title: Acute exacerbations of chronic type B hepatitis are accompanied by increased T cell responses to hepatitis B core and e antigens. Implications for hepatitis B e antigen seroconversion.
abstract: T cell proliferative responses to hepatitis B virus-encoded envelope antigen (S + preS2 + preS1), recombinant core antigen (HBcAg), and natural hepatitis B e antigen (HBeAg) were examined in 22 HBeAg-positive patients with chronic type B hepatitis and 17 healthy hepatitis B surface antigen (HBsAg) carriers. The results showed that HBeAg-positive patients had (a) higher levels of T cell responses to HBcAg/HBeAg than those of healthy HBsAg carriers (P less than 0.001 and P less than 0.01, respectively); (b) a further increase in these T cell responses during acute exacerbations (P less than 0.05 and P less than 0.05, respectively); (c) subsidence in the T cell responses to HBcAg/HBeAg after recovery from acute exacerbations and HBeAg seroconversion, whereas the responses would persist at high levels if the patients did not enter a clinical remission; and (d) low levels of T cell responses to S + preS2 + preS1 either before or after HBeAg seroconversion. The appearance of increasing T cell responses to HBcAg/HBeAg usually occurred in the early phase of acute exacerbations. These findings imply that HBcAg/HBeAg-specific T cells play an important role in the exacerbations of chronic hepatitis B and in HBeAg seroconversion. HBcAg/HBeAg-specific precursor T cell frequencies were serially studied in selected cases by limiting dilution assay. Elevation (two- to fourfold) of HBcAg/HBeAg-specific precursor T cell frequencies contributed to the increase of HBcAg/HBeAg-specific T cell proliferation during acute exacerbations.
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Republic of China.
authors.forename: S L
authors.initials: SL
authors.lastname: Tsai
authors.forename: P J
authors.initials: PJ
authors.lastname: Chen
authors.forename: M Y
authors.initials: MY
authors.lastname: Lai
authors.forename: P M
authors.initials: PM
authors.lastname: Yang
authors.forename: J L
authors.initials: JL
authors.lastname: Sung
authors.forename: J H
authors.initials: JH
authors.lastname: Huang
authors.forename: L H
authors.initials: LH
authors.lastname: Hwang
authors.forename: T H
authors.initials: TH
authors.lastname: Chang
authors.forename: D S
authors.initials: DS
authors.lastname: Chen
mesh_terms: D000328:Adult; D001483:Base Sequence; D005260:Female; D005500:Follow-Up Studies; D006509:Hepatitis B / Q000276:immunology*; D006512:Hepatitis B Core Antigens / Q000276:immunology*; D006513:Hepatitis B e Antigens / Q000276:immunology*; D006521:Hepatitis, Chronic / Q000276:immunology*; D006801:Humans; D007108:Immune Tolerance / Q000276:immunology; D008213:Lymphocyte Activation / Q000276:immunology; D008297:Male; D008969:Molecular Sequence Data; D011446:Prospective Studies; D013601:T-Lymphocytes / Q000276:immunology*; D013997:Time Factors
chemical_list: D006512:Hepatitis B Core Antigens; D006513:Hepatitis B e Antigens