[Immune status of inactive HBsAg antigen carriers with chronic HBV infection]

Hepatitis B e antigen-negative, normal alanine aminotransferase, low or undetectable HBV DNA, and HBsAg levels below 1 000 IU/ml are characteristics of the immune control stage (IC) in inactive hepatitis B surface antigen (IHC) carriers with chronic hepatitis B virus (HBV) infection. This stage improves the host's innate and adaptive immune responses, thereby reducing the ability for viral evasion. The expression of intrahepatic immune genes and metabolism-related genes, including pattern recognition receptors, antiviral effector factors, and interferon pathways, is upregulated in patients at this stage. The functions of innate immunity are also restored, including those of dendritic cells, natural killer cells, and macrophages during the IC stage, while in adaptive immunity, the exhaustion and partial functional reconstruction of HBV-specific T lymphocytes and B lymphocytes are weakened. These suggest that patients in the IHC stage may become an advantageous population for achieving clinical cure of hepatitis B due to their immunological characteristics, which differ statistically from those of patients in the immune tolerance and immune active stages.