinc levels. , 1986, Immunology letters.

[17]  Z. Tian,et al.  Activation and function of hepatic NK cells in hepatitis B infection: an underinvestigated innate immune response , 2005, Journal of viral hepatitis.

[18]  A. Facchini,et al.  IgG subclass distribution of anti-HBs antibodies following vaccination with cDNA HBsAg. , 1992, Journal of immunological methods.

[19]  R. Locksley,et al.  Activation of a nonclassical NKT cell subset in a transgenic mouse model of hepatitis B virus infection. , 2002, Immunity.

[20]  V. Bruss Envelopment of the hepatitis B virus nucleocapsid. , 2004, Virus research.

[21]  M. Levrero,et al.  Viral determinants and host immune responses in the pathogenesis of HBV infection , 2002, Journal of medical virology.

[22]  F. Chisari,et al.  Mechanisms of class I restricted immunopathology. A transgenic mouse model of fulminant hepatitis , 1993, The Journal of experimental medicine.

[23]  D. Subirá,et al.  Hepatitis B virus-specific T-cell proliferation and cytokine secretion in chronic hepatitis B e antibody-positive patients treated with ribavirin and interferon alpha. , 2001, Hepatology.

[24]  F. Marotta,et al.  The pathogenesis of hepatocellular carcinoma is multifactorial event. Novel immunological treatment in prospect. , 2004, La Clinica terapeutica.

[25]  F. Pociot,et al.  An allelic polymorphism within the human tumor necrosis factor alpha promoter region is strongly associated with HLA A1, B8, and DR3 alleles , 1993, The Journal of experimental medicine.

[26]  R. Sprengel,et al.  Animal hepatitis B viruses , 1989 .

[27]  M. Sällberg,et al.  Comparison of class and subclass distribution of antibodies to the hepatitis B core and B e antigens in chronic hepatitis B , 1990, Journal of medical virology.

[28]  Chien-Fu Huang,et al.  Study of IgG subclass profiles of anti-HBs in populations with different HBV infection status. , 2006, Viral immunology.

[29]  G. Foster,et al.  Mutation of gene for mannose-binding protein associated with chronic hepatitis B viral infection , 1996, The Lancet.

[30]  N. Horiike,et al.  Immunoglobulin G subclasses of antibodies to hepatitis B core antigen in HBs antigen positive liver diseases , 1991, Journal of gastroenterology and hepatology.

[31]  M. Yuen,et al.  Natural history of chronic hepatitis B virus infection , 2000, Journal of gastroenterology and hepatology.

[32]  H. Okamoto,et al.  HLA DRB1 and DQB1 alleles and haplotypes influencing the progression of hepatitis C , 1996, Journal of medical virology.

[33]  H. Whittle,et al.  Tuberculosis and chronic hepatitis B virus infection in Africans and variation in the vitamin D receptor gene. , 1999, The Journal of infectious diseases.

[34]  K. Madaliński,et al.  IgG subclass distribution of hepatitis B surface antigen antibodies induced in children with chronic hepatitis B infection after interferon-alpha therapy. , 2000, Journal of Infectious Diseases.

[35]  D. Fremont,et al.  Immune recognition of viral antigens. , 1994, Infectious agents and disease.

[36]  G. Alexander,et al.  Increased production of tumour necrosis factor alpha in chronic hepatitis B virus infection. , 1991, Journal of hepatology.

[37]  H. Whittle,et al.  Response to hepatitis B vaccine in a cohort of Gambian children , 1995, The Pediatric infectious disease journal.

[38]  F. Chisari,et al.  Natural Killer T Cell Activation Inhibits Hepatitis B Virus Replication in Vivo , 2000, The Journal of experimental medicine.

[39]  H. Blum,et al.  Genetic variants of hepatitis B virus and their clinical relevance. , 2005, Minerva gastroenterologica e dietologica.

[40]  M. Sarzotti,et al.  Induction of Protective CTL Responses in Newborn Mice by a Murine Retrovirus , 1996, Science.

[41]  V. A. Santos,et al.  Hepatitis B: epidemiological, immunological, and serological considerations emphasizing mutation. , 2004 .

[42]  M. Chen,et al.  The secreted hepatitis B precore antigen can modulate the immune response to the nucleocapsid: a mechanism for persistence. , 1998, Journal of immunology.

[43]  H. Janssen,et al.  Different composition of intrahepatic lymphocytes in the immune‐tolerance and immune‐clearance phase of chronic hepatitis B , 2006, Journal of medical virology.

[44]  S. Ahn,et al.  Association between hepatitis B virus infection and HLA‐DR type in Korea , 2000, Hepatology.

[45]  F. Callea,et al.  Production of Profibrotic Cytokines by Invariant NKT Cells Characterizes Cirrhosis Progression in Chronic Viral Hepatitis1 , 2004, The Journal of Immunology.

