Alteration in Cellular Immunity after Chronic Hepatitis B Deteriorated into Severe Hepatitis and Its Significance

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 cellmediated immune responses after chb deteriorates into severe hepatic disease and explore the significance of such changes.patients and methods: this study aimed to observe changes in the hbv-specific and -nonspecific cell-mediated immune responses after chb deteriorates into severe hepatic disease 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 admission (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.