Immune Cell Subsets Evaluation as a Predictive Tool for Hepatitis B Infection Outcome and Treatment Responsiveness

Folia Med (Plovdiv). 2017 Mar 1;59(1):53-62. doi: 10.1515/folmed-2017-0008.

Abstract

Background: The patient's immune response is one of the major factors influencing HBV eradication or chronification, and it is thought to be responsible for the treatment success.

Aim: Our study aimed to investigate whether cellular defense mechanisms are associated with the course of HBV infection (spontaneous recovery [SR] or chronification [CHB]) and with the therapeutic approach.

Patients and methods: A total of 139 patients (118 with CHB, 21 SR) and 29 healthy individuals (HI) were immunophenotyped by flowcytometry. Fifty-six patients were treatment-naïve, 20 were treated with interferons and 42 with nucleoside/ nucleotide analogues.

Results: Deficiency of T lymphocytes, helper-inducer (CD3+CD4+), suppressorcytotoxic (CD8+CD3+) and cytotoxic (CD8+CD11b-, CD8+CD28+) subsets, activated T cells (CD3+HLA-DR+, CD8+CD38+) and increased CD57+CD8- cells, elevated percentages of B lymphocytes and NKT cells were observed in CHB patients compared with HI. In SR patients, elevated CD8+CD11b+, NKT and activated T cells were found in comparison with controls. The higher values of T cells and their subsets in SR patients than in CHB patients reflect a recovery of cellular immunity in resolved HBV infection individuals. In both groups of treated patients, reduced T lymphocytes, CD3+CD4+ and CD8+CD38+ subsets were found in comparison with HI. Higher proportions of cytotoxic subsets were observed in treated patients compared with treatment-naïve CHB patients, more pronounced in the group with interferon therapy.

Conclusion: Our data demonstrate that cellular immune profiles may be of prognostic value in predicting the clinical course of HBV infection, and the determination of the therapeutic response.

Keywords: HBV infection; cellular immune response; immunophenotyping.

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Aged
  • Antiviral Agents / therapeutic use
  • B-Lymphocyte Subsets / immunology*
  • Case-Control Studies
  • Disease Progression
  • Female
  • Flow Cytometry
  • Hepatitis B / immunology
  • Hepatitis B, Chronic / drug therapy
  • Hepatitis B, Chronic / immunology*
  • Humans
  • Immunophenotyping
  • Interferon-alpha / therapeutic use
  • Male
  • Middle Aged
  • Natural Killer T-Cells / immunology
  • Polyethylene Glycols / therapeutic use
  • Recombinant Proteins / therapeutic use
  • Remission, Spontaneous
  • T-Lymphocyte Subsets / immunology*
  • T-Lymphocytes, Cytotoxic / immunology
  • T-Lymphocytes, Helper-Inducer / immunology
  • Treatment Outcome
  • Young Adult

Substances

  • Antiviral Agents
  • Interferon-alpha
  • Recombinant Proteins
  • Polyethylene Glycols
  • peginterferon alfa-2a