الفهرس 
General introduction and aim of the workOnly 14 pages are availabe for public view
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Abstract
Currently, 250 million people are living with chronic B virus infection, and the development of novel curative treatments is urgently needed. Immunotherapy is an attractive approach to treat hepatitis B, yet therapeutic approaches to augment the endogenous hepatitis B virus (HBV)- specific T cell response in hepatitis B patients have demonstrated little success. chronic HBV infection may lead to severe sequelae such as liver fibrosis, cirrhosis, and hepatocellular carcinoma. The central role played by T cell responses during the control of HBV infection is now well recognized. CD3 represents the absolute value of total T cells. Their increased value is observed in both protective inflammatory response fighting infectious diseases. Clinical outcomes of HBV infection largely depend on the quality and strength of the host’s immune response. Studies have revealed that T cell immune responses are essential for disease pathogenesis, and have identified CD8+ T lymphocytes as the main cellular subset responsible for viral control.
Therefore, the first aim of the present study is designed to elucidate whether the cellular immune response of recently diagnosed naïve chronic hepatitis B (CHB) patients may be influenced by the replicative status of HBV or not. Also, HBV viral load, HBsAg quantification, and peripheral T-cell subpopulations were evaluated. The level of IFN-γ TNF-α and their correlations with T lymphocyte subsets were included. Further the changes in immune response accompanying the recently used anti-HBV viral drugs were illustrated.
The results of the present study reported lower levels of IFN-γ than that of the controls, a result which confirms the persistence of HBV infection. However, TNF-α values of the patients were significantly higher than those of the controls, which may indicate that TNF-α can inhibit viral replication and the ongoing process of HBV elimination according to the macrophage polarization mechanism in chronic HBV.
There was a positive correlation between CD8+CD38+ T cells and HBsAg quantitation. The combined use of CD8+CD38+ T cells, HBsAg quantitation, and HBV-DNA assessment in patients with CHB can guide the clinician to evaluate the chance of treatment response. It seems that insufficient cellular immune response is critical for the ineffective virus clearance and liver damage in chronic HBV.
Using stepwise linear regression analysis was used to establish new diagnostic scores with higher accuracy and the diagnostic power which were not listed in the literatures before.