AUTHOR=Li Juan , Hu Chun-Hua , Chen Yi , Zhou Mi-Mi , Gao Zhi-Jie , Fu Meng-Jun , Wang Jing , Li Jian-Zhou , Chen Tian-Yan , Zhao Ying-Ren , He Ying-Li 

TITLE=Characteristics of Peripheral Lymphocyte Subsets in Patients With Acute-On-Chronic Liver Failure Associated With Hepatitis B

JOURNAL=Frontiers in Medicine

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.689865

DOI=10.3389/fmed.2021.689865

ISSN=2296-858X

ABSTRACT=<p><bold>Background and Aims:</bold> Acute-on-chronic liver failure (ACLF) is a rare, but dramatic clinical syndrome. There is substantial evidence suggesting that immunity-mediated inflammation plays an important role in HBV-ACLF. Our aim was to characterize the proportion and cell counts of peripheral blood lymphocyte subsets in acute-on-chronic liver failure patients caused by HBV infection.</p><p><bold>Methods:</bold> One hundred and seventeen patients were enrolled in this study, including those with HBV-related ACLF (HBV-ACLF; <italic>n</italic> = 70), and HBV related non-ACLF patients (HBV non-ACLF; <italic>n</italic> = 47). Demographics, clinical and laboratory data at hospital admission were retrospectively analyzed. The percentage and cell count of peripheral lymphocyte subsets were evaluated by flow cytometry. Comparison analysis was performed by <italic>t</italic>-test or non-parametric Mann–Whitney <italic>U</italic>-test. Actuarial probabilities of death were calculated by the Kaplan-Meier method.</p><p><bold>Results:</bold> Both circulating lymphocyte count and lymphocyte percentage were significantly reduced in patients with HBV-ACLF (<italic>P</italic> &lt; 0.001). The CD8<sup>+</sup> T cell, CD4<sup>+</sup> T cell, and CD16<sup>+</sup>CD56<sup>+</sup> NK cell counts were significantly decreased in HBV-ACLF. Consistently, flow cytometric analysis showed that CD8<sup>+</sup> T cell counts were significantly decreased in non-survivors, while no significant differences were found in CD4<sup>+</sup> T cell, CD19<sup>+</sup> B cell, or CD56<sup>+</sup>CD16<sup>+</sup> NK cell counts. Furthermore, the group with the lower CD8<sup>+</sup> T cell count displayed a significantly higher mortality rate compared with the group with the higher CD8<sup>+</sup> T cell count.</p><p><bold>Conclusions:</bold> The abnormal prevalence of lymphocyte subsets may be important in the pathogenesis of HBV-ACLF. The decrease in CD8<sup>+</sup> T cell counts may be related to poor survival in HBV-ACLF patients.</p>