Mutations in Hepatitis D Virus Allow it to Escape Detection by CD8+ T Cells and Evolve at the Population Level

Hepatitis D virus (HDV) super-infection in patients with hepatitis B virus (HBV) is associated with rapid progression to liver cirrhosis and hepatocellular carcinoma. Treatment options are limited, and no vaccine is available. Although HDV-specific CD8+ T cells are thought to control the virus, little is known about which HDV epitopes are targeted by virus-specific CD8+ T cells or why these cells ultimately fail to control the infection. We aimed to define how HDV escapes the CD8+ T cell-mediated response.

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