Immune Cell Subsets Evaluation as a Predictive Tool for Hepatitis B Infection Outcome and Treatment Responsiveness
Snezhina M. Kandilarovasneji_jm@yahoo.com
, Atanaska I. Georgieva
, Anastasiya P. Mihaylova
, Marta P. Baleva
, Valentina K. Atanasova
, Diana V. Petrova
, Georgi T. Popov
and Elissaveta J. Naumova
1 Department of Clinical Immunology and Stem Cell Bank, Alexandrovska University Hospital, Medical University of Sofia, 1 G. Sofiisky St. 1431 Sofia, Bulgaria
2 Department of Clinical Immunology and Stem Cell Bank, Alexandrovska University Hospital, Medical University of Sofia, Sofia, Bulgaria
3 Clinic of Propaedeutics of Internal Diseases, Alexandrovska University Hospital, Medical University of Sofia, Sofia, Bulgaria
4 Clinic of Infectious Diseases, Military Medical Academy, Sofia, Bulgaria
5 Department of Clinical Immunology and Stem Cell Bank, Alexandrovska University Hospital, Medical University of Sofia, 1 G. Sofi isky St. 1431 Sofia, Bulgaria
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.
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