Hepat Mon. 2011;11(10):810-815. DOI: 10.5812/kowsar.1735-143x.760 KOWSAR Journal home page: www.HepatMon.com OISfNic:aPlriMnto1n7th3l5y-1Jo4u3rxn,aNlOounfmltinhbeee1Br7a33q5i9y-,a3tV40ol8aluhmRees1arc,hIsCeunete1r0fo,rOGcatstorobeenrte2r0o1lgyandLiverDisease IMP0LC.A7TFE9AST3COR t:asno .NCOM illieecnbuSOm.TEAOWHM i P trA W DockfinNgovSetuldAinetsvfioralIdehntbiﬁcoartsion Itraconazole;Corticosteroid HBVaSctigneastionfCiKDifernt Alteration in Cellular Immunity after Chronic Hepatitis B Deteriorated into Severe Hepatitis and Its Significance Gu Xibing 1 *, Yang Xiaojuan 1, Lu Zhonghua 1, Wang Juanhua 1 1 Wuxi Hospital for Infectious Diseases, Wuxi, China A R T I C L E I N F O A B S T R A C T Article type: Original Article Article history: Received: 17 Jan 2011 Revised: 23 Apr 2011 Accepted: 12 Aug 2011 Keywords: Hepatitis B, Chronic T-Lymphocytes Killer Cells, Natural Background: It is difficult to predict what type of chronic hepatitis B (CHB) progresses to chronic severe hepatitis B. Objectives: This study aimed to observe changes in the HBV-specific and -nonspecific cell- mediated immune responses after CHB deteriorates into severe hepatic disease and ex- plore the significance of such changes. Patients and Methods: This study aimed to observe changes in the HBV-specific and -non- specific cell-mediated immune responses after CHB deteriorates into severe hepatic dis- ease and explore the significance of such changes. Results: In 49 of 255 CHB patients (19.22%), the disease developed into chronic severe hepatitis (early stage) an average of 10.06 ± 1.73 days after admission. CD4+ and NK cells levels in Group A were lower after progression into severe hepatitis than on the second day of admission (baseline) (P < 0.01). CD8+ cells and nonspecific CTL levels in Group A were higher after progression than at baseline (P < 0.01), and latter was higher than in Group B at baseline (P < 0.01); the levels of CD8+ cells and nonspecific CTLs in Group A after progression were significantly higher than those of Group B 10 days after admis- sion (P < 0.01). There were no significant differences in HBV-specific CTL levels in Group A before and after progression to severe hepatitis (P > 0.05). Conclusions: Our results suggest that the immunological pathogenesis of chronic severe hepatitis B is related to significant rises in CD8+ and nonspecific CTL levels and that such increases predict that the disease will deteriorate into severe hepatitis. c 2011 Kowsar M.P.Co. All rights reserved. Implication for health policy/practice/research/medical education: To predict at certain degree if chronic hepatitis B will develop into severe hepatitis by testing cellular immunity at early stage , provide lab basis to prevent or stop the progress of chronic hepatitis B developing into severe hepatitis. Please cite this paper as: Xibing G, Xiaojuan Y, Zhonghua L, Juanhua W. Alteration in Cellular Immunity after Chronic Hepatitis B Deteriorated into Severe Hepatitis and Its Significance. Hepat Mon. 2011;11(10):810-5. DOI: 10.5812/kowsar.1735-143x.760 1. Background Clinically, liver disease can progress into chronic se- vere hepatitis B in some patients with CHB, even after admission and after receiving treatment. It is difficult to predict which CHB patients will develop chronic severe hepatitis. * Corresponding author: Gu Xibing, Wuxi Hospital for Infectious Dis- eases, Wuxi 214005, China. Tel: +86-13812051392, Fax: +86-51068918000, E-mail: gxb188681@sina.com DOI: 10.5812/kowsar.1735-143x.760 Copyright c 2011, BRCGL, Published by Kowsar M.P.Co. All rights reserved. 2. Objectives The pathogenesis of hepatitis B is associated with cel- lular immune responses that aim to remove HBV from the body (1). If the resulting cellular immunity is too intensive, it can result in the necrosis of many liver cells and severe hepatitis. However, it is unknown whether HBV-specific or nonspecific cellular immune responses immediate the deterioration of CHB. 3. Patients and Methods 3.1. Subjects We enrolled 255 CHB patients into this study from