Abstract
Generation and persistence of anti-hepatitis E virus (HEV) antibodies are synonymous with the development of immunity and considered as correlates of protection against HEV infection. However, issues like longevity of immunological memory following recovery from hepatitis E still remains a puzzle. It is critical to understand whether anamnestic response exists for protection from HEV re-infection. The levels and persistence of anti-HEV antibodies were assessed in hepatitis E recovered individuals 1–30 years post HEV infection. The frequencies and functionality of recombinant HEV capsid protein (rORF2p)-stimulated memory B and T cells were also investigated 1–16 years post infection. Anti-HEV antibodies persisted in 91% of hepatitis E recovered individuals. HEV-specific memory B cell responses were detected in 95% of seropositive hepatitis E recovered individuals. CD4+ and CD8+ T cells displayed an effector memory cell phenotype in hepatitis E recovered individuals. In conclusion, long-lived anti-HEV antibodies and HEV-specific memory B cells are maintained for several years in hepatitis E recovered individuals. Involvement of CD4+ and CD8+ effector memory T cells is an important observation since it is inextricably linked to long-lasting protective immunity. In addition to anti-HEV antibodies, possible role of memory B cell response against HEV re-infection could also be considered.
Highlights
Parameter Sample size Sex ratio (Male:Female) Age Anti-hepatitis E virus (HEV) IgM Anti-HEV IgG Post onset days of illness
Memory T cell development was shown to be essential for controlling hepatitis C virus (HCV) re-infection[12], and HCV-specific memory T cells were shown to persist for 18 years after spontaneous viral clearance in recovered individuals[13]
HEV infection is a global health challenge; yet pressing issues pertaining to longevity of immunological memory and protective immunity against HEV have remained partly answered
Summary
Parameter Sample size Sex ratio (Male:Female) Age (years) Anti-HEV IgM Anti-HEV IgG Post onset days of illness. The presence of HEV-specific memory T cells was observed for more than 1.5 years post HEV genotype 3 infection upon recovery from clinical hepatitis E14. Another group reported persistence of functional memory T cells for over 10 years post HEV genotype 3 infection[15] It is largely unclear for how long HEV-specific anamnestic B and T cell responses exist and whether they have a role against re-infection. With this background, this study was designed to investigate the longevity of antibody, memory B and T cell responses in hepatitis E recovered individuals, 1–30 years post HEV infection
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