Cellular Immunity after Chronic Hepatitis B did not deteriorate, whereas HBV-specific CTLs did not change, which suggests that the immunological patho- genesis of chronic severe hepatitis B is associated with a significant increase in CD8+ and nonspecific CTLs. In ad- dition, before the disease in Group A patients progressed to severe hepatitis, CD8+ and nonspecific CTL levels had already increased markedly. Therefore, significant in- creases in CD8+ and nonspecific CTL levels in CHB pa- tients may predict deterioration of CHB to severe hepa- titis. When the deterioration occurs, the symptoms of patients worsen. Glucocorticoids should be considered in the treatment of such patients to decrease the exces- sively high levels of CD8+ T cells and nonspecific CTLs (17) and prevent CHB patients from developing chronic severe hepatitis. The weaknesses of this study are that we did not test cellular immunity in the liver tissue of patients, the follow-up period was too short, and the sample size was not large enough. Larger-scale, better-designed studies are needed for further exploration of the mechanisms of deterioration of chronic hepatitis B. In conclusion, this study shows that the deterioration of CHB may be asso- ciated with significantly increased levels of CD8+ T cells and nonspecific CTLs, which may predict deterioration of CHB. Acknowledgments None declared. Financial Disclosure None declared. Funding/Support None declared. References 1. Menne S, Roneker CA, Roggendorf M, Gerin JL, Cote PJ, Tennant BC. Deficiencies in the acute-phase cell-mediated immune re- sponse to viral antigens are associated with development of chronic woodchuck hepatitis virus infection following neonatal inoculation. J Virol. 2002;76(4):1769-80. 2. Society of Infectious and Parasitologic Diseases and Society Xibing G et al. 815 of Hepatology CMA. [Chinese medicine national program for prevention and treatment of viral hepatitis]. Chin J Hepatol. 2000;8:324–5. 3. Chen Y, Li L. [Advances in research of cell immune responses of specific cytotoxic T lymphocytes in hepatitis B virus infection]. Foreign Med Sci Epidemiol Lemol 2004;31:27-30. 4. Bathgate AJ, Garden OJ, Forsythe JR, Madhaven KK, Finlayson ND, Simpson KJ, et al. The outcome of the first 165 orthotopic liver transplants in Scotland. Scott Med J. 1999;44(1):9-10. 5. Bektas M, Idilman R, Soykan I, Soydan E, Arat M, Cinar K, et al. Adjuvant therapeutic plasma exchange in liver failure: assess- ments of clinical and laboratory parameters. J Clin Gastroenterol. 2008;42(5):517-21. 6. Jumei C, Zhengsheng Z. [Prevention and control of hepatic fail- ure in patients with severe hepatitis B]. Infect Dis Information. 2008;21(2):65-7. 7. Moriyama T, Guilhot S, Klopchin K, Moss B, Pinkert CA, Pal- miter RD, et al. Immunobiology and pathogenesis of hepato- cellular injury in hepatitis B virus transgenic mice. Science. 1990;248(4953):361-4. 8. Ando K, Moriyama T, Guidotti LG, Wirth S, Schreiber RD, Schlicht HJ, et al. Mechanisms of class I restricted immunopathology. A transgenic mouse model of fulminant hepatitis. J Exp Med. 1993;178(5):1541-54. 9. Chisari FV, Ferrari C. Hepatitis B virus immunopathogenesis. Annu Rev Immunol. 1995;13:29-60. 10. Rehermann B. Intrahepatic T cells in hepatitis B: viral control versus liver cell injury. J Exp Med. 2000;191(8):1263-8. 11. Bertoletti A, Ferrari C. Kinetics of the immune response during HBV and HCV infection. Hepatology. 2003;38(1):4-13. 12. Deng H, Chong YT, Han XY, Zhang FC, Peng XM, Gao ZL, et al. [Changes of antigen-specific cytotoxic T lymphocytes during acute flare-ups in chronic hepatitis B patients]. Chin J Hepatol. 2006;14(10):271-5. 13. Gu X, Yang X, Wang D, Hua Z, Wu H, Chen H, et al. Comparison and significance of specific and non-specific cellular immu- nity in patients with chronic hepatitis B caused by infection with genotypes B or C of hepatitis B virus. Sci China C Life Sci. 2009;52(8):719-23. 14. Xi-bing G, Xiao-juan., Dong Y, Zhong H, Yue-qin X, Zhong-hua L. Relationship between serum HBV DNA level and HBV-specific, nonspecific cytotoxic T lymphocytes and natural killer cells in patients with chronic hepatitis B. Chin Med J. 2009;122(18): 2129- 32. 15. Onji M, Doi Y, Miyaoka H, Masumoto T, Horiike N, Ohta Y. Serum levels of soluble CD4 and CD8 in patients with chronic viral hep- atitis. Hepatogastroenterology. 1994;41(4):377-9. 16. Jie Q, Qiqiang L, Yanhong F, Yongcheng Z, Shaofeng Z. Changes in peripheral blood lymphocytes in patients with hepatitis B. Pract J Hepatol. 2010;13(3):178-9. 17. Xibing G, Haokun C, Haisu L, Yinfan Z, Hong C, Hao P. [Research on sequential treatment of severe hepatitis with corticosteroids and Qianglining]. Chin J Hepatol. 2001;9(6):342. Hepat Mon. 2011;11(10):810-815