The Relationship Between Viral Load And T-lymphocyte Subsets And NK Cells In Baby Cytomegalovirus Hepatitis

Objective:Human cytomegalovirus(HCMV)belongs to the DNA double helix virus of the herpes virus family.It is the most powerful virus in the herpes virus family.Its genome can encode more than 200 viral proteins.HCMV is a pathogen that is commonly susceptible to human beings.After infection,the virus can not be completely eliminated,but it exists in a latent form,and there is a latent infection of HCMV in more than 90%of the population in China.It’s latent mechanism maybe related to HCMV promoter silencing,interfering cell apoptosis,immune escape mechanism and non-coding region regulation.When the immune function changes,HCMV can be activated,causing HCMV active infection.The general population does not show obvious symptoms after the initial infection,and the infant is in an important period of development of organ tissue.The infant immune system is immature,which is highly susceptible to cytomegalovirus.Infant cytomeg-alovirus infection not only affects the normal growth process,but cause multi-system injuries,such as respiratory,digestive and nervous system damage.After cytomegalovirus infection,the infants will show some clinical signs such as jaundice,malnutrition,pneumonia,abnormal liver function,nervous system and digestive system diseases,etc.The immune cells involved in HCMV infection mainly have T cells and NK cells.T lymphocyte subsets and NK cells numbers in infants and young children show significantly lower than that in normal adults,so the infants are the most susceptible to infection of HCMV.It has shown that babies less than 6 months old are the most susceptible to infection of HCMV and the hepatobiliary system is the main target organ.Cytomegalovirus hepatitis is a high incidence of hepatitis,which poses a great threat to the health of children.In this study,little infants who were admitted to Hebei Second hospital and were diagnosed as cytomegalovirus(HCMV)infection were selected as the study subjects.The aim of this study is as follows:1.Changes of T lymphocytes and NK cells in infans with cytomegalovirus hepatitis.2.The correlation between HCMV-DNA load and T lymphocyte subgroup,NK cell number and as well as liver function in children with cytomegalovirus hepatitis.Methods:The 48 infants with active HCMV infection from Hebei Second Hospital from February of 2017 to January of 2018 were chosen to be the object of study,all the infants are less than one year old.Among them,there were 30 cases of cytomegalovirus hepatitis,5 cases of central nervous system injury,9 cases of pneumonia,4 cases of blood system disorders(3cases of thrombocytopenia and 1 case of neutrophils).The infants were divided into cytomegalovirus hepatitis group and non-hepatitis group.10 patients in the normal control group,aged<1 years old,were born in children’s hospital of Hebei province.T lymphocyte subsets(CD3~+T,CD3~+CD4~+T,CD3~+CD8~+T)and NK cel ls(CD3~-CD16~+CD56~+)were measured by flow cytometry.Automatic bio chemical analyzer were used to test liver function 6 items,including tot al bilirubin,direct bilirubin,indirect bilirubin,alanine aminotransferase(ALT),aspertate aminotransferase(AST)and gamma-glutamine transamin ase(GGT);HCMV-DNA was detected by the method of Real-time PC R.Results:1 The change of T lymphocyte subgroup and NK cell level in HCMV infection and normal infants.1.1 The total CD3~+T had no statistically significant in normal infants,HCMV hepatitis infants and HCMV non-hepatitis infants(all P>0.05).1.2 CD3~+CD4~+T and CD3~+CD8~+T cells were significantly lower in HCMV hepatitis infants and HCMV non-hepatitis infants than that of normal infants,there were significant differences.(all P<0.05).But CD3~+CD4~+T and CD3~+CD8~+T cells in HCMV hepatitis infants and HCMV non-hepatitis infants had no statistically significant(P>0.05).1.3 The NK cells were significantly higher in HCMV hepatitis infants than that of HCMV non-hepatitis infants and normal infants,there were significant differences(all P<0.05).But NK cells in HCMV non-hepatitis infants had no statistically significant with that of normal infants(P>0.05).1.4 The CD4/CD8 values in the two groups of HCMV hepatitis and HCMV non-hepatitis were lower than that in the normal group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in HCMV hepatitis group and HCMV non-hepatitis group(P>0.05)2 The correlation of HCMV-DNA load and the biochemical results of liver function and lymphocyte subsets in children with HCMV.2.1 There was no correlation between ALT,AST,TBA,TBil,DBIL and HCMV-DNA(P>0.05).HCMV-DNA was correlated with GGT(r=0.484,P=0.014).2.2 CD3~+T,CD3~+CD4~+T,CD3~+CD8~+T and CD4/CD8 value were not correlated with HCMV-DNA load(P>00.05).NK cells were associated with HCMA-DNA,(r=0.479,P=0.0018)Conclusions:1.Active cytomegalovirus infection in children with peripheral blood T lymphocyte subsets changes,CD3~+CD4~+T,CD3~+CD8~+T,CD4/CD8 are lower than the normal group,tip as the change of the activation of viruses and viral load of peripheral blood in children with CD3~+CD4~+T,the number of CD3~+CD8~+T cells has changed dynamically.2.The increase of NK cells in infants with acute cholestasis HCMV showed that NK cells played an important role in early infection control of HCMV infection.3.HCMV-DNA was correlated with GGT,indicating that GGT was a good indicator of HCMV prognosis.The number of NK cells is related to HCMV-DNA,suggesting that NK cells can effectively control HCMV infection.