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document
Quantitative monitoring of serum hepatitis B virus DNA and blood lymphocyte subsets during combined prednisolone and interferon-alpha therapy in patients with chronic hepatitis B . Several investigators have reported a significantly reduced CD4/CD8 ratio , as defined by monoclonal antibodies , in the peripheral blood of Caucasian patients with chronic active hepatitis B ( CAHB ) . In Asian patients with chronic hepatitis B , quantitative analyses of subpopulations of peripheral blood lymphocytes have not been able to confirm these findings . In this work , we analysed the frequency of peripheral blood lymphocyte subsets in 10 Chinese patients with histologically proven CAHB and seven healthy Chinese individuals . Four of the 10 CAHB patients received combined prednisolone/interferon-alpha2b ( IFN-alpha2b ) therapy . Peripheral blood samples were consecutively collected for analysis of lymphocyte subpopulations using an indirect immunofluorescence ( IF ) method , and hepatitis B virus ( HBV ) DNA was quantified by a chemiluminescent , molecular-hybridization assay . Peripheral blood mononuclear cells from seven Chinese control individuals comprised 63 +/- 3 % CD3+ cells , of which 41 +/- 4 % were of CD4+ and 23 +/- 2 % of CD8+ subsets . The mean CD4/CD8 ratio in the healthy controls was 1.9 ( 95 % confidence interval = 1.1-2.7 ) . The CD4/CD8 ratios were significantly reduced ( P < 0.01 ) in the 10 patients with chronic hepatitis B , compared with those of the controls , owing to a significant increase in the number of CD8+ cells ( P < 0.005 ) . During the treatment with prednisolone , a significant increase in the CD4/CD8 ratio was observed in all treated patients . This increase was mainly caused by a decrease in the number of CD8+ cells and was accompanied by an increase in serum HBV DNA levels , which peaked during the latter part of the prednisolone cycle . During the treatment with IFN-alpha2b , a second increase in the CD4/CD8 ratio was observed , which was caused by an increase in CD4+ cells . A marked decrease in viral load was observed , during treatment with IFN-alpha2b , in patients with HBV DNA levels below 10 000 pg ml-1 . Our data indicate that the CD4/CD8 ratios in Chinese CAHB patients do not differ from those of Caucasian patients with CAHB , when analysed using similar methods for the enumeration of lymphocyte subsets . Profound effects on cellular distribution and viral replication were noted during the combined prednisolone/IFN-alpha2b therapy . Additional studies of the modulatory effect of the combined therapy on the distribution of lymphocyte subsets and cytokine profiles in relation to the therapeutic outcome of HBV infection are warranted .
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Intervention_Pharmacological
combined prednisolone
2288
Intervention_Pharmacological
interferon-alpha therapy
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Intervention_Pharmacological
combined prednisolone/interferon-alpha2b ( IFN-alpha2b ) therapy
2290
Intervention_Pharmacological
prednisolone
2291
Intervention_Pharmacological
IFN-alpha2b
2292
Outcome_Physical
serum hepatitis B virus DNA
2293
Outcome_Physical
blood lymphocyte subsets
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Outcome_Physical
CD4/CD8 ratio
2295
Outcome_Physical
Peripheral blood samples
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Outcome_Physical
Peripheral blood mononuclear cells
2297
Outcome_Physical
mean CD4/CD8 ratio
2298
Outcome_Physical
CD4/CD8 ratios
2299
Outcome_Physical
number of CD8+ cells
2300
Outcome_Physical
CD4/CD8 ratio
2301
Outcome_Physical
number of CD8+ cells
2302
Outcome_Physical
increase in serum HBV DNA levels
2303
Outcome_Physical
viral load