Cellular immune responses in the acute exacerbation of hepatitis B e antigen-positive type B chronic hepatitis

The compositions of lymphocytes in peripheral blood and liver biopsies from 29 patients with hepatitis B e antigen-positive type B chronic hepatitis were studied by an indirect peroxidase-labeled antibody method using monoclonal antibodies to surface antigens on pan T cells (Leu-1 +), cytotoxic/suppressor T cells (Leu-2a +), helper/inducer T cells (Leu-3a +), natural killer/killer cells (Leu-7 +), and B cells (Leu-10 +). In the peripheral blood during the acute exacerbation of chronic hepatitis B, the percentage of cytotoxic/suppressor T cells was decreased, and the ratio of helper/inducer to cytotoxic/suppressor cells was elevated corresponding to the peak of serum transaminase. In contrast, in liver biopsies obtained during acute exacerbation, numerous lymphocytes infiltrated sites of liver cell necrosis and were predominantly cytotoxic/suppressor cells. When compared with the liver biopsies obtained about 2 months after the peak of serum transaminase, cytotoxic/suppressor cells were significantly increased in those obtained during the acute exacerbation period. No significant change of the percentage of natural killer/killer cells was observed in either the peripheral blood or the liver during the acute exacerbation. These findings suggest that T cell cytotoxicity plays an important role in the mechanisms of liver cell damage in acute exacerbation of chronic hepatitis B.