Abstract:

Objective  To observe changes of T helper 17 (Th17), regulatory T cells (Treg), and  the ratio of Thl7/Treg in peripheral blood of patients with acute hepatitis E (AHE) and hepatitis E virus related liver failure (HEV-LF) patients and explore the clinic significance. Methods  The flow cytometry was used to detect the percentages of Treg and Thl7 cells in peripheral blood of 20 healthy controls (control group), 25 patients with AHE (AHE group), and 14 patients with HEV-LF (HEV-LF group). The percentage of Th17/Treg was calculated and indexes such as TBiL, ALT, AST, and PTA were determined. Results  The percentages of Th17 and Treg cell and Th17/Treg of the HEV-LF group were the highest, followed by those of the AHE group and those of the control group were the lowest. Part of differences were statistically significant (P<0.05). For the HEV-LF group, percentage of Th17 positively correlated with ALT and TBiL (r=0.591, 0.539; P<0.05) and negatively correlated with PTA (r=-0.565; P<0.05), while ratio of Th17/Treg positively correlated with ALT (r=0.777; P<0.05) and negative correlated with PTA (r=-0.653; P<0.05) and no other correlations were found (P>0.05). The increase of the percentage of Th17 cells in peripheral blood of patients of HEV-LF group was the risk factor of prognosis （OR=4.301, P<0.05）. Conclusion  Acute infection of HEV results in different degrees of immune dysfunction of patients with different clinical courses. Th17/Treg and Th17 in peripheral blood correlate with the hepatic inflammation and necrosis. The increase of the percentage of Th17 cells in peripheral blood may be a pathogenesis of severe hepatitis E and can be used as an indicator to assess the prognosis of patients with HEV-LF.

Key words: viral hepatitis E, liver failure, T helper 17, regulatory T cells