Peripheral T Lymphocytes Predict the Severity and Prognosis in Patients with HBV-Related Acute-On-Chronic Liver Failure

Abstract Background Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is a life-threatening syndrome with high mortality. Biomarkers are urgently needed to predict the prognosis of HBV-ACLF. Recent evidence suggests a key role for immune system in the pathology of HBV-ACLF. Here, we analyzed the correlation between peripheral blood T lymphocytes and the severity and prognosis in HBV-ACLF patients.Methods Sixty-six patients with HBV-ACLF received conventional medical treatments for four weeks. Twenty-three healthy subjects and 23 HBV patients were enrolled for comparison. We determined white blood cell count, lymphocytes, CD3+, CD4+ and CD8+ T cells, and CD4+CD25+ Treg cells in the blood of all subjects. Their associations with laboratory parameters before or after treatments were statistically analyzed.Results The results showed that compare normal subjects and chronic hepatitis B patients, HBV-ACLF patients had significantly increased white blood count, CD4+ T cells and decreased lymphocytes, CD3+ T cells and Treg cells. Correlation analysis showed that white blood cell, lymphocytes and peripheral T lymphocytes were correlated with PTA and MELD scores. After treatment, white blood cell, lymphocytes, and peripheral T lymphocytes were also correlated with PTA and MELD scores. Additionally, TBIL, ALT, INR, MELD and white blood cell count were potential prognostic criteria for HBV-ACLF patients. In conclusion, HBV-ACLF patients had depletion and dysfunction of immune system. Changes of peripheral T lymphocytes were closely related to the pathogenesis and prognosis of disease.Conclusions Our results may contribute to predict the severity of HBV-ACLF, and provide a prognosis response to improve the treatment of HBV-ACLF.