Value of lymphocyte subset testing in predicting HBsAg decline in chronic hepatitis B patients receiving antiviral therapy

Objective  To investigate whether there are differences in lymphocyte subsets between chronic hepatitis B (CHB) patients receiving different antiviral treatment regimens, and to determine related predictive factors for HBsAg decline. Methods  A retrospective analysis was performed for 68 treatment-experienced CHB patients who attended the outpatient service in Department of Infectious Diseases, Henan Provincial People's Hospital, from October to December 2019, and according to the antiviral treatment regimen, they were divided into PEG-IFNα treatment group with 10 patients, PEG-IFNα+nucleos(t)ide analogues (NAs) treatment group with 21 patients, and NAs treatment group with 37 patients. Related data were recorded, including demographic features, blood routine, albumin, HBsAg, and measurement of lymphocyte subsets. A one-way analysis of variance was used for comparison of normally distributed continuous data between groups, and the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between groups; the chi-square test was used for comparison of categorical data between groups; the multivariate logistic regression analysis was used to investigate independent influencing factors for HBsAg decline. Results  There were significant differences between the three groups in HBsAg decline (H=8.348, P=0.015), absolute value of lymphocytes (F=4.643, P=0.013), and T lymphocyte count (F=7.721, P=0.001). The multivariate logistic regression analysis showed that sex (odds ratio [OR]=0.227, 95% confidence interval [CI]: 0.059-0.878, P=0.032), age (OR=0.931, 95%CI: 0.868-0.999, P=0.047), antiviral treatment regimen (PEG-IFN-α treatment group vs NAs treatment group: OR=9.600, 95%CI: 1.982-46.498, P=0.005; PEG-IFN-α+NAs treatment group vs NAs treatment group: OR=4.800, 95%CI: 1.336-17.243, P=0.016), and T lymphocyte count (OR=0.804, 95%CI: 0.684-0.944, P=0.008) were independent influencing factors for HBsAg decline. Conclusion  For CHB patients receiving PEG-IFNα alone or in combination with NAs, monitoring of lymphocyte subsets during the treatment process may help to judge HBsAg decline, and the lower the absolute value of T lymphocytes, the greater the possibility of HBsAg decline.