B-cell characteristics define HCV reinfection outcome

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

  • Money Gupta
  • Bing Ru Wu
  • Auda A. Eltahla
  • Irene Boo
  • Jing Jing Wang
  • David Agapiou
  • Arunasingam Abayasingam
  • Arnold Reynaldi
  • Elizabeth Keoshkerian
  • Yanran Zhao
  • Nicholas Brasher
  • Lisa Maher
  • Tom Gordon
  • Miles P. Davenport
  • Fabio Luciani
  • Heidi E. Drummer
  • Andrew R. Lloyd
  • Rowena A. Bull

Background & Aims: In individuals highly exposed to HCV, reinfection is common, suggesting that natural development of sterilising immunity is difficult. In those that are reinfected, some will develop a persistent infection, while a small proportion repeatedly clear the virus, suggesting natural protection is possible. The aim of this study was to characterise immune responses associated with rapid natural clearance of HCV reinfection. Methods: Broad neutralising antibodies (nAbs) and Envelope 2 (E2)-specific memory B cell (MBC) responses were examined longitudinally in 15 individuals with varied reinfection outcomes. Results: Broad nAb responses were associated with MBC recall, but not with clearance of reinfection. Strong evidence of antigen imprinting was found, and the B-cell receptor repertoire showed a high level of clonality with ongoing somatic hypermutation of many clones over subsequent reinfection events. Single-cell transcriptomic analyses showed that cleared reinfections featured an activated transcriptomic profile in HCV-specific B cells that rapidly expanded upon reinfection. Conclusions: MBC quality, but not necessarily breadth of nAb responses, is important for protection against antigenically diverse variants, which is encouraging for HCV vaccine development. Impact and implications: HCV continues to have a major health burden globally. Limitations in the health infrastructure for diagnosis and treatment, as well as high rates of reinfection, indicate that a vaccine that can protect against chronic HCV infection will greatly complement current efforts to eliminate HCV-related disease. With alternative approaches to testing vaccines, such as controlled human inoculation trials under consideration, we desperately need to identify the correlates of immune protection. In this study, in a small but rare cohort of high-risk injecting drug users who were reinfected multiple times, breadth of neutralisation was not associated with ultimate clearance of the reinfection event. Alternatively, characteristics of the HCV-specific B-cell response associated with B-cell proliferation were. This study indicates that humoral responses are important for protection and suggests that for genetically very diverse viruses, such as HCV, it may be beneficial to look beyond just antibodies as correlates of protection.

OriginalsprogEngelsk
TidsskriftJournal of Hepatology
ISSN0168-8278
DOI
StatusE-pub ahead of print - 2024

Bibliografisk note

Funding Information:
Research support for the HITS-p cohort included grants from the National Health and Medical Research Council of Australia (NHMRC) \u2013 Project Nos. 2228887, 1146082, Partnership no. 1016351, and Program Nos. 510488 and 1053206. The HITS-c cohort was supported by the UNSW Hepatitis C Vaccine Initiative and NHMRC Project Grant no. 630483. The Kirby Institute is funded by the Australian Government of Health and Ageing. A.A.E., J.J.W., M.P.D., F.L., A.R.L. and R.A.B. are supported by NHMRC Research Fellowships (Numbers: 1130128, 1090759, 1128416, 1041897, 1084706, and 1080001). A.P.U is supported by The Novo Nordisk Foundation BRIDGE research fellowship.

Publisher Copyright:
© 2024 The Authors

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