The Role Of Peripheral Blood B Cells And NK Cells In Antiviral Efficacy Evaluation Of Chronic Hepatitis B In Children

In this study,by analyzing the characteristics of peripheral blood B cells and NK cells in children with chronic hepatitis B（CHB）in antiviral therapy,we explored the predictive efficacy of peripheral blood B cells and NK cells in antiviral therapy for chronic hepatitis B in children,and provided potential immunological predictors for the prognosis of chronic hepatitis B in children.The clinical data of 309 HBe Ag-positive children aged 1～18 years with chronic hepatitis B were included in the study,and according to the antiviral treatment effect of 48 weeks,they were divided into hepatitis B surface（HBs Ag）loss group and No HBs Ag loss group.Continuous monitoring was used to detect serum alanine aminotransferase（ALT）levels,fluorescence quantitative polymerase chain reaction（FQ-PCR）to detect HBV DNA levels and HBV genotypes,and electrochemiluminescence immunoassay to detect HBs Ag,hepatitis B surface antibody（HBs Ab）,hepatitis B e antigen（HBe Ag）and hepatitis B e antibaby（HBe Ab）.Pearson’s test was used to analyze the correlation between indicators;The receiver operating characteristic curve（ROC）was used to assess the predictive value of HBs Ag loss of B cells and NK cells after 48 weeks of antiviral therapy.The study found that the absolute peripheral blood B cell count in the HBs Ag loss group was significantly higher than that in the No HBs Ag loss group,the former showed a trend of first increasing and then decreasing in the process of antiviral treatment,peaking at week 24,and the latter showing a slow downward trend.The absolute count of peripheral blood NK cells in the HBs Ag loss group was significantly higher than that in the No HBs Ag loss group,the former also showed a trend of first increasing and then decreasing,peaking at week 36,and the latter showing an irregular trend.In addition,absolute B cell counts at baseline,week 12,week 24 and week 36 were negatively correlated with serum HBs Ag quantification at week 48（r=-0.349,P<0.001;r=-0.310,P<0.001;r=-0.369,P<0.001;r=-0.334,P<0.001）.At the same time,the absolute B cell count at week 24 was negatively correlated with the quantification of serum HBs Ag at week 24 and week 36（r=-0.350,P<0.001;r=-0.383,P<0.001）;Absolute NK cell count at week36 of antiviral therapy was negatively correlated with serum HBs Ag levels at week 48（r=-0.305,P=0.001）.ROC curve analysis showed that B cells at week 24 of antiviral therapy had a good predictive effect on HBs Ag loss at48 weeks,with an AUC of 0.806（95%CI:0.731;0.882）,an optimal cut-off value of 2.925 log₁₀cells/μL,a sensitivity of 78.9%,a specificity of 73.9%,and a positive predictive value（PPV）of 50.85%.The negative predictive value（NPV）was 68.35%.At week 36 of antiviral therapy,NK cells had a good predictive effect on HBs Ag loss at 48 weeks,with an AUC of 0.719（95%CI:0.624;0.813）,an optimal cut-off value of 2.384 log₁₀cells/μL,sensitivity of 76.3%,specificity of 66%,PPV of 46.03%,and NPV of 88%.In summary,the absolute peripheral blood B cell count and NK cell absolute count of HBs Ag losed children with chronic hepatitis B were higher than those who did not losed HBs Ag.Absolute peripheral blood B cell count and NK cell absolute count were significantly negatively correlated with HBs Ag quantification.Absolute B cell count at week 24and absolute NK cell count at week 36 had good predictive efficacy on HBs Ag loss at 48 weeks,and the combination of the two had better effect on HBs Ag loss at 48 weeks,which could be used as potential immunological predictors for judging antiviral efficacy.