Effects of entecavir on peripheral blood lymphocyte profiles in chronic hepatitis B patients with suboptimal responses to adefovir

Summary The aim of the present study was to assess the long‐term impact of entecavir ( ETV ) on T, B and natural killer ( NK ) cell immunity in patients with suboptimal responses to adefovir ( SRA ) chronic hepatitis B ( CHB ). Thirty SRA CHB patients and 20 age‐ and gender‐matched healthy controls ( HC ) completed at least 6 months of ETV treatment. H epatitis B virus ( HBV ) DNA loads, alanine aminotransferase ( ALT ) and aspartate aminotransferase ( AST ) and the frequency of different subsets of T, B and NK cells in individual subjects were measured. There were smaller numbers of CD 3 – CD 56 + and CD 244 + NK cells, CD 3 + CD 8 + T cells and cytokine‐secreting CD 4 + T cells, but greater numbers of CD 3 + CD 4 + , CD 4 + CD 25 + Foxp3 + , CD 4 + CD 25 + CD 127 low T cells and CD 19 + CD 27 + B cells, detected in SRA patients. After switching to ETV monotherapy, the levels of HBV DNA and hepatitis B s antigen, as well as hepatitis B e antigen seropositivity, decreased gradually, accompanied by decreases in ALT and AST levels. Furthermore, the number of NK , CD 8 + and cytokine‐secreting CD 4 + T cells increased, whereas the number of CD 4 + , CD 4 + CD 25 + Foxp3 + , CD 4 + CD 25 + CD 127 low T cells and CD 19 + CD 27 + B cells decreased, in SRA CHB patients. The frequency of CD 4 + interferon‐ γ ‐positive T cells was negatively associated with serum HBV DNA levels. Thus, treatment with ETV inhibits HBV replication, modulates T and NK cell immunity and improves liver function in SRA CHB patients.