T-lymphocyte subpopulations in patients with various courses after hepatitis B virus infection

The course of a hepatitis B virus infection is probably determined by the cellular immune response of the host, which is partly regulated by the T helper and T suppressor cells. We therefore counted immunoregulatory T-cell subsets in the peripheral blood of 97 patients with various courses of hepatitis B virus infection: 23 of these patients were asymptomatic HBsAg carriers without detectable liver disease, 13 had chronic persistent hepatitis B, 19 had chronic active hepatitis B (11 HBeAg, 8 anti-HBe), 7 had chronic active hepatitis with anti-HBs or anti-HBc, and 35 were healthy controls with anti-HBs after recovery from acute hepatitis B. Peripheral blood mononuclear cells were specifically labelled with monoclonal Leu-1 (T cells), Leu-2a (T suppressor/cytotoxic cells), and Leu-3a (T helper cells) antisera and analyzed by flow cytometry. Leu-3a/Leu-2a ratios for patients with persistent virus infection did not differ from those found for patients who cleared the hepatitis virus antigens. There was, however, evidence that the number of T suppressor cells in the subgroup of patients with ongoing chronic active hepatitis and anti-HBe had decreased. These findings suggest that elimination of hepatitis B virus is unlikely to be related to the relative number of peripheral T-cell subsets. The few patients who develop chronic active hepatitis after partial clearance of the virus probably have an enhanced immunoreactivity compared with those with the commoner courses of this disease.