STUDY OF T-LYMPHOCYTES SUBSETS IN PATIENTS WITH HBV CHRONIC CARRIERS

This study included 13 patients with Chronic Hepatitis B (CHB), 9 individuals were diagnosed with Healthy carriers (HBV–HC) and 7 patients with autoimmune chronic active hepatitis (AICAH), and 16 human as control group. The number and the percentage of TLymphocyte (CD3 + Cells) in the peripheral blood of these groups of patients showed no significant differences but in the patients with CHB showed reduction in the percentages and absolute numbers of CD4 + cells (P < 0.001), significant decreased CD4 + /CD8 + cells ratio (P < 0.001) and increase in the percentages and absolute number of CD8 + cells (P < 0.001) were found, in compared with healthy control group. HBV-HC group showed no significant difference in all these values. The patients with AICAH demonstrated a slight significant increase in CD4 + / CD8 + cell ratio (P < 0.05) but the percentage and absolute number of CD8 + and CD4 + cells were normal in AICAH when compared their results with control group. Introduction About 10% of patients suffering from acute type B hepatitis fail to clearance Hepatitis B Surface antigen (HBs Ag) from the blood and become chronic carriers in adult. But this percentage is 90% in children (1,2). The virus is not cytotoxic for hepatocytes and the liver cells damage is related to immunological reactions patterns of host (3,4). The cell mediated immune response to antigens compounds of the virus. Plays an important role in the lysis of infected hepatocytes in acute and chronic HBV Induce hepatitis (5). The expression of HBV surface antigen (HBs Ag) or core antigen (HBc Ag) on the surface membrane of liver cells play as the main target antigens for host defense mechanisms (6,7). In the patients with autoimmune chronic active hepatitis (AICAH) the immune response occur against self antigen of hepatocytes membrane, the immunopathogenic mechanisms of cellular that result in viral persistence and hepatocellular injury in type B hepatitis remained unclear (8,9). Defect in the immunoregulatory system have played a role in the development of chronic hepatitis B. The importance of balance between inducer (CD4 + cells) and suppressor (CD8 + cells) cells in maintaining immune hemostasis has recently been illustrated and abnormalities of these cells subpopulations have been associated with a number of human disease (6). Previous studies support the hypothesis: that two factors are important in pathogenesis of HBV induced hepatocellular injury ; Viral replication and immune response (10) On the strength of those investigators , the aim of this study was proposed for determination of CD8 + cells and the ratio of CD4 + / CD8 + cells in blood circulation which gave a good picture for immune hemostasis . Materials & Methods Patients: Twenty nine patients have previous infection with HBV. According to clinical serological and Biochemical tests. All cases were taken from Central public Health Laboratories. Forty five cases divided into following groups: CHB with clinical disorder symptoms (13), HBV – HC (9), AICAH with HBV markers (7) control group (16). Clinical and laboratory features of patients, and control groups show in table (-1-). Heparinized blood and serum was collected from all these patients and control. All cases have not any markers for other viruses except HBV markers; nobody had received immunosuppressive or antiviral drug treatment.