| Objective:Hepatitis B virus related cirrhosis is the result of long-term sustainable replication of hepatitis B virus and repeated activities and developments of hepatitis. Previous studies show that patients with hepatitis B related cirrhosis have different degrees of HBV replication, and their hepatic cells display obvious inflammation and necrosis. Therefore, inhibiting the replication of hepatitis B virus is the key to control the disease. Lamivudine is regarded as a good anti-viral drug for decom-pensated cirrhosis, which has lesser kidney toxicity than other nucleoside drugs. It is a consensus that patients with chronic HBV infection have immunological disorders, and T cell-mediated immunity plays an important role in the immune pathology of the liver, the abnormalities of which are dominant parts in the pathogenesis of chronic hepatitis and cirrhosis. By detecting the liver function score, T lymphocyte subsets (CD4+, CD8+ T cell percentage and CD4+/CD8+ ratio) and T lymphocyte argyrophilic nucleolar organizer region protein (AgNORs), we investigated the changes of liver function and immune function in patients with hepatic cirrhosis after therapy of lamivudine.Methods:50 patients in our hospital with hepatitis B virus related cirrhosis were selected as a treatment group, who were received conven-tional therapy (with vitamin C, glutathione and other regular routine therapy) and added lamivudine (GlaxoSmithKline, History available products) with oral administration of 100mg/d for 6 months. Other antiviral drugs and immunomodulator therapy was not used during the treatment. The complications (ascites, hepatic encephalopathy, bleeding, hypoproteinemia) were given appropriate treatments. The outpatients were not applied other drugs except for lamivudine and diuretics, and healthy volunteers in control group were not accepted any treatment. Correlation between T lymphocyte subsets, AgNORs and Child-Push degree, also and HBVDNA studied on patients of pretreatment. The level of HBVDNA was detected by Real-time quantitative PCR, liver function was monitored by Automatic biochemical analyzer, prothrombin time was monitored by Automatic coagulometer, T lymphocyte subsets were detected by flow cytometry and AgNORs was assayed by KL tumor immune image analysis system. The contents of HBVDNA, liver function, prothrombin time, T lymphocytes and AgNORs, and Child-Push scores of the patients were compared before and after lamivudine treatment for 6 months.Results1. The level of T lymphocytes AgNORs, the percentage of CD4+ T cells and the ratio of CD4+/ CD8+ were decreased(P<0.05), whereas the percentage of CD8+ T cells was increased (P<0.05) with illness extent gradually (Child-Push grade A→B→C) before lamivudine treatment.2. The serum concentration of T lymphocytes AgNORs, the percentages of CD4+ T cells and CD8+ T cells, and the ratio of CD4+/ CD8+ in patients with hepatic cirrhosis had no statistical difference between high and low loads groups of HBVDNA contents before lamivudine treatment.3. HBVDNA negative cases were 48 in 50 patients with hepatic cirrhosis after lamivudine therapy for 6 months, the negative conversion rate was 96% and the Child-Push scores in all patients were notable lower(P<0.01).4 The percentage of CD4+ T cells, the ratio of CD4+/CD8+ and the level of T lymphocytes AgNORs in patients treated with lamivudine were increased (p<0.01), whereas the percentage of CD8+ T cells was decreased(p<0.01),which was contrary to the healthy control group(p<0.01).Conclusion1. There was an imbalance in cellular immunity of T lymphocytes in patients with hepatic cirrhosis. Immunological disorders had been increased with the illness extent and there was no statistical difference between the severity of cirrhosis and HBVDNA load (P>0.05).2. Lamivudine treatment for hepatic cirrhosis could suppress the replication of HBV, control the liver inflammation, improve the liver function and prevent the progress of the disease effectively.3. Lamivudine could improve the immunologic function of the patients with hepatic cirrhosis, possibly by the way of suppressing replication of HBV, decreasing immune pressure from viremia's and improving the liver function.
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