T lymphocyte responses to hepatitis B virus (HBV) core
antigen (
HBcAg) are vigorous and easily detectable in vitro during recovery from acute
hepatitis B but significantly weaker in patients with chronic HBV
infection. In contrast, T cell responses to
hepatitis B surface antigen (
HBsAg) are almost undetectable during
infection and even in a substantial fraction of subjects receiving vaccination with
HBsAg. The aim of this study was to investigate whether the use of dendritic cells (DCs) in an in vitro assay could increase the detection of HBV-specific T cells in these conditions. Autologous monocyte-derived DCs, compared to direct
HBsAg addition to the cultures, increased the stimulation of HBs- specific T cells. These were detected in 73% of healthy subjects who had recently received
hepatitis B vaccine and in 43% of patients recovering from acute
hepatitis B. Likewise, proliferation in response to DC-presented
HBcAg was detected in both CD4(+) and CD8(+) T cells from the majority of
chronic hepatitis B patients. A longitudinal evaluation of HBc-specific T cell responses during and after a 1-year treatment with pegylated
interferon (IFN)-alpha showed that HBc-specific CD4(+) T cell responses had no correlation with sustained virus suppression whereas CD8(+) T cell responses were more frequently detected in patients able to control HBV replication after
therapy interruption. The use of autologous DCs as antigen-presenting cells appears applicable to clinically relevant in vitro evaluation of T cell responses, particularly in those conditions characterized by low frequency of circulating
antigen-specific cells and suboptimal in vivo activation.