Effect Of Telbivudine On Peripheral Blood T Cell Subsets In Pregnant Women With Hepatitis B Virus

Objective:To observe the effect of telbivudine on peripheral blood T cell subsets in pregnancy with hepatitis B virus,further explore whether telbivudine has immunomodulatory effects in early pregnancy in patients with hepatitis B virus except to effectively reduce the viral load.Methods: 60 pregnant women(at 12 weeks of gestation)with chronic hepatitis B,who had a high HBV DNA load,were enrolled.The patients were divided into two groups basing on their voluntary choice: Ld T-treated-group(n=30)and non-treated-group(n=30).The former received oral telbivudine 9(600mg)once daily until 12 weeks after delivery and was administered compound glycyrrhizin for liver protection,while the later was given compound glycyrrhizin for liver protection alone.30 HBs Ag negative pregnant women were normal controls.Careful observation of adverse reactions and regular detection of liver function,HBV-DNA,CK are necessary throughout the course of the medication.Peripheral venous blood were sampled and submitted to analysis of the proportion of CD3 +T,CD4 +T,CD8 +T by flow cytometry in all the groups when they go to pregnancy for 37 wekks but are not on labor.Results: Comparison of the three groups in terms of age,pregnant women,motherhood,gestational age at delivery,mode of delivery,the difference was not statistically significant(P> 0.05).HBVDNA levels were compared before and after treatment of pregnant women,pre-treatment,two groups of pregnant women without HBVDNA level difference(t = 1.59,P = 0.12);after treatment,telbivudine group had significantly lower HBVDNA levels than the untreated group(t = 39.08,P = 0.00).There was no significant difference in ALT level between the two groups before treatment(t =-2.19,P = 0.83).The ALT level in the telbivudine group was(21.9 ± 11.4)U / L and in the untreated group was(66.5 ± 35.1)U / L,the ALT in the telbivudine group was significantly lower than that in the untreated group(t =-6.62,P = 0.00).The proportion of CD3 + T cells in the control group,non-antiviral group and telbivudine group was 63.9 ± 7.9,65.7 ± 6.5,68.0 ± 7.6,the difference was not statistically significant(F = 1.11,P = 0.335).CD4 + T cells were42.3 ± 5.6,24.1 ± 4.7,43.4 ± 6.4,the difference was statistically significant(F = 111.5,P<0.05).the ratio of CD8 + T lymphocytes in the three groups was 24.0 ± 4.6,41.2 ±(P<0.05).The ratio of CD4 + / CD8 + T cells in the three groups was 1.8 ± 0.4,0.6 ± 0.1,1.9 ± 0.5,the difference was statistically significant(P <0.05),the difference was statistically significant F = 117.2,P <0.05).There was no significant difference in the proportion of CD3 + T cells between the three groups.Compared with the control group,the percentage of CD4 + T cells and CD4 + / CD8 + T cells decreased and the ratio ofCD8 + T cells increased(P <0.05).The ratio of CD4 + T cells and the ratio of CD4 + /CD8 + T cells in peripheral blood were decreased and the ratio of CD8 + T cells decreased(P <0.05),compared with the high virus group,(P <0.05).There was no significant difference in CD4 +,CD8 + T cell ratio and CD4 + / CD8 + T cell ratio between telbivudine group and control group(P> 0.05).Conclusions : 1.Pregnancy with high HBV viral load had abnormal cellularimmune function.Ld T treatment can increase the proportion of CD4+ T and the ratio of CD4 + /CD8 + T cells,restore the balance of CD4+ T and CD8+ T cells,that is,Telbivudine may have an effect on peripheral blood T cell subsets in pregnant women with chronic hepatitis B.It is hypothesized that telbivudine may have a modulatory effect on the cellular immune function of hepatitis B pregnant women.2.Telbivudine could effectively reduce the HBVDNA load and ALT level in the peripheral blood of pregnant women with chronic hepatitis B,and no drug-related adverse reactions were found during the treatment.The telbivudine was safe and effective for early and middle stages of pregnancy.