Immune function changes and their association with hepatitis activity in HBeAg-positive chronic HBV carriers after cessation of maternal-infant blockade therapy

Abstract

Abstract: Objective To investigate the differences in immune function between the hepatitis activity group and the non-hepatitis activity group among HBeAg-positive chronic HBV carriers after discontinuation of maternal-infant blockade therapy and to analyze the association between immune function changes and hepatitis activity. Methods A total of 105 HBeAg-positive chronic HBV carriers who attended at Cangzhou People′s Hospital from January 2022 to June 2024 were enrolled. Based on hepatitis activity status after three months of discontinuation, patients were divided into the hepatitis activity group (n=32) and the non-hepatitis activity group (n=73). Clinical data, including liver function indicators (alanine aminotransferase (ALT), aspartate aminotransferase (AST)), immune markers (CD4⁺ T-cell ratio, CD4⁺/CD8⁺ T-cell ratio), HBV DNA load, and inflammatory cytokines (interleukin-6 (IL-6), tumor necrosis factor (TNF) -α), were collected. Pearson correlation coefficient was used to determine the correlation between liver function indicators and immune function markers. Multivariate logistic regression analysis was conducted to identify factors influencing hepatitis activity in HBeAg-positive chronic HBV carriers after cessation of maternal-infant blockade therapy. Results At 1, 3, and 6 months after drug withdrawal, patients in the hepatitis activity group showed significantly elevated levels of ALT and AST, along with decreased CD4⁺ T cell percentage and CD4⁺/CD8⁺. These differences were most significant after 3 months of discontinuation [ALT at 3 months: (72.09±8.10) U/L vs. (36.12±6.45) U/L, P<0.05; AST: (68.59±7.22) U/L vs. (33.55±4.22) U/L, P<0.05; CD4⁺ T cell percentage: (37.01±3.04)% vs. (39.91±3.15)%, P<0.05; CD4⁺/CD8⁺: (1.48±0.18) vs. (1.70±0.19), P<0.05]. At 1, 3, and 6 months after drug cessation, levels of HBV DNA, IL-6, and TNF-α were also significantly higher in the hepatitis activity group than in the non-hepatitis activity group. Differences in IL-6 and TNF-α were most significant at 3 months post-withdrawal [IL-6: (15.67±4.02) pg/mL vs. (11.51±2.94) pg/mL, P<0.05; TNF-α: (18.41±4.55) pg/mL vs. (14.58±3.62) pg/mL, P<0.05], while the difference in HBV DNA was most significant at 6 months [(6.13±0.90) vs. (4.71±0.90) log₁₀ U/mL, P<0.05]. Pearson correlation analysis showed that the CD4⁺ T cell percentage had significantly negative correlation with ALT and AST (r=-0.390, -0.440; P<0.05), and the CD4⁺/CD8⁺ had also negatively correlation with ALT and AST (r=-0.483, -0.460; P<0.05). Multivariate logistic regression analysis indicated that ALT, AST, CD4⁺, CD4⁺/CD8⁺, HBV DNA, IL-6, and TNF-α were all influencing factors for hepatitis activity (P<0.05). Conclusion After cessation of maternal-infant blockade therapy, the decline in CD4⁺ T-cell ratio and CD4⁺/CD8⁺ is significantly associated with the occurrence of hepatitis activity in HBeAg-positive chronic HBV carriers. Changes in these immune indicators, HBV DNA load, and inflammatory cytokines may serve as potential biomarkers for predicting hepatitis activity.

Key words: Maternal-infant blockade, HBeAg-positive, Chronic HBV carrier, Immune function, Hepatitis activity

CAO Yan-min, XING Bao-heng, ZONG Fang, GAO Su-juan. Immune function changes and their association with hepatitis activity in HBeAg-positive chronic HBV carriers after cessation of maternal-infant blockade therapy[J]. Chinese Hepatolgy, 2025, 30(7): 958-962.

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