Productive replication of hepatitis C virus in perihepatic lymph nodes in vivo: implications of HCV lymphotropism |
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Authors: | Pal Sampa Sullivan Daniel G Kim Sean Lai K Kay-Yin Kae John Cotler Scott J Carithers Robert L Wood Brent L Perkins James D Gretch David R |
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Affiliation: | Department of Laboratory Medicine, University of Washington Medical Center, Seattle, Washington 98104, USA. |
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Abstract: | BACKGROUND & AIMS: The pathogenesis of chronic hepatitis C is poorly understood. This study examines the ability of hepatitis C virus (HCV) to infect, replicate in, and produce progeny virus from perihepatic lymph nodes in vivo. METHODS: Lymph node (LN) biopsy specimens were taken from 20 patients with HCV genotype 1 infection and end-stage liver disease and 20 noninfected negative controls. Sections were probed with HCV RNA strand-specific riboprobes and antibodies specific for HCV core and nonstructural region 3 antigens plus B-cell (CD20) and T-cell (CD2) antigens. In a selected case, HCV quasispecies in serum, peripheral blood mononuclear cells, liver, and perihepatic lymph nodes were analyzed by clonal frequency analysis and sequencing. RESULTS: HCV infection was confirmed in 17 of 20 (85%) of lymph node specimens by in situ hybridization, and HCV replication was confirmed in 50% of cases by detection of HCV replicative intermediate RNA. HCV core and nonstructural 3 antigens were detected in lymph nodes by immunocytochemistry. Infected cell phenotypes were primarily CD20 B cells, although other cell types were positive for HCV replication markers. Quasispecies analysis in one case indicated that 68% of variants circulating in serum were also present in lymphoid tissues, and only 40% of serum variants were identified in liver, documenting a major contribution of lymphoid replication to HCV viremia. CONCLUSIONS: HCV lymphotropism provides new insights into the complex pathobiology of chronic hepatitis C in humans. We demonstrate for the first time a major contribution of extrahepatic HCV replication to circulating virus in serum (viremia). |
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Keywords: | E1, envelope 1 HVR, hypervariable region ICC, immunocytochemistry ISH, in situ hybridization NS3, HCV nonstructural region 3 RI, replicative intermediate |
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