[The relationship between clinical outcomes of hepatitis B virus infection and the host' s cellular immunity].

OBJECTIVE: To investigate the differences of peripheral blood T-lymphocyte subsets and the frequencies of HBV-specific CD4 T cells in patients with symptomatic chronic hepatitis B, asymptomatic HBV carriers and patients who had recovered from subclinical HBV infection, to analyze the relationship between different clinical outcomes after HBV infection and the host's cellular immunity and to give a new clue to the treatment of chronic hepatitis B. METHODS: Flow cytometry was used to detect the peripheral blood T-lymphocyte subsets in 30 patients with symptomatic chronic hepatitis B, 22 asymptomatic HBV carriers, 9 patients who had recovered from subclinical HBV infection and 11 healthy blood donors. The frequencies of HBV-specific CD4+ T cells in relation to recombinant HBV core antigen were tested with IFNgamma enzyme-linked immunospot assays (ELISpot). RESULTS: Compared with patients who had recovered from subclinical HBV infection and normal controls, the count of CD4+ T cells decreased in patients with symptomatic chronic hepatitis B. The frequencies of HBV-specific CD4+ T cells were (156 +/- 105), (56 +/- 68) and (229 +/- 114) SFC/10(6)PBMC (SFC: spot-forming cells; PBMC: peripheral blood mononuclear cells) respectively in patients with symptomatic chronic hepatitis B, asymptomatic HBV carriers and patients who had recovered from subclinical HBV infection. The frequencies of HBV-specific CD4+ T cells in patients with symptomatic chronic hepatitis B were markedly higher than those in asymptomatic HBV carriers (P < 0.01), but lower than that in patients who had recovered from subclinical HBV infection (P < 0.05). CONCLUSION: There was significant difference in the frequencies of HBV-specific T cells in patients with symptomatic chronic hepatitis B, asymptomatic HBV carriers and patients who had recovered from subclinical HBV infection and these might be one of the primary reasons for the different clinical outcomes after HBV infection.