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Backgroud  IL-17 +  T helper cells and Foxp3 +  regulatory T cells are CD4 +  T helper cells with reciprocally regulated differentiation and function. Their frequency and function vary in patients with chronic hepatitis B. In this study, we investigated the balance between IL-17 +  T cells and Foxp3 +  regulatory T cells and illustrated their function in the aggravation of chronic hepatitis B (CHB).    Results  Twenty-six patients with chronic HBV -related liver failure (CLF), thirty-one patients with acute on chronic HBV-related liver failure (ACLF) and twelve normal controls were enrolled in our study. The expressions of IL-17, Foxp3, CD4, CD8 and perforin in liver tissue were measured by immunochemistry for the evaluation of liver-infiltrating lymphocytes. The frequency of liver IL-17 +  T cells on liver inflammatory cells and their proportion in the total CD4 +  T cell population increased markedly in the ACLF group, while the frquency of Foxp3 +  T cells and their proportion in the total CD4 +  T cell population did not show a significant difference in the two HBV infection groups. In addition, the ACLF group showed a dramatically higher IL-17 +  /Foxp3 +  ratio than the CLF group. CD4 +  T cells increased significantly in the liver of patients with ACLF, compared with those in the liver of patients with CLF.    Conclusions  Our findings suggest that intrahepatic IL-17 +  T cells play an important role in the development of chronic HBV and that the imbalance between IL-17 +  and Foxp3 +  T cells in the liver may lead to progression of the disease but the mechanism should be further explored.

The balance between intrahepatic IL-17+ T cells and Foxp3+ regulatory T cells plays an important role in HBV-related end-stage liver disease