Original Articles
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Jul 21, 2009; 15(27): 3382-3393
Published online Jul 21, 2009. doi: 10.3748/wjg.15.3382
Peripheral T-lymphocyte subpopulations in different clinical stages of chronic HBV infection correlate with HBV load
Jing You, Lin Zhuang, Yi-Feng Zhang, Hong-Ying Chen, Hutcha Sriplung, Alan Geater, Virasakdi Chongsuvivatwong, Teerha Piratvisuth, Edward McNeil, Lan Yu, Bao-Zhang Tang, Jun-Hua Huang
Jing You, Yi-Feng Zhang, Hong-Ying Chen, Lan Yu, Bao-Zhang Tang, Department of Infectious Diseases, First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan Province, China
Lin Zhuang, Department of Hepatology, Third Kunming People’s Hospital, Kunming 650041, Yunnan Province, China
Hutcha Sriplung, Alan Geater, Virasakdi Chongsuvivatwong, Edward McNeil, Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
Teerha Piratvisuth, NKC Institute of Gastroenterology and Hepatology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
Jun-Hua Huang, Department of Infectious Diseases, Yunnan General Hospital of Chinese People’s Armed Police Forces, Kunming 650111, Yunnan Province, China
Author contributions: You J, Sriplung H, Geater A, Chongsuvivatwong V and Piratvisuth T conceptualized and designed the study; You J and the staff of the research group assisted with the data collection; You J, Zhuang L, Sriplung H, Geater A and Chongsuvivatwong V supervised the data collection, quality control of field work, data entry and checking; You J, Sriplung H, Geater A and Chongsuvivatwong V were responsible for the data management, analysis and interpretation; You J, Sriplung H, Geater A and Chongsuvivatwong V drafted and revised the paper; all authors read and approved the final manuscript; You J, Zhuang L, Sriplung H and Chongsuvivatwong V contributed equally to this work.
Correspondence to: Jing You, MD, PhD, Department of Infectious Diseases, First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan Province, China. jingyoukm@126.com
Telephone: +86-871-5324888
Fax: +86-871-5352828
Received: December 26, 2008
Revised: May 24, 2009
Accepted: May 31, 2009
Published online: July 21, 2009
Abstract

AIM: To characterize the peripheral T-cell subpopulation profiles and their correlation with hepatitis B virus (HBV) replication in different clinical stages of chronic HBV infection.

METHODS: A total of 422 patients with chronic HBV infection were enrolled in this study. The patients were divided into three stages: immune-tolerant stage, immune active stage, and immune-inactive carrier stage. Composition of peripheral T-cell subpopulations was determined by flow cytometry. HBV markers were detected by enzyme-linked immunosorbent assay. Serum HBV DNA load was assessed by quantitative real-time polymerase chain reaction.

RESULTS: CD8+ T-cells were significantly higher in patients at the immune-tolerant stage than in patients at the immune-active and -inactive carrier stages (36.87 ± 7.58 vs 34.37 ± 9.07, 36.87 ± 7.58 vs 28.09 ± 5.64, P < 0.001). The peripheral blood in patients at the immune-tolerant and immune active stages contained more CD8+ T-cells than CD4+ T-cells (36.87 ± 7.58 vs 30.23 ± 6.35, 34.37 ± 9.07 vs 30.92 ± 7.40, P < 0.01), whereas the peripheral blood in patients at the immune-inactive carrier stage and in normal controls contained less CD8+ T-cells than CD4+ T-cells (28.09 ± 5.64 vs 36.85 ± 6.06, 24.02 ± 4.35 vs 38.94 ± 3.39, P < 0.01). ANOVA linear trend test showed that CD8+ T-cells were significantly increased in patients with a high viral load (39.41 ± 7.36, 33.83 ± 7.50, 31.81 ± 5.95 and 26.89 ± 5.71, P < 0.001), while CD4+ T-cells were significantly increased in patients with a low HBV DNA load (37.45 ± 6.14, 33.33 ± 5.61, 31.58 ± 6.99 and 27.56 ± 5.49, P < 0.001). Multiple regression analysis displayed that log copies of HBV DNA still maintained its highly significant coefficients for T-cell subpopulations, and was the strongest predictors for variations in CD3+, CD4+ and CD8+ cells and CD4+/CD8+ ratio after adjustment for age at HBV-infection, maternal HBV-infection status, presence of hepatitis B e antigen and HBV mutation.

CONCLUSION: Differences in peripheral T-cell subpopulation profiles can be found in different clinical stages of chronic HBV infection. T-cell impairment is significantly associated with HBV load.

Keywords: Hepatitis B virus; Chronic hepatitis B virus infection; Clinical stages; Hepatitis B virus DNA; T lymphocyte subpopulation