Study on the relationship between immune state and disease progression or disease severity of patients infected with hepatitis B virus_West China Medical Journal

Authors：

CHENZhu ,  ZENGYilan , WANGLi , HURong , WUBei , ZHULi , TANGYuzhen

Hepatitis Department, Public Health Clinical Center of Chengdu, Chengdu, Sichuan, 610066, P.R. China;

Corresponding author：

ZENGYilan, Email: 277796360@qq.com

Keywords：

Hepatitis, type B; Immunoglobulin; Complement; T-lymphocyte subsets; Disease progression

DOI：

10.7507/1002-0179.201506109

Video：

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Objective To explore the relationship between immune state and disease progression or severity of patients with hepatitis B virus (HBV). Methods A total of 332 patients infected with HBV diagnosed and treated from January 2012 to December 2013 were divided into acute hepatitis B (AHB) group (n=25), chronic hepatitis B (CHB) group (n=237) and cirrhosis group (n=70) according to disease progression. Moreover, CHB group was divided into mild (n=24), moderate (n=103), serious (n=72) and severe group (liver failure group,n=38) according to disease severity, while cirrhosis group was divided into hepatocellular carcinoma (HCC) group (n=13) and non-HCC group (n=57). The immune indexes including immunoglobulin (Ig), complement (C) and T-lymphocyte subsets were tested and compared. Results The immune indexes were not significantly different between AHB group and CHB group (P>0.05). Compared with AHB group and CHB group, cirrhosis group had higher levels of IgG and IgA, and lower levels of CD3⁺, CD4⁺ and CD8⁺ T cells count (P<0.05). Compared with non-HCC group, HCC group had more male patients without antiviral therapy, who had higher levels of C3 and C4 (P<0.05). As disease progressed, the levels of alanine fcell couaminotransferase, aspartate aminotransferase, total cholesterol, Fibroscan index, IgG, and IgA of CHB patients all gradually increased, while the levels of C3 and C4 and the counts of CD3⁺ and CD4⁺ T cells gradually declined. Conclusions The immune state of patients infected with HBV has a certain relationship with disease progression or severity, and immunoglobulin, complement and T cells count can partly reflect the severity of the disease. Cirrhosis patients accompanied with high levels of C3 and C4 should pay high attention to antiviral therapy and be vigilant on HCC.

Citation： CHENZhu, ZENGYilan, WANGLi, HURong, WUBei, ZHULi, TANGYuzhen. Study on the relationship between immune state and disease progression or disease severity of patients infected with hepatitis B virus. West China Medical Journal, 2017, 32(1): 31-36. doi: 10.7507/1002-0179.201506109 Copy

