Change in peripheral blood CD4~+ regulatory T cells and its association with antiviral effect in patients with chronic hepatitis C

Objective To investigate the change in peripheral blood CD4~+regulatory T( Treg) cells and its association with antiviral effect in patients with chronic hepatitis C( CHC). Methods A total of 85 CHC patients who completed standard antiviral therapy and follow- up in The First People's Hospital of Tianmen from January 2013 to January 2016 were enrolled as CHC group,and 40 healthy volunteers were enrolled as control group. Flow cytometry was used to measure peripheral blood CD4~+Treg cells,and the serum levels of HCV RNA,aspartate aminotransferase( AST),and alanine aminotransferase( ALT) were measured before treatment,at 12 and 48 weeks of treatment,and at24 weeks of follow- up. The t- test was used for comparison of continuous data between groups. Results Before treatment,the CHC group had significantly higher levels of HCV RNA,AST,ALT,and CD4~+Treg cells than the control group( all P < 0. 001). At 12 weeks of treatment,of all patients in the CHC group,36( 42. 35%) achieved early virological response( EVR)( EVR group) and 49( 57. 65%) did not achieve EVR( no- EVR group); the EVR group had significant reductions in the levels of HCV RNA and CD4~+Treg cells after treatment( t = 39. 241 and 8. 763,both P < 0. 001),and there were significant differences in the levels of HCV RNA and CD4~+Treg cells between the two groups( t = 76. 520 and 8. 227,both P < 0. 001). At 48 weeks of treatment,of all patients in the CHC group,49( 57. 65%)achieved end- of- treatment response( ETR)( ETR group) and 36( 42. 35%) did not achieve ETR( no- ETR group); the ETR group had significant reductions in the levels of AST,ALT,CD4~+Treg cells,and HCV RNA at 48 weeks of treatment( t = 46. 197,11. 806,15.368,and 9. 694,all P < 0. 001) and had significantly lower levels than the no- ETR group( t = 72. 612,9. 274,9. 682,and 7. 729,all P< 0. 001). At 24 weeks of follow- up,of all patients in the CHC group,39( 45. 88%) achieved sustained virological response( SVR)( SVR group),among whom 30 achieved EVR and 32 achieved ETR,and 46( 54. 12%) did not achieve SVR( no- SVR group); at 48 weeks of treatment and 24 weeks of follow- up,the SVR group had significantly lower levels of HCV RNA,AST,ALT,and CD4~+Treg cells than the no- SVR group( at 48 weeks of treatment: t = 117. 564,17. 113,10. 564,and 4. 452,all P < 0. 001; at 24 weeks of follow- up: t = 11. 196,20. 997,13. 384,and 7. 900,all P < 0. 001). Conclusion CHC patients have an increase in peripheral blood CD4~+Treg cells and antiviral therapy can effectively reduce the level of CD4~+Treg cells and alleviate liver injury. Measurement of peripheral blood CD4~+Treg cells can be used as an assessment index for the development of CHC and the effect of antiviral therapy.