Study On The Correlation Between HBsAg Titer,Treg Cells And Disease Activity In Chronic Hepatitis B Virus Infectors

Objective:To study the differences of HBsAg titer and the frequency of Treg cells among different types of chronic hepatitis B infectors,and to analyze the correlation between HBsAg titer,Treg cells and disease activity.Methods:There were 128 patients with chronic hepatitis B infection who met the inclusion criteria of our study diagnosed and treated in the First People’s Hospital of Huaihua City from December 2017 to December 2018,divided into carrier group and activists group.Variance analysis was used to analyze the difference of HBsAg titer and CD4~+CD25~+Foxp3~+Treg cells frequency between the two groups,and subgroup analysis was carried out.Binary Logistic regression analysis was used to find out the factors affecting disease activity.ROC curves were used to assess their accuracy in predicting disease activity.In addition,activists group were divided into mild hepatitis group,moderate hepatitis group,serious hepatitis group and liver failure group according to the severity of liver function damage.The differences of HBsAg titer and CD4~+CD25~+Foxp3~+Treg cells frequency in each group were compared and their correlation with disease activity was analyzed.Results:1.Compared with carrier group,activists group had higher titer of HBsAg(P<0.05).Subgroup analysis showed that HBeAg positive CHB patients had a significant increase in HBsAg titer compared with carriers and hepatitis B cirrhosis patients(P<0.05).According to the severity of liver function damage,moderate hepatitis patients had the highest HBsAg titer,which was statistically significant compared with carriers(P<0.05).2.Compared with carrier group,activists group had higher frequency of CD4~+CD25~+Foxp3~+Treg cells(P<0.05).Subgroup analysis showed that HBeAg positive CHB patients and hepatitis B cirrhosis patients had a significant increase in frequency of CD4~+CD25~+Foxp3~+Treg cells compared with carriers(P<0.05).According to the severity of liver function damage,patients with mild hepatitis had a significant increase in frequency of CD4~+CD25~+Foxp3~+Treg cells compared with carriers(P<0.05).3.Binary Logistic regression analysis showed that HBsAg titer and CD4~+CD25~+Foxp3~+Treg cells were the predictors of disease activity(P<0.05).For every 1 log10 IU/ml increase in HBsAg titer,the risk of disease activity increased by 1.949 times,and for every 1%increase in the frequency of CD4+CD25+Foxp3+Treg cells,the risk of disease activity increased by 1.361 times,and the prediction accuracy was 78.9%.4.The AUC of CD4~+CD25~+Foxp3~+Treg cells to predict disease activity at 66%.The AUC of HBsAg titer to predict disease activity at65.3%.The AUC of the combination of CD4~+CD25~+Foxp3~+Treg cells and HBsAg titer to predict disease activity at 69.4%,P=0.002,Yoden index at0.387,sensitivity at 68.3%,and specificity at 70.4%.5.The frequency of CD4~+CD25~+Foxp3~+Treg cells is positively correlated with HBsAg titer and HBV-DNA(P<0.05).The frequency of CD4~+CD25~+Foxp3~+Treg cells is significantly positively correlated with HBsAg titer in liver failure group(P<0.05).Conclusions:1.The frequency of CD4~+CD25~+Foxp3~+Treg cells and HBsAg titer increased in different degrees in patients with chronic hepatitis B activity,which suggests that CD4~+CD25~+Foxp3~+Treg cells and HBsAg titer are related to disease activity.The combined detection of the two has higher value in predicting disease activity and could help us to judge the state of disease activity.2.The frequency of CD4~+CD25~+Foxp3~+Treg cells are significantly increased in HBeAg-positive CHB patients and liver cirrhosis patients,which suggests that the body may alleviate liver damage by increasing the frequency of CD4~+CD25~+Foxp3~+Treg cells to carry out negative immune regulation on the body.Due to its immunosuppressive effect,virus infection persists and the disease could continues to develop into cirrhosis.3.CD4~+CD25~+Foxp3~+Treg cells,HBsAg titer and HBV-DNA are positively correlated.HBsAg titer is related to the immune state of the body.CD4~+CD25~+Foxp3~+Treg cells have an important relationship with the onset and prognosis of chronic hepatitis B virus infectors.