Kubitschke A, Bahr M J, Aslan N, Bader C, Tillmann H L, Sarrazin C, Greten T, Wiegand J, Manns M P, Wedemeyer H
Department of Gastroenterology, Hannover Medical School, Hannover, Germany.
Eur J Clin Invest. 2007 Jan;37(1):54-64. doi: 10.1111/j.1365-2362.2007.01753.x.
The risk of hepatitis C virus (HCV) infection after occupational exposure is low with seroconversion rates between 0 and 5%. However, factors associated with natural resistance against HCV after needle stick injury are poorly defined. HCV-specific T-cell responses have been described in cross-sectional studies of exposed HCV-seronegative individuals.
In this study, we prospectively followed 10 healthcare professionals who experienced an injury with an HCV-contaminated needle. Blood samples were taken on the day or the day after the event and at different time points during follow-up for up to 32 months. HCV-specific T-cell responses were investigated directly ex vivo and in T-cell lines.
None of the individuals became positive for HCV-RNA in serum tested with the highly sensitive transcription-mediated amplification (TMA)-assay or in peripheral blood mononuclear cells (PBMC). All of them remained anti-HCV negative throughout follow-up. At the time of injury, HCV-specific CD4+ T-cell responses were already detectable in two individuals and became detectable thereafter in three additional persons. Transient HCV-specific CD8+ T-cell responses developed in two HLA-A2 positive patients, which became negative until the most recent follow-up after 5 and 17 months, respectively.
We demonstrate the development of HCV-specific T cells in HCV-exposed individuals after needle stick injury indicating subinfectious exposure to HCV. T-cell immunity against HCV may contribute to the low prevalence of HCV in medical healthcare professionals in Western countries.
职业暴露后丙型肝炎病毒（HCV）感染风险较低，血清转化率在0%至5%之间。然而，针刺伤后与对HCV天然抵抗力相关的因素尚不清楚。在暴露的HCV血清阴性个体的横断面研究中已描述了HCV特异性T细胞反应。
在本研究中，我们前瞻性地跟踪了10名因被HCV污染的针头刺伤的医护人员。在事件发生当天或次日以及随访期间长达32个月的不同时间点采集血样。直接在体外和T细胞系中研究HCV特异性T细胞反应。
在用高灵敏度转录介导扩增（TMA）检测法检测的血清或外周血单个核细胞（PBMC）中，没有个体的HCV-RNA呈阳性。在整个随访期间，他们均保持抗HCV阴性。受伤时，在两名个体中已可检测到HCV特异性CD4+T细胞反应，此后在另外三名个体中也可检测到。两名HLA-A2阳性患者出现了短暂的HCV特异性CD8+T细胞反应，分别在5个月和17个月后的最近一次随访时变为阴性。
我们证明了针刺伤后HCV暴露个体中HCV特异性T细胞的产生，表明存在亚感染性HCV暴露。针对HCV的T细胞免疫可能导致西方国家医护人员中HCV的低流行率。
