| Background/AimsAfter a body infected by HBV, the course and recovery of the disease are influenced by the interaction among virus, the immune stage of the body and hepatic cells. The immune stage of the body places an essential role in the turnover of HBV infection and the results of treatment. At the same time, peripheral T lymphocyte subpopulations are critical index of immune stage of CHB patients. Telbivudine is currently effective medicine in treating CHB patients. It can modulates immune functions of cells and alleviate the inflammatory degree and fibrosis degree of hepatic tissue. Therefore, it is infavor of clearing HBV. Studies show that the early response of anti-virus treatment(the level of decreased HBV DNA after anti-virus treatment for12or24weeks) to naive CHB patients is an effective prognostic factor to the occurance of drug resistence. Therefore, in long term anti-virus treatment, the earlier and fater HBV DNA decreases the better results of the longterm treatment. This study included29CHB patients and test their peripheral T lymphocyte subpopulations, HBV DNA, HBsAg, HBeAg and so on both at the beginning of anti virus treatment and after24weeks treatment. We expect to find the relationship between changes of T lymphocyte subpopulations and early response of naive CHB patients treated by telbifudine, and afford more ways to predict and assess when patients are under treatment. Methods and objects1. Objects’ selection29naive CHB patients were included from JiNan infectious disease hospital from2010June to September. They are standardized as:having a carrier history of HBV for6months and their initial obnormal level of ALT/AST; having never received anti vurus treatment; HBV DNA>1×105copies/mL; having not experienced seroconversion; ALT ranges from52to400U/L, AST ranges from52to400U/L, TBil<25μmol/L; having not other complications. They signed informed instructions and willing to take test according to schedule.24medical persons comprised of control group.2. Methods of anti virus treatmentEach one of the29CHB patients is dosed600mg telbivudine daily, which lasts24weeks.3. Testing itemsT lymphocyte(T细胞)subpopulations were tested by agent made by BD sciences corporation, which adopted FC techenique; Highly sensitive HBVDNA test used COBAS Taqman techenique; HBsAg、HBeAg and anti-HBe were tested through ELISA techenique; ALT and AST were examined by automatic analysis system(ULN is40U/L).4. StatisticsNumerical data uses median(upper quartile, lower quartile); treatment results are compared through t test;16.0SPSS is used to analyse these data; P<0.05means the difference has significant statistic meaning.Results1.CD4+(median:34%)(t=3.109,P=0.004), CD4+\CD8+T细胞(1.28)(t=2.273,P=0.031) level of29CHB patients is lower than control group (38%、1.50);2. After24weeks’ treatment, restoration of ALT and AST were65.5%and100%respectively; 3. After24weeks’treatment,an increase of CD4+\CD8+T细胞(1.25to1.29)(t=2.615,P=0.015), and a decrease of CD8+T细胞(t=2.452,P=0.023)(31%to28%) were found in the one-1gHBsAg-dropping group.4. An increased tendency of CD4+、CD8+T细胞,and a decreased tendency of CD4+\CD8+T细胞were found in the three-1gHBeAg-dropping group at24th week, but those results did not show statistic significance;5.3patients had achieved HBeAg seroconversion after24weeks, with significant increase of both CD4+T细胞(39%to50%)(t=3.167, P=0.004) and CD4+\CD8+T细胞(2.02to2.61)(t=4.178,P<0.001);6. The fastest dropping group of lgHBVDNA showed an increase of CD4+T细胞(34%to38%)(t=2.453,P=0.021) and a subtle change of CD8+T细胞.Conclusions1. After24weeks’telbivudine treatment for naive CHB patients, the inhibition of virus replication、a partial restoration and improvement of the impaired cellular immune response were induced.2. An increase of CD4+T细胞、CD4/CD8+T细胞,and a decrease of CD8+T细胞could be regarded as parameters for good response at an early therapeutic stage. |
PDF Full Text Request