The Level Change And Clinical Significance Of Treg Cells In Chronic Hepatitis B Patients With Antiviral Treatment

Object By investigating the relationship between clinically relevant serum markers（HBe Ag,HBV-DNA,ALT）and the level of peripheral blood CD4 +CD25 + CD127Low/-Treg cell in HBe Ag-positive chronic hepatitis B patients after antiviral therapy,we analysis whether antiviral drugs have a regulatory role on the immune system and whether there are differences in the effect of CD4 + CD25 +CD127Low/-Treg cells between interferon and nucleoside（acid）analogs.Desirable to provide a reference value for the prognosis of patients with antiviral therapy.Methods we select 18 healthy controls.130 cases of HBe Ag-positive CHB were treated with nucleoside drugs follow the guidelines for prevention and treatment of chronic hepatitis B.The level of peripheral blood CD4⁺CD25⁺CD127^Low-Treg cell were analysissed by flow cytometry.Serum HBV markers were detected by enzyme-linked immunosorbent assay（ELISA）.Serum HBV-DNA load were detected by real-time PCR method.Automatic biochemical analyzer detect the main indicators of liver function.Review the above indicators at the 48 weeks.In addition,13 cases of HBe Ag-positive CHB patients be given nucleotide analogue therapy and 10 cases were given Long acting interferon,1needle / week.Every three months to review these indicators once,until 12 months.Results（1）The level of CD4⁺CD25⁺CD127^Low /-Treg was（5.50 ± 2.01）%in 26 cases of immune tolerance group,and was（3.87 ± 1.55）% in 29 cases of immune clearance group,and was（4.18 ± 1.20）% in 18 healthy controls,there were significant differences among the three groups（P = 0.002）.The tolerance group was significantly higher than the immune clearance group,healthy control group（P <0.05）,immune clearance group and the healthy control group had no significant difference（P> 0.05）.（2）After 48 weeks treatment of nucleoside drugs,the level of CD4 +CD25 + CD127 Low /-Treg cells was（5.56 ± 1.14）% in HBe Ag no change group,and was（4.63 ± 1.61）% in HBe Ag negative group,and was（4.33 ±1.64）% in HBe Ag seroconversion group,and was（4.18 ± 1.20）% in healthy control group.There are significant differences between the four groups.（P =0.047）.Wherein,HBe Ag no change group was significantly higher than HBe Ag negative,HBe Ag seroconversion group,healthy control group（P <0.05）.HBe Ag negative group,HBe Ag seroconversion group and the healthy control group had no significant difference（P> 0.05）,HBe Ag negative group and HBe Ag seroconversion group also had no difference（P = 0.531）.（3）The level of CD4⁺CD25⁺CD127^Low /-Treg cells was（4.34 ±1.79）% in HBV-DNA negative group,and was（5.30 ± 2.31）% in HBV-DNA positive group,the latter of which HBV carrier volume is 4.84 ± 1.91 lg copies/ m L,the difference was statistically significant（P = 0.044）.The level of CD4 +CD25 + CD127 Low /-Treg cells was（4.33 ± 1.79）% in ALT normalization group,and was（4.79 ± 1.84）% in ALT normalization group,the latter of which ALT mean 310.44 ± 468.82 U / L,There was no significant difference（P = 0.496）.（4）The level of CD4 + CD25 + CD127 low /-Treg cells with the treatment of nucleoside analogue was in a downward trend,the biggest decline was in the 6th month;The level of CD4 + CD25 + CD127 low /-Treg cells with the treatment of Interferon was also in a downward trend,the biggest decline was in the 6th month and in the 12 th month.（5）During treatment of these two drugs in patients with chronic hepatitis B,the level of CD4 + CD25 + CD127 low /-Treg cells showed a downward trend,but the levels of two treatment groups were significantly different（P = 0.047）.Conclusion Antiviral drugs on the immune system has a regulatory role,There were differences in the effects of two drugs on CD4⁺CD25⁺CD127^Low/-Treg cell level,such as nucleoside（acid）analogue and interferon.At the September and December,the regulation of the function of immune regulation of interferon drugs is stronger than that of nucleoside（acid）analog.