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Medicina Universitaria

2008, Número 41

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Med Univer 2008; 10 (41)


Inmunopatogénesis de la hepatitis C

Gutiérrez RG, Kershenobich D

Idioma: Español
Referencias bibliográficas: 80
Paginas: 225-229
Archivo PDF: 273.85 Kb.


RESUMEN

El conocimiento de la patogénesis de la infección crónica por el virus de la hepatitis C (VHC) es crucial tanto para la determinación de una terapia antiviral exitosa como para encontrar una vacuna. En este trabajo se explica como inmediatamente después de la infección por el VHC, este se replica eficientemente, induciendo la producción de interferones tipo I, sin embargo, el rápido incremento en la replicación viral no es reconocido en forma adecuada por la respuesta inmune adaptativa y después de un intervalo corto, la carga viral se incrementa y persiste en la mayoría de los individuos infectados. Se considera que este fenómeno tiene una naturaleza inmunológica, que involucra tanto a linfocitos T citotóxicos, como a un mecanismo indirecto que implica la síntesis de citocinas que son inducidas por el VHC. Se considera que si ocurre una respuesta insuficiente o inadecuada de células T (CD4+ y CD8+) específicas del virus, el ARN-VHC persiste en células T hepáticas, situación que se observa aún en aquellos individuos que alcanzan una respuesta terapéutica con una inhibición viral considerada como sostenida. El VHC ha desarrollado varias estrategias para escapar a la erradicación mediada por las células T, que incluye interferir con la vía de presentación de las moléculas del Complejo Mayor de Histocompatibilidad (MHC) Clase I del huésped o teniendo un “escondite” en células a las que les falta la expresión de las MHC clase I. Finalmente, se describe y reconoce la importancia que tienen varias citocinas en la respuesta inmune por el huésped posterior a la exposición al VHC.


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