Functional characterization of peripheral blood lymphocytes in chronic HBsAg carriers

Increased proportions of suppressor/cytotoxic T cells have been identified in the peripheral blood of chronic HBsAg carriers and to investigate a possible relationship to T cell cytotoxicity against autologous hepatocytes, suppressor cell activity, viral replication and the histological type of disease, 42 consecutive HBsAg carriers undergoing a liver biopsy have been investigated. The proportion of suppressor/cytotoxic lymphocytes directly correlated with T cell cytotoxicity to autologous hepatocytes and both were higher in those with HBeAg in serum than in those with anti-HBe or those on corticosteroid therapy. There was no relationship to underlying histological classification. In contrast, suppressor cell regulation of IgG producing cells was unrelated to the proportion of suppressor/cytotoxic lymphocytes in peripheral blood or HBeAg status, but impaired function was associated with chronic hepatitis, particularly chronic active hepatitis. These data suggest that the increased proportion of suppressor/cytotoxic lymphocytes in the peripheral blood of HBsAg carriers represents an increase in the cytotoxic and not the suppressor cell subset and that this is a consequence of active viral replication and not of the severity of hepatic inflammation. Defective suppressor cell function may be one factor in the development of chronic active hepatitis, but is not reflected by alterations in the T4:T8 ratio.