Immune evasion versus recovery after acute hepatitis C virus infection from a shared source

Ian Tester, Susan Smyk-Pearson, Ping Wang, Anne Wertheimer, Ermei Yao, David M. Lewinsohn, John E. Tavis, Hugo R. Rosen

Research output: Contribution to journalArticlepeer-review

158 Scopus citations


Acute infection with hepatitis C virus (HCV) rarely is identified, and hence, the determinants of spontaneous resolution versus chronicity remain incompletely understood. In particular, because of the retrospective nature and unknown source of infection in most human studies, direct evidence for emergence of escape mutations in immunodominant major histocompatibility complex class I-restricted epitopes leading to immune evasion is extremely limited. In two patients infected accidentally with an identical HCV strain but who developed divergent outcomes, the total lack of HCV-specific CD4+ T cells in conjunction with vigorous CD8+ T cells that targeted a single epitope in one patient was associated with mutational escape and viral persistence. Statistical evidence for positive Darwinian selective pressure against an immunodominant epitope is presented. Wild-type cytotoxic T lymphocytes persisted even after the cognate antigen was no longer present. JEM

Original languageEnglish (US)
Pages (from-to)1725-1731
Number of pages7
JournalJournal of Experimental Medicine
Issue number11
StatePublished - Jun 6 2005

ASJC Scopus subject areas

  • Medicine(all)


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