OBJECTIVETo investigate the compositions of Th1/Th2/Th3 cells in chronic hepatitis B virus (HBV)-infected individuals by determining the expression of interleukin-4 (IL-4), inetrferon-gamma (IFN-gamma), and transform growth factor-beta (TGF-beta) in single CD4(+) T cells isolated from peripheral blood mononuclear cells (PBMCs) and the role of polarized Th cell populations in chronic HBV-infection was discussed.

METHODSPBMCs from chronically infected HBV individuals were isolated, stimulated by PMA/Ionomycin/Monensin, and IL-4, IFN-gamma and TGF-beta production by CD4(+) T cells was determined by using fluorescence activated cell sorter (FACS) analysis.

RESULTSThe percentage of IFN-gamma-producing T cells, IL-4-producing T cells and TGF-beta-producing T cells ranged from 2.3% - 18.6%, 1.1% - 8.7% and 0.7% - 7.1% respectively in CD4(+) T cells from non-infected individuals. Most of CD4(+) T cells from PBMCs in chronically infected HBV individuals were Th0 cells. The proportion of Th1 cells increased significantly with hepatic inflammatory activity, and in the active period of chronic hepatitis B infection were higher than those in the non-active period (P < 0.05). Th2 cell percentage in CD4(+) T cells from HBV-infected individuals did not differ significantly (P > 0.05), but were higher than that from controls (P < 0.05). Th3 cell percentage in CD4(+) T cells from asymptomatic carrier (AsC) group was higher than that in the chronic hepatitis B (CHB) and control groups (P < 0.05).

CONCLUSIONSTh1 phenotype cytokines were positively correlated with hepatic inflammatory activity in chronic hepatitis B and Th2 cells may be associated with the persistence of HBV infection. Th3 cells cooperating with Th2 cells can negatively regulate immune responses and may be associated with the immune tolerant state of chronic HBV infection.

CD4-Positive T-Lymphocytes ; immunology ; Hepatitis B, Chronic ; immunology ; metabolism ; pathology ; Humans ; Interferon-gamma ; biosynthesis ; Interleukin-4 ; biosynthesis ; T-Lymphocytes, Helper-Inducer ; immunology ; Th1 Cells ; immunology ; Th2 Cells ; immunology ; Transforming Growth Factor beta ; biosynthesis

Objective To investigate the prognostic factors for acute-on-chronic liver failure (ACLF) after the withdrawal of nucleos(t)ide analogues (NAs) for the antiviral treatment of chronic hepatitis B (CHB).Methods The clinical data of 67 hospitalized patients with ACLF after withdrawal of NAs for the antiviral treatment of CHB were analyzed retrospectively.Results The HBeAg status before initial treatment and after recurrence,course of the antiviral treatment,duration from the withdrawal of NAs to recurrence,and type of NAs before and after withdrawal were not associated with the prognosis of ACLF.The Cox univariate regression analysis showed that serum bilirubin,international normalization ratio,serum creatinine,model of end-stage of liver disease (MELD) score,hepatic encephalopathy,and concurrent infection were associated with the 12-week death.The Cox multivariate regression analysis showed that MELD score and hepatic encephalopathy were independent predictors for 12-week death.The area under the receiver operating characteristic curve for the MELD score to predict 12-week death was 0.906,with an optimal cutoff value of 32,a sensitivity of 82.9％,a specificity of 88.5％,a positive predictive value of 91.9％,and a negative predictive value of 76.7％.Conclusion MELD score and hepatic encephalopathy are closely associated with the prognosis of patients with ACLF after withdrawal of NAs for the antiviral treatment of CHB.