title: Decreases in activated CD8+ T cells in patients with severe hepatitis B are related to outcomes.
abstract: BACKGROUND
  Many studies on T helper (Th)1, Th2, T regulatory and Th17 cells have been carried out in acute-on-chronic liver failure (ACLF). However, CD8(+) T cell, as a main participant in immune-mediated injuries and defense against microorganisms, has seldom been studied in ACLF.
  
  
  OBJECTIVE
  The purpose of this study was to investigate the CD8(+) T cell function, and the outcomes of patients with severe hepatitis [SH; serum bilirubin (SB) ≥ 10 mg/dl and prothrombin activity (PTA) < 60 %].
  
  
  METHODS
  Thirty-six patients with chronic HBV-associated SH were included. Twenty normal chronic hepatitis B (CHB) patients (2 < SB < 10 (mg/dl) and PTA ≥ 60 %) and 28 healthy volunteers were enrolled as control groups.
  
  
  RESULTS
  Twenty-six patients with SH were diagnosed with ACLF (SB ≥ 10 mg/dl and PTA ≤ 40 %). The non-recovered ACLFs (NR-ACLF) had higher HBV DNA loads than recovered ACLFs (R-ACLF) (6.03 ± 1.79 vs. 4.36 ± 1.61 (log10, IU/L)). The NR-ACLFs had the highest neutrophil:lymphocyte ratios (5.10 ± 2.37) (all P < 0.001; a = 0.05). The CHBs had higher perforin(+) and TCM (CD45RA(-)CD62L(hi)CCR7(+)) proportions [31.28 ± 19.51, 5.32 ± 3.57 (%)] compared to R-ACLFs (11.75 ± 15.35, 0.78 ± 0.76 (%); P = 0.004, 0.001, respectively), or NR-ACLFs (11.61 ± 5.79, 1.14 ± 0.67 (%); P = 0.006, 0.003). The non-ACLF SHs had higher CD38(+) proportions than R-ACLFs or NR-ACLFs (25.46 ± 8.02 vs. 16.24 ± 7.77 or 16.81 ± 6.30 (%), P = 0.039, 0.023).
  
  
  CONCLUSIONS
  High neutrophil:lymphocyte ratios and a decrease in activated CD8(+) T cells may be related to poor outcomes in patients with SH.
authors: The Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors: Yinong
authors: Y
authors: Ye
authors: Jing
authors: J
authors: Liu
authors: Qing
authors: Q
authors: Lai
authors: Qiyi
authors: Q
authors: Zhao
authors: Liang
authors: L
authors: Peng
authors: Chan
authors: C
authors: Xie
authors: Genglin
authors: G
authors: Zhang
authors: Shaoquan
authors: S
authors: Zhang
authors: Yufeng
authors: Y
authors: Zhang
authors: Jianyun
authors: J
authors: Zhu
authors: Yangsu
authors: Y
authors: Huang
authors: Zhaoxia
authors: Z
authors: Hu
authors: Dongying
authors: D
authors: Xie
authors: Bingliang
authors: B
authors: Lin
authors: Zhiliang
authors: Z
authors: Gao
mesh_terms: D065290:Acute-On-Chronic Liver Failure / Q000276:immunology*; D056704:Adaptive Immunity; D000328:Adult; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology*; D016207:Cytokines / Q000097:blood; D004279:DNA, Viral / Q000097:blood; D018450:Disease Progression; D005260:Female; D006509:Hepatitis B / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D016207:Cytokines; D004279:DNA, Viral