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Diagnostic Laboratory Immunology

Impaired Lymphocyte Reactivity Measured by Immune Function Testing in Untransplanted Patients with Cirrhosis

Russell M. Yee, Mandeep S. Lehil, Catherine Rongey, Hui Shen, Myrna L. Cozen, Alexander Monto, James C. Ryan
Russell M. Yee
aMailman School of Public Health, Columbia University, New York, New York, USA
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Mandeep S. Lehil
bDepartment of Medicine and Immunology, San Francisco, California, USA
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Catherine Rongey
bDepartment of Medicine and Immunology, San Francisco, California, USA
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Hui Shen
bDepartment of Medicine and Immunology, San Francisco, California, USA
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Myrna L. Cozen
bDepartment of Medicine and Immunology, San Francisco, California, USA
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Alexander Monto
bDepartment of Medicine and Immunology, San Francisco, California, USA
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James C. Ryan
bDepartment of Medicine and Immunology, San Francisco, California, USA
cDepartment of Veterans Administration Medical Center and University of California, San Francisco, California, USA
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DOI: 10.1128/CVI.00595-12
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    Fig 1

    Cumulative analysis of mitogen-inducible CD4+ T cell ATP values as measured by the IFT assay. Values are displayed as boxes representing interquartile (25th to 75th percentile) groups. The horizontal bar within each box represents the median value, the plus sign (+) represents the mean, and whiskers represent the full range of values in each patient group.

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  • Table 1

    Demographic and clinical characteristics

    VariableValue for groupP valuea
    Chronic HCV, no cirrhosis (n = 35)Chronic HCV, cirrhosis (n = 40)Alcohol/NASH cirrhosis (n = 21)Uninfected, no cirrhosis (n = 22)
    Age, yr (mean ± SD)57.0 ± 8.860.8 ± 4.760.0 ± 6.258.4 ± 7.60.06c
    Gender, no. (%)
        Female2 (5.7)1 (2.5)0 (0.0)1 (4.5)0.76b
        Male33 (94.3)39 (97.5)21 (100.0)21 (95.5)
    Ethnicity, no. (%)
        Caucasian19 (54.3)26 (65.0)17 (81.0)15 (68.2)0.49
        Black10 (28.6)8 (20.0)1 (4.8)4 (18.2)
        Other6 (17.1)6 (15.0)3 (14.3)3 (13.6)
    Hepatocellular carcinoma, no. (%)
        Yes0 (0.0)7 (17.9)3 (14.3)0 (0.0)0.006b
        No35 (100.0)32 (82.1)18 (85.7)22 (100.0)
    BMI (mean ± SD)27.2 ± 4.628.4 ± 4.3629.2 ± 6.329.3+-5.20.40c
    Alcohol, no. (%)
        Yes2 (5.9)16 (41.0)17 (81.0)5 (22.7)<0.0001
        No32 (94.1)23 (59.0)4 (19.0)17 (77.3)
    ATP (ng/ml), median (IQR)432 (366.2–552.1)256.7 (176.5–425.5)392.1 (280.3–519.4)456.3 (301.6–726.8)0.0001c
    ALT (U/liter), median (IQR)40 (26–64)67 (39–96.5)23 (15–35)27 (20–52)<0.0001c
    • ↵a P values were calculated from the chi-square test for category variables and ANOVA for continuous variables unless otherwise indicated.

    • ↵b P values were calculated from Fisher's exact test.

    • ↵c The variable was rank transformed.

  • Table 2

    Association between patient group and CD4+ T cell reactivity

    VariableValue for groupRelative risk (95% CI)P value
    ATP ≤ 226 (n = 21)ATP > 226 (n = 97)
    Cirrhosis, no. (%)
        Yes18 (29.5)43 (70.5)7.5 (2.1–27.3)0.002
        No3 (5.3)54 (94.7)Reference
    HCV/cirrhosis group, no. (%)
        Chronic HCV and cirrhosis13 (32.5)27 (67.5)4.8 (1.0–23.8)0.05
        Alcohol/NASH cirrhosis5 (23.8)16 (76.2)3.1 (0.5–18.3)0.21
        Chronic HCV, no cirrhosis1 (2.9)34 (97.1)0.3 (0.03–3.5)0.33
        Uninfected, no cirrhosis2 (9.1)20 (90.9)Reference
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Impaired Lymphocyte Reactivity Measured by Immune Function Testing in Untransplanted Patients with Cirrhosis
Russell M. Yee, Mandeep S. Lehil, Catherine Rongey, Hui Shen, Myrna L. Cozen, Alexander Monto, James C. Ryan
Clinical and Vaccine Immunology Mar 2013, 20 (4) 526-529; DOI: 10.1128/CVI.00595-12

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Impaired Lymphocyte Reactivity Measured by Immune Function Testing in Untransplanted Patients with Cirrhosis
Russell M. Yee, Mandeep S. Lehil, Catherine Rongey, Hui Shen, Myrna L. Cozen, Alexander Monto, James C. Ryan
Clinical and Vaccine Immunology Mar 2013, 20 (4) 526-529; DOI: 10.1128/CVI.00595-12
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