Virus-specific T cell immune response in children and adolescents with chronic hepatitis B virus infection.
OBJECTIVE
To study the hepatitis B-specific T cell-mediated immune response in chronically infected children and adolescents.


METHODS
In all, 36 HBsAg-positive patients, 2 to 19 years old, were included. There were 9 HBeAg-positive patients with normal levels of alanine aminotransferase (ALT) (group 1), 18 HBeAg-positive patients with elevated ALT (group 2), and 9 HBeAg-negative, anti-HBe-positive patients (group 3). Four patients in group 2 were treated with interferon during the study. In all patients, HBcAg-specific T cell proliferation and ALT levels were prospectively studied in repeated samples for a mean follow-up time of 1.6 years. The baseline HBV-DNA and plasma cytokine levels were determined, and genotypes were analyzed.


RESULTS
The percent of patients with at least 1 sample indicating T cell proliferation was 55% in group 1 and 89% in groups 2 and 3, respectively (P = 0.07 group 1 vs group 2, P = 0.013 group 1 vs the combined groups 2 and 3). Tendencies for positive correlations between the degree of T cell proliferation and ALT levels were noted in groups 1 and 3 and for negative correlations in HBeAg seroconverting patients of group 2. In patients with successful interferon treatment, a pattern of more vigorous T cell proliferation than in patients with spontaneous seroconversion was noted.


CONCLUSIONS
A majority of patients showed signs of ongoing T cell proliferation. The continuation of the T cell-mediated immune response seems to be of importance in maintaining the HBeAg seroconversion over time.
Fischler
Björn
B
Department of Pediatrics, Karolinska University Hospital, Huddinge, Stockholm, Sweden. bjorn.fischler@karolinska.se
Nyström
Jessica
J
Björnsdottir
Thora
T
Lindh
Gudrun
G
Hultgren
Catharina
C
D000293:Adolescent; D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D049109:Cell Proliferation; D002648:Child; D016207:Cytokines / Q000097:blood; D004279:DNA, Viral / Q000097:blood / Q000235:genetics; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D006512:Hepatitis B Core Antigens / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006513:Hepatitis B e Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology*; D019694:Hepatitis B, Chronic / Q000188:drug therapy / Q000276:immunology* / Q000821:virology; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D013601:T-Lymphocytes / Q000166:cytology / Q000502:physiology*; D019562:Viral Load
D000998:Antiviral Agents; D015415:Biomarkers; D016207:Cytokines; D004279:DNA, Viral; D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens; D016898:Interferon-alpha; D000410:Alanine Transaminase