Peripheral T-cell phenotypes in chronic active hepatitis B. Correlation with serum hepatitis B virus (HBV) markers and clinical features.

We have studied peripheral blood T-cell phenotypes using monoclonal antibodies in untreated heterosexual patients with chronic active hepatitis B (CAH-B) to investigate its relationship to HBV serological markers and clinical features. Compared to the controls, CAH-B patients formed three subgroups: one with low, one with normal and a third with high OKT4/OKT8 ratios. The CAH-B patients with an elevated OKT4/OKT8 ratio tended to be symptomatic, have a past history of acute hepatitis, a shorter disease duration and a more severe histological liver disease than patients with a low OKT4/OKT8 ratio. All cases with high OKT4/OKT8 ratio were HBeAg-positive and 88% HBV-DNA-positive by molecular hybridization. In contrast only 10% of the cases with low OKT4/OKT8 ratio were HBeAg-positive and 40% HBV-DNA-positive. Delta-positive cases were only found in the subgroups with low (40%) and normal (25%) ratios. Sequential studies were performed in the 12 HBeAg-positive cases: seroconversion of HBeAg to anti-HBe was observed in 3, all with high OKT4/OKT8 ratios. This study delineates two major subgroups in CAH-B using peripheral T-cell phenotypes. This classification may prove to be useful in the follow-up of patients with CAH-B and in predicting their responsiveness to anti-viral therapy.