Decreases in Activated CD8 + T Cells in Patients with Severe Hepatitis B Are Related to Outcomes

Background Many studies on T helper (Th)1, Th2, T regulatory and Th17 cells have been carried out in acute-on-chronic liver failure (ACLF). However, CD8 + T cell, as a main participant in immune-mediated injuries and defense against microorganisms, has seldom been studied in ACLF. Aims The purpose of this study was to investigate the CD8 + T cell function, and the outcomes of patients with severe hepatitis [SH; serum bilirubin (SB) ≥10 mg/dl and prothrombin activity (PTA) <60 %]. Methods Thirty-six patients with chronic HBV-associated SH were included. Twenty normal chronic hepatitis B (CHB) patients (2 < SB < 10 (mg/dl) and PTA ≥ 60 %) and 28 healthy volunteers were enrolled as control groups. Results Twenty-six patients with SH were diagnosed with ACLF (SB ≥ 10 mg/dl and PTA ≤ 40 %). The non-recovered ACLFs (NR-ACLF) had higher HBV DNA loads than recovered ACLFs (R-ACLF) (6.03 ± 1.79 vs. 4.36 ± 1.61 (log 10 , IU/L)). The NR-ACLFs had the highest neutrophil:lymphocyte ratios (5.10 ± 2.37) (all P < 0.001; a = 0.05). The CHBs had higher perforin + and T CM (CD45RA − CD62L hi CCR7 + ) proportions [31.28 ± 19.51, 5.32 ± 3.57 (%)] compared to R-ACLFs (11.75 ± 15.35, 0.78 ± 0.76 (%); P = 0.004, 0.001, respectively), or NR-ACLFs (11.61 ± 5.79, 1.14 ± 0.67 (%); P = 0.006, 0.003). The non-ACLF SHs had higher CD38 + proportions than R-ACLFs or NR-ACLFs (25.46 ± 8.02 vs. 16.24 ± 7.77 or 16.81 ± 6.30 (%), P = 0.039, 0.023). Conclusions High neutrophil:lymphocyte ratios and a decrease in activated CD8 + T cells may be related to poor outcomes in patients with SH.