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Viral load and lymphocyte subpopulations in newly diagnosed patients with chronic Hepatitis B

Anastasiya Mihaylova, Marta Baleva, Atanaska Georgieva, Valentina Atanasova, Diana Petrova, Snejina Mihailova, Georgi Popov, Naumova Elissaveta


INTRODUCTION: The immune response against Hepatitis B virus (HBV) represents a key factor for infection outcome. However, the relation between viral replication and host immune reactivity is still a matter of investigation.

AIM: To investigate whether the cellular immune response of newly diagnosed treatment naïve chronic hepatitis B (CHB) patients may be influenced by the replicative status of HBV.

MATERIALS AND METHODS: A total of 45 (17 female and 28 male) newly diagnosed untreated CHB patients aged 42.48±13.19 years (19÷71 years) were enrolled in this study. The patients were divided in two groups according to the viral load: >0÷≤104 copies/ml (n=25) and >10 4÷<108 copies/ml (n=17). Flowcytometric immunophenotyping was performed for evaluation of the cellular immunity. Serum HBV DNA load was assessed by quantitative real-time polymerase chain reaction.

RESULTS: Similar alterations were observed in both patients` groups in comparison with healthy controls which could be summarized as follows: decreased total T cells (CD3+) due to low helper-inducer (CD3+CD4+) and suppressor-cytotoxic (CD3+CD8+) subpopulations; reduced effector cytotoxic (CD8+CD11b-; CD8+CD28+) and activated (CD3+HLA-DR+, CD8+CD38+) T-cell subsets; increased CD57+CD8- cells; elevated percentage of B lymphocytes. No significant differences in the studied immune parameters were detected between both patients` groups except the significantly elevated CD4/CD8 ratio in individuals with higher in comparison to those with lower HBV DNA levels.

CONCLUSION: Alterations in the cellular immune repertoire of CHB patients were observed resulting mainly in significantly decreased T-cell subpopulations, particularly those with effector cell immune phenotype regardless of the viral load.


chronic hepatitis B; viral load; cellular immunity; immune cell subsets

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About The Authors

Anastasiya Mihaylova
Department of clinical immunology, University hospital, Medical university of Sofia

Marta Baleva
Department of clinical immunology, University hospital, Medical university of Sofia

Atanaska Georgieva
Department of clinical immunology, University hospital, Medical university of Sofia

Valentina Atanasova
Department of clinical immunology, University hospital, Medical university of Sofia

Diana Petrova
Clinic of propaedeutics of internal diseases, University hospital, Medical university of Sofia

Snejina Mihailova
Department of clinical immunology, University hospital, Medical university of Sofia

Georgi Popov
Clinic of infectious diseases, Military medical academy of Sofia

Naumova Elissaveta
Department of clinical immunology, University hospital, Medical university of Sofia

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