Hepatitis B virus (HBV) recurrence after orthotopic
liver transplantation (OLT) is associated with poor graft- and patient-survival. Treatment with HBV-specific
immunoglobulins (
HBIG) in combination with nucleos(t)ide analogs is effective in preventing HBV
reinfection of the graft and improving OLT outcome. However, the role of HBV-specific cellular immunity in viral containment in immune suppressed patients in general and in OLT recipients in particular is unclear. To test whether or not OLT recipients maintain robust HBV-specific cellular immunity, the cellular immune response against HBV was assessed in 15 OLT recipients and 27 individuals with chronic and 24 subjects with self-limited HBV
infection, respectively; using an overlapping
peptide set spanning the viral nucleocapsid- and envelope-
protein sequences. The data demonstrate that OLT recipients mounted fewer but stronger clusters of differentiation (CD)8 T cell responses than subjects with self-limited HBV
infection and showed a preferential targeting of the nucleocapsid
antigen. This focused response pattern was similar to responses seen in chronically infected subjects with undetectable
viremia, but significantly different from patients who presented with elevated HBV
viremia and who mounted mainly immune responses against the envelope
protein. In conclusion, virus-specific CD4 T cell-mediated responses were only detected in subjects with self-limited HBV
infection. Thus, the profile of the cellular immunity against HBV was in immune suppressed patients similar to subjects with chronic HBV
infection with suppressed HBV-
DNA.