Effect Of T Lymphocyte Phenotype On Immune Status Of Chronic HBV Infection And Its Applications

Objective At present,the immunotherapy of chronic HBV infection is the focus of research to achieve functional cure of chronic hepatitis B patients as soon as possible.In order to explore the connection between T cell phenotype and immunologic status of chronic hepatitis B and its applications.Methods A total of 157patients were selected from the first Hospital of Lanzhou University from January 1,2015 to May 30,2019.According to the inclusion and exclusion criteria,77 patients met the inclusion criteria.Chronic HBV infection was divided into immune tolerance stage and non-immune tolerance stage according to HBeAg status and serum levels of alanine aminotransferase(ALT),HBsAg and HBV DNA.The main laboratory indexes such as T cell phenotype test,hepatitis B immunity test,hepatitis B virus quantity test,blood routine test and liver and kidney function were obtained and APRI and FIB-4 was calculated.Result The percentage of Treg and PD-1T cells in the immune tolerance stage was significantly lower than that in the non-immune tolerance stage(U=12.000 and59.000;P=0.001 and 0.013,respectively).The percentage of CD3~+CD8~+T cells and CD8~+CD45RO~+T cells in the immune tolerance stage were significantly lower than those in the non-immune tolerance stage(U=104.000 and 149.500,P=0.033 and0.025,respectively).The percentage of Treg and PD-1T cells in the low HBVDNA group was significantly higher than that in the high HBVDNA group(U=178.500 and255.000,P=0.003 and 0.018,respectively),while the percentage of CD3~+T cells and CD8~+CD45RO~+T cells in the HBVDNA low level group was significantly higher than that in the HBVDNA high level group(U=104.000 and 149.500,P=0.033 and 0.025,respectively).There was a negative correlation between APRI and the percentage of Treg,and the difference was statistically significant(the areas under the curve of efficacy curve for evaluating immune status of 0.379),There was a negative correlation between FIB-4 and the percentage of CD3~+CD4~+T cells,CD3~+CD8~+T cells,CD4~+CD45RO~+T cells and CD8~+CD45RO~+T cells(P=0.023,0.016,0.041,0.045,r=-0.259,-0.275,-0.233,-0.229,respectively).Treg,PD-1T cells and CD8~+CD45RO~+T cells were 0.793(95%CI:0.651-0.936),0.802(95%CI:0.678-0.927)and 0.816(95%CI:0.706-0.927),respectively.Conclusion There is a disorder of T cell phenotype in patients with chronic HBV infection.and different T cell functions have different effects on hepatitis B virus clearance.The detection of T cell phenotype is helpful to understand the immune status and adjust the immune function of patients with chronic hepatitis B.it provides a new reference basis for the functional cure of patients with chronic hepatitis B.