Immune status and autoantibody formation in children with chronic hepatitis B infection.

ABSTRACT

BACKGROUND: The hepatitis B virus (HBV) causes a wide spectrum of disease which ranges from acute hepatitis to liver cirrhosis. Patients who fail to mount a vigorous immune response in acute HBV develop chronic infection. Therefore, the aim of the study was to determine the cellular and humoral immune parameters of the patients with chronic HBV and to evaluate the prevalence of autoantibodies before the beginning of immunomodulator and antiviral therapy. METHODS: In this comparative study, serum immunoglobulins, IgG subclasses, secretory IgA, serum complement components, lymphocyte subsets and CD11a, CD18, CD54 molecules on lymphocytes were determined in 44 hospitalized patients of chronic HBV infection and 20 cases of healthy control subjects. RESULTS: Significant increase in IgG and significant decrease in the complement C4 were observed. The mean percentage of CD3+ lymphocytes, reflecting the percentage of total T cells was significantly higher in the patient group due to the increase of CD8+ lymphocytes. The mean percentage of CD19+ B lymphocytes was lower in the patient group secondary to the increase of their total T cells. No significant difference was found in cell surface adhesion molecules between patient and control groups. The percentage of antinuclear antibody positivity was 18.2%. CONCLUSIONS: Our data show that ANA formation is part of the natural course of chronic HBV infection and this value may reflect the tendency to autoimmune diseases and the importance of clinical follow-up. The abnormalities observed in immunological parameters may reflect the role of the cellular and humoral immune system in pathogenesis.