The Relations Between The Replication Of HBV And The Changes Of The Immune Function In Patients With Acute Exacerbation Of Chronic Hepatitis B

OBJECTIVE: The study is to investigate the change of RBC immunoadherence ability, T-lymphocyte subsets and serum beta-2-microglobulin levels in acute exacerbation of chronic HBV patients with serum HBV-DNA positive or negative . METHODS: Seventy-five patients with acute exacerbation of chronic hepatitis B were collected in the study, and normal adult sixty-one cases as control group. Serum HBV DNA levels were quantitatively determined using fluorescent quantitative polymerase chain reaction (FQ-PCR), RBC Immunoadherence Ability were measured by zymosan adherence to human erythrocytes, T-lymphocyte subsets were determined using indirect immunofluorescent assay, serum beta-2-microglobulin levels were measured by radioimmunoassay (RIA), and serological markers of viral hepatitis as well as other parameters relevant to liver function were also determined. RESULTS:(1)Red cell C3b Receptor Rosette (RCR), CD3+ T-lymphocyte, CD4+ T-lymphocyte and CD4+/CD8+ were significantly lower (P=0.021,0.041,0.012 and 0.001 respectively) than normal control group in patients with acute exacerbation of chronic hepatitis B, Red cell Immune Complex Rosette (RICR), CD8+ T-lymphocyte, serum beta-2-microglobulin levels were higher(P=0.033,0.003 and 0.016 respectively). (2)RCR, CD3+ T-lymphocyte, CD4+ T-lymphocyte and CD4+/CD8+ were significantly lower in HBV DNA-positive group vs HBV DNA-negative group (P=0.001,0.021,0.001 and 0.001 respectively), RICR, CD8+ T-lymphocyte, serum beta-2-microglobulin levels were significantly higher(P=0.013,0.002 and 0.001 respectively). (3) The decrease of CD3+ T-lymphocyte, CD4+ T-lymphocyte and CD4+/CD8+ in HBV DNA-negative group was obvious than that in normal control group(P=0.003,0.001 and 0.002 respectively), the increase of RICR, CD8+ T-lymphocyte was obvious too(P=0.004and 0.004 respectively).(4)According to the patients with acute exacerbation of chronic hepatitis B, RICR showed a significantnegative correlation with RCR and CD4+/CD8+ (r=-0.460,P=0.000 and r=-0.325,P=0.004 respectively), serum beta-2-microglobulin levels were correlated with CD3+ T-lymphocyte(r=-0.375,P=0.002).CONCLUSIONS: (1) There existed lower RBC immunoadherence ability, disorder of the function of cellular immunity and higher serum beta-2-microglobulin levels in the patients with acute exacerbation of chronic hepatitis B.(2)Serum HBV replication play a critical role in the lower RBC immunoadherence ability, disorder of the function of cellular immunity and higher serum beta-2-microglobulin levels, which contribute to explanation to the pathogenesis of chronic hepatitis B.(3)The determination of serum HBV-DNA, RBC immunoadherence ability, T-lymphocyte subsets and serum beta-2-microglobulin levels is clinically useful for observing the state of the illness and evaluating the therapeutic effect of chronic hepatitis B. (4)The results could help,from three different perspsctives of RBC immunoadherence ability, T-lymphocyte subsets and serum beta-2-microglobulin levels.to explain some pathogenesis of chronic hepatitis B and the internal association among the three indexes.