The effect of hepatitis B virus on T lymphocyte and its subsets in chronic hepatitis B patients in different ALT stages: A new concept ALT in HBV infection

The characteristics of peripheral blood lymphocyte main subsets in rheumatoid arthritis patients concurrent with hepatitis b virus infection: a retrospective cohort study

OBJECTIVE

The distribution of peripheral blood lymphocytes may change due to the influence of diseases. This study aims to investigate the impact of Hepatitis B virus (HBV) infection on the distribution of peripheral blood lymphocyte subsets in patients with Rheumatoid Arthritis (RA).

METHODS

Two hundred ninety-eight patients were recruited from a retrospective cohort of patients with RA. Patients with RA (n = 43) who had hepatitis B surface antigen (HBsAg) positivity in the serum were categorized into the HBV group (HBV-RA group), while 255 RA patients without HBsAg positivity were assigned to the control group. The patients in the HBV-RA group were further divided into two subgroups based on their levels of HBV DNA: those with levels below the lower limit of quantification (< 20 IU/ml) formed the HBV DNAlow group, while those with levels above or equal to this limit (≥ 20 IU/ml) constituted the HBV DNAhigh group. Demographic, clinical and laboratory data were also collected.

RESULTS

Compared with those of the control group, a higher proportion of CD19+ B cells and CD8+ T cells and a lower CD4+/CD8+ ratio were observed in the HBV-RA group (all P < 0.05). The same trend was observed in the HBV DNAhigh group compared to the HBV DNAlow group (all P < 0.05). Additionally, based on multivariable logistic regression analysis, the male gender, DAS-28 ≥ 2.6, a high proportion of CD19 + B and CD8 + T cells, and the elevated levels of rheumatoid factor (RF) were found to be significantly associated with RA concurrent with HBV infection (all P < 0.05). In the HBV-RA group, a correlation analysis was conducted revealing a positive association between CD19 + B cells and DAS-28 score, as well as CD8 + T cells and DAS-28 score. There was no statistically significant difference in CD4/CD8 ratio between different DAS-28 groups, however the study revealed a significant negative association between the ratio of CD4 +/CD8 + and the DAS-28 score.

CONCLUSION

The high proportion of CD19 + B and CD8 + T cells were closely associated with RA concurrent with HBV infection.

A novel strategy against hepatitis B virus: Glycyrrhetnic acid conjugated multi-component synergistic nano-drug delivery system for targeted therapy

It is well known that Glycyrrhetnic acid (GA) has significant liver-targeting and anti-inflammatory effects. Syringopicroside (SYR) and Hydroxytyrosol (HT), the active components of the Chinese herb Syringa oblata Lindl, have earned great reputation for their potential in preventing or treating viral hepatitis type B. Therefore, we loaded SYR and HT into GA-conjugated PEG-PLGA, so that they could target the liver in additional to exerting their own pharmacological effects in a synergistic. However, the in vivo targeting and the low bioavailability of SYR and HT pose a huge challenge. Therefore, we synthesized GA-conjugated multi-component nano-drug delivery system (SH-GPP). SH-GPP had a regular spherical shape with a uniform size distribution of 110.5 ± 3.18 nm. We further evaluated the effects of SH-GPP in vitro and in vivo. In the in vivo experiment, we evaluated the following parameters: the serum ALT and AST values; liver tissue homogenate MDA and SOD; HE staining of the pathological liver sections; and the liver coefficient. In the in vitro studies, the following parameters were evaluated: cellular uptake of SH-GPP; wound healing/scratch assay; cellular apoptosis; cell cycle; HBsAg; and HBeAg content. SH-GPP had better anti-hepatitis B effect than Syringopicroside and hydroxytyrosol (SH) and NPP alone. The targeting ability of GA enabled HT and SYR in GPP to reach the liver accurately, and played a synergistic role to maximize their therapeutic effects. This study provides a novel strategy against hepatitis B virus, and also provides a feasible scheme for improving the low bioavailability of the active components of traditional Chinese medicine.

Safety and antibody response to inactivated COVID-19 vaccine in patients with chronic hepatitis B virus infection

BACKGROUND AND AIMS

The safety and antibody responses of coronavirus disease 2019 (COVID-19) vaccination in patients with chronic hepatitis B (CHB) virus infection is still unclear, and exploration in safety and antibody responses of COVID-19 vaccination in CHB patients is significant in clinical practice.

METHODS

362 adult CHB patients and 87 healthy controls at an interval of at least 21 days after a full-course vaccination (21-105 days) were enrolled. Adverse events (AEs) were collected by questionnaire. The antibody profiles at 1, 2 and 3 months were elucidated by determination of anti-spike IgG, anti-receptor-binding domain (RBD) IgG, and RBD-angiotensin-converting enzyme 2 blocking antibody. SARS-CoV-2 specific B cells were also analysed.

RESULTS

All AEs were mild and self-limiting, and the incidence was similar between CHB patients and controls. Seropositivity rates of three antibodies were similar between CHB patients and healthy controls at 1, 2 and 3 months, but CHB patients had lower titers of three antibodies at 1 month. Compared to healthy controls, HBeAg-positive CHB patients had higher titers of three antibodies at 3 months (all P < .05) and a slower decline in antibody titers. Frequency of RBD-specific B cells was positively correlated with titers of anti-RBD IgG (OR = 1.067, P = .004), while liver cirrhosis, antiviral treatment, levels of HBV DNA, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) and total bilirubin (TB) were not correlated with titers of anti-RBD IgG.

CONCLUSIONS

Inactivated COVID-19 vaccines were well tolerated, and induced effective antibody response against SARS-CoV-2 in CHB patients.

Cytokines and Chemokines in HBV Infection

Chronic hepatitis B virus (HBV) infection remains a leading cause of hepatic inflammation and damage. The pathogenesis of chronic hepatitis B (CHB) infection is predominantly mediated by persistent intrahepatic immunopathology. With the characterization of unique anatomical and immunological structure, the liver is also deemed an immunological organ, which gives rise to massive cytokines and chemokines under pathogenesis conditions, having significant implications for the progression of HBV infection. The intrahepatic innate immune system is responsible for the formidable source of cytokines and chemokines, with the latter also derived from hepatic parenchymal cells. In addition, systemic cytokines and chemokines are disturbed along with the disease course. Since HBV is a stealth virus, persistent exposure to HBV-related antigens confers to immune exhaustion, whereby regulatory cells are recruited by intrahepatic chemokines and cytokines, including interleukin-10 and transforming growth factor β, are involved in such series of causal events. Although the considerable value of two types of available approved treatment, interferons and nucleos(t)ide analogues, effectively suppress HBV replication, neither of them is sufficient for optimal restoration of the immunological attrition state to win the battle of the functional or virological cure of CHB infection. Notably, cytokines and chemokines play a crucial role in regulating the immune response. They exert effects by directly acting on HBV or indirectly manipulating target immune cells. As such, specific cytokines and chemokines, with a potential possibility to serve as novel immunological interventions, combined with those that target the virus itself, seem to be promising prospects in curative CHB infection. Here, we systematically review the recent literature that elucidates cytokine and chemokine-mediated pathogenesis and immune exhaustion of HBV infection and their dynamics triggered by current mainstream anti-HBV therapy. The predictive value of disease progression or control and the immunotherapies target of specific major cytokines and chemokines in CHB infection will also be delineated.