The Effects Of Peginterferon α-2a On The Peripheral Blood CD4~+CD25~+CD27low Regulatory T Cell And The Intrahepatic Hbv Cccdna Quantification In The Patients With Chronic Hepatitis B

Objective By detecting peripheral blood CD4+CD25+CD127lowregulatory T cell counts andintrahepatic HBV DNA and HBV cccDNA quantification in the patients with chronic hepatitisB(CHB), to observe whether there are correlations between these indexes;by the way, toobserve the effects of interferon on these indexes and to discuss the clinical significance of theresearch results. Methods30patients of HBeAg-positive chronic hepatitis B were selectedinto this study,they have been treated with pegylated interferon α-2a for48weeks. All thepatients were selected to detect peripheral blood CD4+CD25+CD127lowregulatory T cellcounts by the flow cytometry before treatment, the time of treatment24weeks and the time oftreatment48weeks.,22cases of30were selected to do liver biopsy and detect the intrahepaticHBV DNA、HBV cccDNA quantification before and after treatment. The quantities ofintrahepatic HBV cccDNA and HBV DNA were assayed by FQ-PCR and the serum HBVDNA was detected by PCR. There were30normal controls for detecting peripheral bloodCD4+CD25+CD127lowregulatory T cell counts. Results The peripheral bloodCD4+CD25+CD127lowregulatory T cell count was positively correlated with the plasma HBVDNA (lgIU/ml)(Pearson correlation coefficient r=0.38, P<0.05),and there was no significantcorrelation with the level of liver inflammation and fibrosis stage(Rank correlation test, P>0.05),also there were no significant correlations with the ALT, intrahepatic HBV DNA andHBV cccDNA quantification(lgcps/mg)(Pearson correlation coefficient r=0.044,0.31，0.162,with all that P>0.05).The peripheral blood HBV DNA load was positively correlated withintrahepatic HBV DNA、 HBV cccDNA quantification(Pearson correlation coefficientr=0.573,0.406, with each that P<0.05),the intrahepatic HBV DNA quantification waspositively correlated with intrahepatic HBV cccDNA quantification (Pearson correlationcoefficient r=0.761, P<0.05).The ALT, serum HBV DNA and liver inflammation wereimproved for antiviral treatment in the patients,individually, their comparative werestatistically significant (P <0.05);The stage of fibrosis was improved for antiviral treatment inthe patients also, but there was no statistically significant (P>0.05). ALT normalization ratewas (26/30)86%, the serum HBV DNA negative conversion rate of30CHB cases with HBeApositive was (19/30)63.33%after48weeks of treatment, HBeAg/anti-HBe seroconversion rate was (7/30)23.33%. The level of intrahepatic HBV DNA was7.12±0.96lg before treatment,the level of intrahepatic HBV cccDNA was5.39±1.16lg before treatment.After treatment, thelevel of intrahepatic HBV DNA was6.99±1.17lg, the level of intrahepatic HBV cccDNA was4.96±1.18lg;Individually, their comparative were no statistically significant (P>0.05).Thelevel of peripheral blood CD4+CD25+CD127lowregulatory T cell counts in the patients wassignificantly higher than of the control group, there was statistically significant in thedifference (P <0.05);With the time of treatment prolonging, the level of peripheral bloodCD4+CD25+CD127lowregulatory T cell counts gradually decreased from9.27±2.07%in thepre-treatment to7.92±2.46%in the time of treatment24weeks and to6.49±1.59%in thetime of treatment48weeks, there was statistically significant in the each of the differences(P<0.05), the level of peripheral blood CD4+CD25+CD127lowregulatory T cell counts in thetime of treatment48weeks was still higher than the level of the normal control group,therewas statistically significant in the difference (P<0.05).The levels of peripheral bloodCD4+CD25+CD127lowregulatory T cell counts were statistically different in each stage oftreatment in the group of serum HBV DNA negative conversion, but there was no statisticaldifference in each stage of treatment in the group of serum HBV DNA no-negative conversion.The level of intrahepatic HBV DNA decreased1.00lg comparing with baseline after48–weektreatment in the group of HBeAg/anti-HBe seroconversion, the level of intrahepatic HBVcccDNA decreased0.68lg comparing with baseline in the group of HBeAg/anti-HBeseroconversion, individually, their comparative were no statistically significant (P>0.05);Thelevel of peripheral blood CD4+CD25+CD127lowregulatory T cell couns in the time oftreatmen48weeks was significantly lower than of that in baseline, there was statisticallysignificant in the difference (P<0.05), the post-treatment level of peripheral bloodCD4+CD25+CD127lowregulatory T cell was close to of that in normal control group, but stillhigh, there was statistically significant in the difference (P<0.05). Conclusion The level ofperipheral blood CD4+CD25+CD127lowregulatory T cell counts in the HBeAg positivepatients of chronic hepatitis B(CHB) is positively correlated with the load of the serumHBV DNA, and there is no significant correlation with the intrahepatic HBV DNA and HBVcccDNA quantification. The peripheral blood HBV DNA load is positively correlated with theintrahepatic HBV DNA、 HBV cccDNA quantification,the intrahepatic HBV DNAquantification is positively correlated with the intrahepatic HBV cccDNA quantification.Thelevel of peripheral blood CD4+CD25+CD127lowregulatory T cell counts in the the HBeAg positive patients of chronic hepatitis B is higher than of that in the normal person,when thepatients are treated with the interferon,if the level of peripheral blood CD4+CD25+CD127lowregulatory T cell counts decreases significantly by continuously monitoring,that it can predictthat the patient will have a good effect of antiviral therapy. Interferon for antiviral therapy caneffectively inhibit the HBV replication, increase seroconversion rates, improve liver functionand liver pathology. Interferon therapy last48weeks can depress the level of intrahepaticHBV DNA and HBVcccDNA. The level of intrahepatic HBVcccDNA and HBV DNA in thegroup of HBeAg/anti-HBe seroconversion are significantly lower than those who do notachieve HBeAg/anti-HBe seroconversion,but at this time,the patient will have an high risk ofrecurrence too if he do not continue to be treated with antiviral drugs.