Research ArticleTransplantation

HCV-Induced Immune Responses Influence the Development of Operational Tolerance After Liver Transplantation in Humans

Science Translational Medicine  25 Jun 2014:
Vol. 6, Issue 242, pp. 242ra81
DOI: 10.1126/scitranslmed.3008793

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Turning the Tables on Tolerance

When it comes to transplantation, chronic viral infection may not be so bad after all. Bohne et al. demonstrate that chronic infection with hepatitis C virus (HCV) does not prevent the development of tolerance in liver transplant patients. Animal studies have previously indicated that immune responses to infection prevent the establishment of transplantation tolerance, which has resulted in the exclusion of individuals with persistent infection from transplantation tolerance trials. This prospective trial of immunosuppression withdrawal in HCV-infected liver transplant recipients found that the HCV-induced immune response did not influence outcome. Rather, tolerance induction was associated with expression of immunoregulatory genes that were specific for HCV infection. Thus, HCV infection not only does not always prevent the development of transplantation tolerance but also may actually contribute to restraining antitransplant immune responses.