title: Similar frequencies, phenotype and activation status of intrahepatic NK cells in chronic HBV patients after long-term treatment with tenofovir disoproxil fumarate (TDF).
abstract: Currently, much effort is directed at further improving treatment for chronic hepatitis B patients by assessing the effect of immunomodulatory agents during therapy with nucleotide analogues (NUC). Although there are some reports on the effect of NUC therapy on peripheral natural killer (NK) cells, no studies investigated the long-term effects of NUC treatment on intrahepatic NK cells of chronic HBV patients. We aimed to prospectively investigate cell frequencies, phenotype, and activation status of intrahepatic NK cells of CHB patients on prolonged treatment with TDF.
  
  
  
  Fine needle aspiration biopsies were collected from 11 chronic HBV patients at baseline, and at 12, 24, and 48 weeks of treatment with a daily 245 mg dose of TDF. Four patients underwent an additional aspiration biopsy after appoximately 6 years of treatment.
  
  
  
  Longitudinal evaluation of these patients during tenofovir therapy showed that all patients achieved a viral load reduction with undetectable DNA load after 48 weeks of therapy. Repeated sampling of the liver during therapy showed that the frequency of distinct lymphocyte populations in the liver remained unchanged despite viral load reduction. During the course of therapy, no modulation of the expression levels and frequencies of CD69, HLA-DR, NKG2A and NKG2D on liver NK cells were detected. However, evaluation of intrahepatic NK cell activation after continuous TDF therapy for 6 years demonstrated a mild increase in 3 out of 4 patients.
  
  
  
  Our findings provide a unique insight in the intrahepatic NK cell compartment in chronic HBV patients during prolonged treatment. We observed that long-term NUC-induced viral suppression, accompanied by gradual decrease of HBsAg levels, had no or only a limited effect on the frequencies, phenotype, and activation status of intrahepatic NK cells.
authors.affiliation: Dept. of Gastroenterology and Hepatology, Erasmus Medical Centre University Hospital, Rotterdam, The Netherlands.
authors.forename: Eric T T L
authors.initials: ET
authors.lastname: Tjwa
authors.affiliation: Dept. of Gastroenterology and Hepatology, Erasmus Medical Centre University Hospital, Rotterdam, The Netherlands.
authors.forename: Roeland
authors.initials: R
authors.lastname: Zoutendijk
authors.affiliation: Dept. of Gastroenterology and Hepatology, Erasmus Medical Centre University Hospital, Rotterdam, The Netherlands.
authors.forename: Gertine W
authors.initials: GW
authors.lastname: van Oord
authors.affiliation: Dept. of Gastroenterology and Hepatology, Erasmus Medical Centre University Hospital, Rotterdam, The Netherlands.
authors.forename: Lauke L
authors.initials: LL
authors.lastname: Boeijen
authors.affiliation: Dept. of Gastroenterology and Hepatology, Erasmus Medical Centre University Hospital, Rotterdam, The Netherlands.
authors.forename: Jurrien G P
authors.initials: JG
authors.lastname: Reijnders
authors.affiliation: Dept. of Gastroenterology and Hepatology, Erasmus Medical Centre University Hospital, Rotterdam, The Netherlands.
authors.forename: Margo J H
authors.initials: MJ
authors.lastname: van Campenhout
authors.affiliation: Dept. of Gastroenterology and Hepatology, Erasmus Medical Centre University Hospital, Rotterdam, The Netherlands.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: de Knegt
authors.affiliation: Dept. of Gastroenterology and Hepatology, Erasmus Medical Centre University Hospital, Rotterdam, The Netherlands.
authors.forename: Harry L A
authors.initials: HL
authors.lastname: Janssen
authors.affiliation: Dept. of Gastroenterology and Hepatology, Erasmus Medical Centre University Hospital, Rotterdam, The Netherlands.
authors.forename: Andrea M
authors.initials: AM
authors.lastname: Woltman
authors.affiliation: Dept. of Gastroenterology and Hepatology, Erasmus Medical Centre University Hospital, Rotterdam, The Netherlands. Electronic address: p.a.boonstra@erasmusmc.nl.
authors.forename: Andre
authors.initials: A
authors.lastname: Boonstra
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000494:pharmacology* / Q000627:therapeutic use; D015415:Biomarkers; D005260:Female; D006515:Hepatitis B virus / Q000187:drug effects*; D019694:Hepatitis B, Chronic / Q000188:drug therapy / Q000276:immunology* / Q000378:metabolism / Q000821:virology*; D006801:Humans; D016130:Immunophenotyping; D007694:Killer Cells, Natural / Q000187:drug effects* / Q000276:immunology*; D008099:Liver / Q000276:immunology / Q000821:virology; D008213:Lymphocyte Activation / Q000187:drug effects*; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D055654:NK Cell Lectin-Like Receptor Subfamily C / Q000378:metabolism; D055655:NK Cell Lectin-Like Receptor Subfamily K / Q000378:metabolism; D010641:Phenotype; D000068698:Tenofovir / Q000494:pharmacology* / Q000627:therapeutic use; D019562:Viral Load; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D015415:Biomarkers; D055654:NK Cell Lectin-Like Receptor Subfamily C; D055655:NK Cell Lectin-Like Receptor Subfamily K; D000068698:Tenofovir
keywords: Antiviral therapy; Chronic hepatitis B; FNAB; Intrahepatic; NK cells; Tenofovir