[46]  P. Lehmann,et al.  Induction of TH1 and TH2 Immunity in Neonatal Mice , 1996, Science.

[47]  M. Turner,et al.  Mannose binding protein gene mutations associated with unusual and severe infections in adults , 1995, The Lancet.

[48]  S. Tong Mechanism of HBV genome variability and replication of HBV mutants. , 2005, Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology.

[49]  P. Matzinger,et al.  Neonatal Tolerance Revisited: Turning on Newborn T Cells with Dendritic Cells , 1996, Science.

[50]  L. Seeff,et al.  Natural history of chronic hepatitis C , 2002, Hepatology.

[51]  C. Snapper,et al.  Regulation by interferon alpha of immunoglobulin isotype selection and lymphokine production in mice , 1991, The Journal of experimental medicine.

[52]  F. Carnot,et al.  Absence of association between HLA antigens and chronicity of viral hepatitis in haemodialyzed patients. , 1994, Journal of hepatology.

[53]  K. Hu Occult hepatitis B virus infection and its clinical implications , 2002, Journal of viral hepatitis.

[54]  F. Chisari,et al.  Hepatitis B virus immunopathogenesis. , 1995, Annual review of immunology.

[55]  F. Skvaril,et al.  Immunoglobulin G subclass restriction of antibodies against hepatitis B surface antigen , 1983, Infection and immunity.

[56]  H. Thomas,et al.  The hepatitis B virus. , 1990, Bailliere's clinical gastroenterology.

[57]  P. Lambert,et al.  Neonatal and early life immune responses to various forms of vaccine antigens qualitatively differ from adult responses: predominance of a Th2‐biased pattern which persists after adult boosting , 1996, European journal of immunology.

[58]  F. Ramsdell,et al.  Fas and FasL in the homeostatic regulation of immune responses. , 1995, Immunology today.

[59]  H C Thomas,et al.  Association between an MHC class II allele and clearance of hepatitis B virus in the Gambia. , 1995, The New England journal of medicine.

[60]  F. Chisari,et al.  Hepatitis B virus structure and biology. , 1989, Microbial pathogenesis.

[61]  Rolf M. Zinkernagel,et al.  Immunology Taught by Viruses , 1996, Science.

[62]  Chien-Chou Lin,et al.  ANTI-HBC IgG SUBCLASSES IN DIFFERENT POPULATIONS BY COMPARING A VARIETY OF ELISA PLATES , 2001, Journal of immunoassay & immunochemistry.

[63]  R. D. de Man,et al.  Intrahepatic CD8+ T-lymphocyte response is important for therapy-induced viral clearance in chronic hepatitis B infection. , 2005, Journal of hepatology.

[64]  Z. Qiu,et al.  [Difference and significance of peripheral blood T-lymphocyte subsets in patients with chronic hepatitis B and asymptomatic HBV carriers]. , 2005, Zhonghua yi xue za zhi.

[65]  F. Skvaril,et al.  IgG subclasses of anti-HBs antibodies in vaccinated and nonvaccinated individuals and in anti-HBs immunoglobulin preparations. , 1984, International archives of allergy and applied immunology.

[66]  J. Goedert,et al.  Comprehensive Analysis of Class I and Class II HLA Antigens and Chronic Hepatitis B Virus Infection , 2003, Journal of Virology.

[67]  M. Farrar,et al.  The molecular cell biology of interferon-gamma and its receptor. , 1993, Annual review of immunology.

[68]  C. Seeger,et al.  Novel mechanism for reverse transcription in hepatitis B viruses , 1993, Journal of virology.

[69]  F. Chisari,et al.  Intracellular inactivation of the hepatitis B virus by cytotoxic T lymphocytes. , 1996, Immunity.

[70]  G. Gerken,et al.  HLA-DRB1*1301 and *1302 protect against chronic hepatitis B. , 1997, Journal of hepatology.

[71]  F. Chisari,et al.  To kill or to cure: options in host defense against viral infection. , 1996, Current opinion in immunology.

[72]  T. Ishikawa,et al.  Decreased function of peripheral blood dendritic cells in patients with hepatocellular carcinoma with hepatitis B and C virus infection , 2000, Journal of gastroenterology and hepatology.

[73]  Schneider,et al.  A tumour necrosis factor‐alpha (TNF‐α) promoter polymorphism is associated with chronic hepatitis B infection , 1998 .

[74]  H. Schaller,et al.  Hepatitis B virus replication‐an update , 1996, Journal of viral hepatitis.

[75]  M. Carrington,et al.  Class II HLA alleles and hepatitis B virus persistence in African Americans. , 1999, The Journal of infectious diseases.

[76]  U. Boehm,et al.  Cellular responses to interferon-gamma. , 1997, Annual review of immunology.