慢性乙型肝炎患者HBV C、B基因型与特异性细胞毒性T淋巴细胞表面PD-1表达的关系

目的 探讨慢性乙型肝炎（CHB）患者HBV C、B基因型与HBV特异性细胞毒性T淋巴细胞（CTL）表面程序性死亡受体-1（PD-1）表达的关系和意义.方法 共研究CHB患者71例,人白细胞抗原（HLA）-A2阳性,HBV DNA ＞103拷贝/ml,其中C基因型34例（47.89％）,B基因型36例（50.70％）.比较C、B基因型感染者外周血HBV特异性CTL表面PD-1的表达水平、HBV特异性CTL水平、HBV DNA水平、ALT和TBil的水平.结果 CHB C基因型感染者的HBV特异性CTL表面PD-1的表达水平（37.30±3.05％）高于B基因型感染者（26.19±3.06％）,t=15.47,P＜0.001,HBV特异性CTL水平（0.25±0.03％）低于B基因型感染者（0.45±0.13％）,t=21.54,P＜0.001,HBV DNA水平（6.75±0.77lo910拷贝/ml）高于B基因型感染者（4.96±1.12 log10拷贝/ml）,t=7.93,P＜0.001,ALT水平（487.39±87.36IU/L）高于B基因型感染者（235.25±90.91IU/L）,t=12.32,P＜0.001,TBil水平（49.73±6.45）高于B基因型感染者（28.48±5.89％）,t=9.01,P＜0.001.结论 CHB C基因型感染者外周血HBV特异性CTL表面PD-1表达水平高于B基因型感染者,导致C基因型感染者HBV特异性CTL水平低于B基因型感染者,HBV DNA水平高于B基因型感染者,因此,肝功能损害比B基因型感染者重.

Relationship between genotypes HBV C and B with specific cytotoxic T lymphocyte surface PD-1 expression in patients with chronic hepatitis B

Objective To explore relationship between genotypes HBV C and B with HBV specific cytotoxic T lymphocyte （CTL） surface programmed death receptor-1 （PD-1） and its significance in patients with chronic hepatitis B （CHB）.Methods A total of 71 CHB patients were studied,human leukocyte antigen（HLA）-A2 positive,HBV DNA 〉 103 copies/ml,of which 34 cases（47.89%）had genotype C and 36 cases （50.70%） had genotype B.Peripheral blood HBV specific CTL surface PD-1 expression level,HBV specific CTL level,HBV DNA level,ALT and TBil levels of patients infected with genotype C and B were compared.Results HBV specific CTL surface PD-1 expression level of CHB patients infected with genotype C （37.30 ± 3.05%） was higher than that of patients infected with genotype B （26.19 ± 3.06%）,t =15.47,P 〈 0.001,HBV specific CTL level （0.25 ± 0.03%） was lower than that of patients infected with genotype B （0.45 ±0.13%）,t =21.54,P 〈0.001,HBV DNA level （6.75 ±0.77 log10 copies/ml） was higher than that of patients infected with genotype B （4.96 ± 1.12 log10 copies/ml）,t =7.93,P 〈 0.001,ALT level （487.39 ± 87.36IU/L） was higher than that of patients infected with genotype B （235.25 ± 90.911U/L）,t =12.32,P 〈 0.001,TBil level （49.73 ± 6.45） was higher than that of patients infected with genotype B （28.48 ± 5.89%）,t =9.01,P 〈 0.001.Conclusion Peripheral blood HBV specific CTL surface PD-1 expression level of CHB patients infected with genotype C was higher than that of patients infected with genotype B,resulting in lower HBV specific CTL level and higher HBV DNA level of patients infected with genotype C than patients infected with genotype B,so damage to liver functions was more serious than patients infected with genotype B.