Aim: To examine the hepatitis C virus (HCV) levels and immunological markers in cirrhotic patients after splenectomy.
Methods: HCV RNA titers as well as cellular and humoral immune markers were determined in 20 cirrhotic patients after splenectomy and in 32 cirrhotic controls with an intact spleen.
Results: Serum HCV RNA titers were lower in the splenectomized patients than in the controls (186+/-225 x 10(3)copies/mL vs 541+/-417 x 10(3) copies/mL, P<0.01). HCV RNA was judged to have been spontaneously eradicated in 4 splenectomized patients, but in none of the controls. Natural killer cell activity was higher in the splenectomized patients than in the controls (41.2+/-19.3% vs 24.7+/-15.3%, P<0.01), and natural killer cell activity was negatively correlated to HCV RNA titers in the splenectomized patients except in those with serotype 2-related infection. The CD4/CD8 ratio was significantly lower in the splenectomized patients than in the controls.
Conclusion: The findings suggest that splenectomy may diminish virus burden in cirrhotic patients with HCV infection at least in part, through augmentation of natural killer cell activity.