The Clinical Study On Expressions Of Lymphocyte Subsets And HLA-DR Antigen In Patients With Chronic Hepatitis B And Cirrhosis

Background and ObjectiveSpecific immune response mediated by T lymphocyte was an important factor to result in hepatic injury, which directly and indirectly effected development and turnover of hepatitis B. Recognition foreigen antigen of T lymphocyte was controlled by human leucocyte antigen. HLA-DR antigen was most complicated in all molecule of human leucocyte antigen. There were studies about the expression of HLA-DR antigen in acute hepatitis B and hepatoma, but not in disease secondary chronic HBV infection. To observe change of immune function and clinical significance by detecting the expressions of lymphocyte populations and HLA-DR antigen on T lymphocyte subsets of patients with chronic hepatitis B and liver cirrhosis.MethodsEnrolled 127 patients with chronic hepatitis B and cirrhosis in the study were divided into 5 groups:chronic slight hepatitis B (17cases), chronic mild hepatitis B (25cases),chronic serious hepatitis B(19cases), cirrhosis without splenectomy, (38cases) and cirrhosis with splenectomy (28cases). Those patients were admitted to hospitalization in our department, Jinan infectious Hospital, from March 2008 to August 2009. All cases did not receive anti-HBV agents or steroids 6 month before sampling and were without autoimmune disease such as diabetes. Concurrence of HCV, HDV, HEV, EBV, CMV and HIV infections were excluded from enrolled individuals. Meanwhile, twenty-two healthy donors were established as the control. The expressions of lymphocyte populations and HLA-DR antigen in peripheral blood were detected by flow cytometry. The age and sex ratio of each group were comparable. Differences among groups were determined by analysis of variance and t-test.Results1. The level of CD8+ in patients with chronic serious hepatitis B was increased (P<0.05), which in patients with chronic slight and mild hepatitis B was no difference than that of the health group. The expressions of CD3+,CD8+ in patients with liver either splenectomy or without splenectomy were decreased significantly than that of the health control and chronic hepatitis B (P<0.01), meanwhile the expression of CD4+ in patients with cirrhosis with splenectomy was decreased (P<0.01)2. The level of CD19+B of patients with cirrhosis was higher than that of the health group (P<0.05, P<0.01). The expression of CD19+B was increased in patients with chronic hepatitis B, but there was no different between chronic hepatitis B and the health group.3. Excepted patients with splenectomy, the expression of HLA-DR antigen in T cell of patients with chronic hepatitis B and cirrhosis without splenectomy were significantly increased than that of the health group (P<0.01). The levels of CD3+DR+, CD4+DR+,CD8+DR+ in patients with splenectomy were increased than that of cirrhosis without splenectomy.Conclusions1. Immunity function of patients with chronic hepatitis B and cirrhosis were imbalance that on one hand the expression of T cell was imbalance, on the other hand activity of T cell was disbalance, which was obvious for patients in cirrhosis with splenectomy.2. The longer course of disease was, the graver imbalance of cell and humoral Immune function were. It was the most outstanding for patients in cirrhosis with splenectomy.3. Splenectomy played an important role in the immune function of patients with cirrhosis.