| Objectives:To research the effect of telbivudine on the proportion of peripheral blood CD4 + CD25 + CD127low/-regulatory T cells in total lymphocytes in patients with HBeAg-positive chronic hepatitis B.To analysis the relations between the change of the ratios of CD4+CD25+CD127low/-regulatory T cells and the levels of HBeAg,HBV DNA,transaminase as well as the situation of HBeAg serum conversion.To investigate the mechanism of higher rate of HBe Ag serum conversion under telbivudine treatment among patients with HBeAg-positive chronic hepatitis B.Methods: Thirty-five patients who were diagnosed with HBeAg-positive chronic hepatitis B and accepted to treat with telbivudine at the Affiliated Hospital of Luzhou Medical College?Sichuan,China?were randomly selected as experimental group for the study.Thirty-five age and gender-matched healthy blood donors were randomly recruited as the healthy controls.The ratios of peripheral blood CD4+CD25+CD127low/-regulatory T cells in total lymphocytes of healthy controls and experimental group before and after treated for 12,24,36 and 48 weeks with telbivudine were measured by flow cytometry.At the corresponding time points,the levels of HBV DNA,HBeAg and alanine aminotransferase were detected.SPSS 17.0software was used to carry out statistical analysis.Measurement datadescribed as?Mean±Standard deviation?.Two independent samples t test was used to compare the difference between health controls and experimental group.Paired samples t test was used to compare the targets at two time points in experimental group before and after treatment.Linear correlation analysis and the Spearman correlation coefficient were used to analyze the relations between different variables.Fisher's exact test was used to compare rates.The difference is statistically significant if P < 0.05.Then,the proportions of regulatory T cells of the experimental group at baseline and healthy controls were compared.The the change of the ratios of regulatory T cells,the levels of HBeAg,HBV DNA and transaminase as well as HBeAg serum conversion of experimental group at different time points during treatment were analyzed.The relations between the proportions of regulatory T cells and the values which have mentioned at the corresponding time points were investigated.Results: 5 patients withdrew from the study during follow-up and there are 30 patients completing the observation eventually.There are statistically significant differences of the proportions of CD4+CD25+CD127low/-regulatory T cells in total lymphocytes between the baseline of experimental group?12.55±1.78?% and healthy controls?8.32±1.00?%?P<0.05?.After treated for 12,24,36 and 48 weeks,the proportions of regulatory T cells in experimental group are?10.42±1.04?%,?9.55±0.74?%,?8.78±0.67?% and?8.74±0.71?% in order.All of the values are statistically lower than its former one?P<0.05?,except the last.No significant difference between the proportions of healthy controls and experimental group which have treated for 48 weeks?P=0.055 > 0.05?.However,the difference in the ratio between experimental group which treated for 36 weeks and health controls is statistically significant?P=0.032<0.05?.Before and after treated for 12,24,36 and 48 weeks,the levels of HBeAg of experimental group are?39.59±10.64?,?22.01±9.78?,?15.09±8.78?,?11.31 ± 6.78?and?9.22 ± 6.98?in order.All the values are statistically lower than its former one?P<0.05?.There are linear correlations between the proportions of regulatory T cells and the levels of HBeAg at the corresponding time points in experimental group?r=0.862,0.857,0.654,0.632 and 0.645?before and after treatment.There is no statistically significant relation between the proportion of regulatory T cells and the corresponding ALT level.It is found that there are higher rates of HBeAg-negative,HBeAg seroconversion and HBV DNA below the detection limit in the subgroup which has lower proportion of regulatory T cells after treated for 48 weeks.Conclusions: The proportion of peripheral blood CD4+CD25+CD127low/-regulatory T cells in total lymphocytes in HBeAg?+?chronic hepatitis B is significantly higher than healthy controls.The ratio decreases gradually until treated for 48 weeks with telbivudine.There are linear correlations significantly between the proportions of regulatory T cells and the levels of HBeAg at the corresponding time points after treated with telbivudine in HBeAg-positive chronic hepatitis B.Thesubgroup of lower proportion of regulatory T cells has higher rates of HBV DNA below the detection limit.The inhibition of the quantity or function of regulatory T cells and the secondary effect is the possible reason of the higer rate of HBeAg seroconversion under telbivudine treatment in patients with HBeAg-positive chronic hepatitis B. |
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