1.	Ganem D, Prince AM. Hepatitis B virus infection--natural history and clinical consequences. N Engl J Med, 2004, 350(11): 1118-1129.
2.	Rehermann B. Pathogenesis of chronic viral hepatitis: differential roles of T cell and NK cells. Nat Mesd, 2013, 19(7): 859-868.
3.	中华医学会. 病毒性肝炎防治方案. 中华肝脏病杂志, 2000, 8(6): 324-329.
4.	中华医学会肝病学分会, 中华医学会感染病学分会. 慢性乙型肝炎防治指南(2010 年版). 临床肝脏病杂志, 2011, 27(1): 1-16.
5.	中华医学会感染病学分会肝衰竭与人工肝学组, 中华医学会肝病学分会重型肝病与人工肝学组. 肝衰竭诊治指南(2012 年版). 中华临床感染病杂志, 2012, 5(6): 321-322.
6.	中华人民共和国卫生部. 原发性肝癌诊疗规范. 临床肿瘤学杂志, 2011, 16(10): 929-946.
7.	孙焕焕, 张永宏. T 细胞在慢性乙型肝炎发病机制中的作用研究进展. 传染病信息, 2014, 27(4): 237-239.
8.	杨晨辰, 黄睿, 刘勇, 等. 慢性 HBV 感染者不同免疫状态下及抗病毒治疗后外周血 T 细胞亚群比例和细胞因子水平特点. 中华实验和临床感染病杂志: 电子版, 2014, 8(2): 191-197.
9.	盛雄, 谢新生. 120 例乙型肝炎患者外周血 T 淋巴细胞亚群测定及意义. 中西医结合肝病杂志, 2009, 19(1): 46-47.
10.	赵永晓, 冯丽英. CD8⁺CTL 在乙型肝炎发病作用中的研究现状及进展. 世界华人消化杂志, 2009, 17(4): 384-388.
11.	张建春, 翁锡定, 陈孙云, 等. 乙型肝炎患者外周血 T 淋巴细胞亚群的变化. 实用肝脏病杂志, 2013, 16(4): 356-357.
12.	王琦. 免疫球蛋白血清检测在肝病患者中的作用. 中国民康医学, 2014, 26(1): 36-37.
13.	谢婵, 谢俊强, 张宇锋, 等. 抗病毒治疗对慢性乙型肝炎患者免疫球蛋白及补体的影响. 中华传染病杂志, 2012, 30(2): 100-104.
14.	Loggi E, Gamal N, Bihl F, et al. Adaptive response in hepatitis B virus infection. J Viral Hepat, 2014, 21(5): 305-313.
15.	Farci P, Diaz G, Chen Z, et al. B cell gene signature with massive intrahepatic production of antibodies to hepatitis B core antigen in hepatitis B virus-associated acute liver failure. Proc Natl Acad Sci USA, 2010, 107(19): 8766-8771.
16.	Abu-Amara M, Feld JJ. Does antiviral therapy for chronic hepatitis B reduce the risk of hepatocellular carcinoma?. Semin Liver Dis, 2013, 33(2): 157-166.
17.	唐宗生, 郝友华, 杨东亮. HBV 持续性感染中 T 细胞功能耗竭的机制研究进展. 中华肝脏病杂志, 2012, 20(11): 871-873.
18.	Lim YS, Kim WR. The global impact of hepatic fibrosis and endstage liver disease. Clin Liver Dis, 2008, 12(4): 733-746.
19.	王祖莲, 曹向红. 肝癌患者 31 例血清免疫球蛋白、补体的检测及临床意义. 中国社区医师, 2013, 15(6): 267.
20.	Mi SP, Beom KK, Kyung SK, et al. Antiviral efficacies of currently available rescue therapies for multidrug-resistant chronic hepatitis B. Clin Mol Hepatol, 2013, 19(1): 29-35.
21.	陈洁, 张欣欣. 乙型肝炎病毒特征与肝硬化及原发性肝细胞癌关系的研究进展. 中华肝脏病杂志, 2014, 22(2): 153-155.
22.	王铭, 陈芳, 谢艳, 等. 人工肝治疗乙型肝炎病毒相关慢加急性肝功能衰竭的短期预后影响因素分析. 华西医学, 2016, 31(9): 1516-1520.
23.	龚非力. 医学免疫学. 2 版. 北京: 科学出版社, 2004: 42-59.
24.	郭银燕, 袁春蓓, 俞海英, 等. 慢性乙型肝炎与肝衰竭患儿外周血 T 淋巴细胞亚群的差异. 肝脏, 2014, 19(7): 514-517.
25.	陈智, 朱海红, 杨英. 细胞因子风暴与肝衰竭. 临床肝胆病杂志, 2014, 30(10): 981-983.
26.	Veiga-Parga T, Sehrawat S, Rouse BT. Role of regulatory T cells during virus infection. Immunol Rev, 2013, 255(1, SI): 182-196.
27.	Lau GK, Suri D, Liang R, et al. Resolution of chronic hepatitis B and anti-HBs seroconversion in humans by adoptive transfer of immunity to hepatitis B core antigen. Gastroenterology, 2002, 122(3): 614-624.
28.	王俊忠, 杨东亮. 免疫调节治疗慢性乙型肝炎病毒感染的研究进展. 中华肝脏病杂志, 2015, 23(3): 227-230.
29.	Li F, Wei H, Wei H, et al. Blocking the natural killer cell inhibitory receptor NKG2A increases activity of human natural killer cells and clears hepatitis B virus infection in mice. Gastroenterology, 2013, 144(2): 392-401.
30.	乔艳, 徐东平, 李进, 等. 慢性乙型肝炎的免疫治疗研究进展. 实用肝脏病杂志, 2016, 19(4): 493-496.

