Abstract: Objective To investigate the effect of optimized antiviral treatment with nucleoside (acid) analog tenofovir disoproxil fumarate on hepatitis B-related cirrhotic patients and its influence on peripheral blood T lymphocyte subsets and cytokines levels. Methods Thirty-six patients with chronic hepatitis B-related liver cirrhosis admitted from January 2017 to December 2018 were selected as the observation group. Thirty cases of healthy physical examination population during the same time period were selected as the control group. Clinical indicators such as liver and kidney function, HBV-DNA load in the observation group before and after treatment were collected and analyzed. The levels of T lymphocyte subsets and cytokines levels including IL-2, IFN-γ, IL-4 and IL-10 were detected and compared between these two groups. Results After antiviral treatment, the level of alanine aminotransferase (ALT) in the observation group was significantly improved than that of before treatment (tALT=13.728, P<0.05), without significant alteration in renal function. The negative change rate of HBV DNA titer was 100%. Although the percentage of CD3+ cells (68.6±12.3) and CD4+ cells (40.6±9.3), and the ratio of CD4+/CD8+ (1.3±0.6) in the observation group after anti-viral treatment were significantly increased (tCD3+=9.382, tCD4+=14.175, tCD4+/CD8+=9.753, P<0.05), the levels were still lower than those of the control group (tCD3+=4.947, tCD4+=6.598, tCD4+/CD8+=7.329,P<0.05); On the contrary, the percentage of CD8+ cells in the observation group (30.3±6.2) was significantly lower than that of before treatment (tCD8+=12.368, P<0.05), but still higher than that in the control group (tCD8+=5.986, P<0.05). Serum anti-Th1 cell cytokines IL-2 (32.24±16.55pg/ml) and IFN-γ (9.08±5.23 pg/ml) levels in patients of the observation group were significantly lower after TDF treatment (tIL-2=7.615, tIFN-γ=18.763, P<0.05), but higher than that of the control group (tIL-2=5.784, tIFN-γ=13.643, P<0.05); The cytokine IL-4 (45.90±18.27 pg/mL) and IL-10 (19.85±5.63 pg/mL) levels of Th2 cells in the observation group were significantly higher than those of before treatment (tIL-4=11.249,tIL-10=17.452, P<0.05), but still significantly lower than that of the control group (tIL-4=10.476, tIL-10=9.415, P<0.05). Conclusion Antiviral therapy with TDF effectively improves liver function and reduces HBV DNA viral load in patients with hepatitis B-related liver cirrhosis. The treatment restores immune function and has a significant impact on the serum levels of immunological cytokines in the patients.

Key words: Optimize antiviral therapy, Hepatitis B-related liver cirrhosis, T cell immunity, Cytokines