Different Immune Stages Ifn-γ Spot Level In Chronic Hepatitis B Infection And It Is In The Study Of Low Level ALT Antiviral Treatment Time About Chronic Hepatitis B

Objectives:1. Through the detection of chronic hepatitis B infection in different immunestages PBMC secretion of interferon gamma spot level after HBsAg stimulation,discuss the immune pathogenesis of chronic hepatitis B from the cellular level.2. The atypical status gruoup that low level of ALT in patients with chronichepatitis B infection are accepted liver biopsy, through the detection of the interferongamma spot level and liver biopsy pathological results of comprehensive analysis,provide basic immunology and pathological basis for the low level ALT chronichepatitis B infection selection for antiviral therapy.3. On the part of patients receiving antiviral therapy after detection the level ofinterferon gamma spot, evaluate the treatment effect.Methods: Using the density gradient centrifugation, separate the peripheralvenous blood PMBC from a random selection of patients with chronic HBV infection(17cases of atypical status group、14cases of immune tolerance group and16casesof immune clearance group) and15cases of normal control group, using the HBsAgstimulus incubated with the test object PBMC cells, applicate ELISPOT detecte thelevel of interferon gamma spot about chronic HBV infection, four groups ofinterferon gamma spot level were analysis of variance comparing; At the same time,on16cases of atypical status group (low level ALT) do liver biopsy, the liverspecimens were graded inflammation and fibrosis index, analysis the associationbetween interferon gamma spot level and liver inflammatory grading;8cases chronicHBV infection of liver biopsy was higher or equal G2/S2and received antiviraltreatment again3months later using ELISPOT detection interferon gamma dot level,and paired t test with interferon gamma spot number level before treatment.Results:1. The comparison of interferon gamma spot number levels produced by PBMCwhich are stimulated in different immune stages of chronic hepatitis B infection: in addition to atypical status group and immune tolerance group there was no significantdifference, the remaining have significant difference, compared to the normal vsimmune tolerance P <0.05, normal control vs atypical state P <0.05, normal controlvs immune clearance P <0.05, atypical status vs immune tolerance P=0.847,atypical status vs immune clearance P <0.05, immune clearance vs immune toleranceP <0.05; the immune clearance of chronic HBV infection HBsAg stimulus interferongamma spot number level and serum ALT are significant correlated(r=0.976, P <0.05); in the atypical status group of chronic HBV infection, HBsAg stimulusinterferon gamma spot number level and serum ALT have no significant correlation(r=0.033, P=0.899).2. Liver biopsy in16cases with low levels of ALT in chronic hepatitis B,livertissue inflammation grade greater than or equal G2total of8cases, accounting for50%, fibrosis staging greater than or equal S2total of3cases, which accounted for18.9%; liver tissue inflammation and fibrosis staging greater than or equal G2/S2total of9cases, accounting for56.3%, less than <G2/S2total of7cases,accounting for43.2%; at the same time its interferon gamma dot levels and liverinflammation grades have significant correlation (r=0.630, P=0.009).3.8cases of chronic HBV infection which liver biopsy results greater than orequal G2/S2and received antiviral therapy before and after antiviral therapyinterferon gamma spot number level has statistics difference (P=0.01).Cnoclusions:1. Chronic hepatitis B with different immune stages the interferon gamma spotlevel expression is different; the immune clearance phase expression of the highestspot level,the immunity is activated, cellular immune function is strong, atypicalstatus group and immune tolerance group spots expression levels are low, consideringthe organism cellular immunity is low，from the cell level,further explore the immunepathogenesis of chronic hepatitis B infection.2. Low levels of ALT with chronic HBV infection the liver biopsy resultsprompt a large part of the patients achieved the antiviral indication, and the interferongamma spot level and liver inflammation were positively correlated,prompting theinflammation of liver more obvious, the higher of the interferon gamma spot level. 3. Through ELISPOT detecting the interferon gamma spot level can betterevaluate the effect of antiviral treatment in patients with chronic hepatitis B infection.