1. Ganem D, Prince AM. Hepatitis B virus infection--natural history and clinical consequences. N Engl J Med, 2004, 350(11): 1118-1129.
2. Rehermann B. Pathogenesis of chronic viral hepatitis: differential roles of T cell and NK cells. Nat Mesd, 2013, 19(7): 859-868.
3. 中华医学会. 病毒性肝炎防治方案. 中华肝脏病杂志, 2000, 8(6): 324-329.
4. 中华医学会肝病学分会, 中华医学会感染病学分会. 慢性乙型肝炎防治指南(2010 年版). 临床肝脏病杂志, 2011, 27(1): 1-16.
5. 中华医学会感染病学分会肝衰竭与人工肝学组, 中华医学会肝病学分会重型肝病与人工肝学组. 肝衰竭诊治指南(2012 年版). 中华临床感染病杂志, 2012, 5(6): 321-322.
6. 中华人民共和国卫生部. 原发性肝癌诊疗规范. 临床肿瘤学杂志, 2011, 16(10): 929-946.
7. 孙焕焕, 张永宏. T 细胞在慢性乙型肝炎发病机制中的作用研究进展. 传染病信息, 2014, 27(4): 237-239.
8. 杨晨辰, 黄睿, 刘勇, 等. 慢性 HBV 感染者不同免疫状态下及抗病毒治疗后外周血 T 细胞亚群比例和细胞因子水平特点. 中华实验和临床感染病杂志: 电子版, 2014, 8(2): 191-197.
9. 盛雄, 谢新生. 120 例乙型肝炎患者外周血 T 淋巴细胞亚群测定及意义. 中西医结合肝病杂志, 2009, 19(1): 46-47.
10. 赵永晓, 冯丽英. CD8⁺CTL 在乙型肝炎发病作用中的研究现状及进展. 世界华人消化杂志, 2009, 17(4): 384-388.
11. 张建春, 翁锡定, 陈孙云, 等. 乙型肝炎患者外周血 T 淋巴细胞亚群的变化. 实用肝脏病杂志, 2013, 16(4): 356-357.
12. 王琦. 免疫球蛋白血清检测在肝病患者中的作用. 中国民康医学, 2014, 26(1): 36-37.
13. 谢婵, 谢俊强, 张宇锋, 等. 抗病毒治疗对慢性乙型肝炎患者免疫球蛋白及补体的影响. 中华传染病杂志, 2012, 30(2): 100-104.
14. Loggi E, Gamal N, Bihl F, et al. Adaptive response in hepatitis B virus infection. J Viral Hepat, 2014, 21(5): 305-313.
15. Farci P, Diaz G, Chen Z, et al. B cell gene signature with massive intrahepatic production of antibodies to hepatitis B core antigen in hepatitis B virus-associated acute liver failure. Proc Natl Acad Sci USA, 2010, 107(19): 8766-8771.
16. Abu-Amara M, Feld JJ. Does antiviral therapy for chronic hepatitis B reduce the risk of hepatocellular carcinoma?. Semin Liver Dis, 2013, 33(2): 157-166.
17. 唐宗生, 郝友华, 杨东亮. HBV 持续性感染中 T 细胞功能耗竭的机制研究进展. 中华肝脏病杂志, 2012, 20(11): 871-873.
18. Lim YS, Kim WR. The global impact of hepatic fibrosis and endstage liver disease. Clin Liver Dis, 2008, 12(4): 733-746.
19. 王祖莲, 曹向红. 肝癌患者 31 例血清免疫球蛋白、补体的检测及临床意义. 中国社区医师, 2013, 15(6): 267.
20. Mi SP, Beom KK, Kyung SK, et al. Antiviral efficacies of currently available rescue therapies for multidrug-resistant chronic hepatitis B. Clin Mol Hepatol, 2013, 19(1): 29-35.
21. 陈洁, 张欣欣. 乙型肝炎病毒特征与肝硬化及原发性肝细胞癌关系的研究进展. 中华肝脏病杂志, 2014, 22(2): 153-155.
22. 王铭, 陈芳, 谢艳, 等. 人工肝治疗乙型肝炎病毒相关慢加急性肝功能衰竭的短期预后影响因素分析. 华西医学, 2016, 31(9): 1516-1520.
23. 龚非力. 医学免疫学. 2 版. 北京: 科学出版社, 2004: 42-59.
24. 郭银燕, 袁春蓓, 俞海英, 等. 慢性乙型肝炎与肝衰竭患儿外周血 T 淋巴细胞亚群的差异. 肝脏, 2014, 19(7): 514-517.
25. 陈智, 朱海红, 杨英. 细胞因子风暴与肝衰竭. 临床肝胆病杂志, 2014, 30(10): 981-983.
26. Veiga-Parga T, Sehrawat S, Rouse BT. Role of regulatory T cells during virus infection. Immunol Rev, 2013, 255(1, SI): 182-196.
27. Lau GK, Suri D, Liang R, et al. Resolution of chronic hepatitis B and anti-HBs seroconversion in humans by adoptive transfer of immunity to hepatitis B core antigen. Gastroenterology, 2002, 122(3): 614-624.
28. 王俊忠, 杨东亮. 免疫调节治疗慢性乙型肝炎病毒感染的研究进展. 中华肝脏病杂志, 2015, 23(3): 227-230.
29. Li F, Wei H, Wei H, et al. Blocking the natural killer cell inhibitory receptor NKG2A increases activity of human natural killer cells and clears hepatitis B virus infection in mice. Gastroenterology, 2013, 144(2): 392-401.
30. 乔艳, 徐东平, 李进, 等. 慢性乙型肝炎的免疫治疗研究进展. 实用肝脏病杂志, 2016, 19(4): 493-496.

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Study on the relationship between immune state and disease progression or disease severity of patients infected with hepatitis B virus

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