Chronic hepatitis B infection alters peripheral immune response in women with reproductive failure

Problem: Does hepatitis B infection affect peripheral blood immune response in women with reproductive failure?
Method of study: Two hundred and twenty-seven women, including 10 HBsAg^{+} HBeAg^{+} , 27 HBsAg^{+} HBeAg^{-} hepatitis sero-positive women, and 190 women without HBV infection, formed the study population. Their peripheral immune responses containing lymphocyte subsets, cytokine production, expression of cell surface markers and intracellular toxicity molecules, and pregnancy outcomes were retrospectively compared.
Results: Comparing with HBsAg^{+} HBeAg^{-} carriers and HBsAg^{-} group, HBsAg^{+} HBeAg^{+} group had lower rates of CD3^{+} CD4^{+} helper T cells (31.7% vs 38.0% and 36.8%, P < 0.05, respectively), but higher frequency of CD19^{+} B cells (17.8% vs 14.0% and 13.2%, P < 0.05 and P < 0.01, respectively). NK cells in HBsAg^{+} HBeAg^{+} patients showed lower cytotoxic activity than that in two other groups (P < 0.05). Comparing with HBsAg^{-} patients, HBsAg^{+} HBeAg^{+} group exhibited decreased expression of the activating receptor NKG2D (56.2% vs 66.1%, P < 0.05), as well as reduced expression of granzyme B (54.8% vs 70.5%, P < 0.05), perforin (49.9% vs 65.0%, P < 0.05), and granulysin (52.0% vs 67.9%, P < 0.01). Generally, a higher clinical pregnancy rate (85.7% vs 56.9%) and higher early miscarriage rate (33.3% vs 20.3%) were noticed in HBsAg^{+} HBeAg^{+} group than HBsAg^{-} group.
Conclusion: Chronic HBV infection alters peripheral immune responses by upregulating B-cell frequency, decreasing CD3^{+} CD4^{+} helper T cells, and decreasing peripheral NK function and toxicity. These may influence pregnancy outcome on HBV-infected patients, and the pathogenesis of HBV infection on pregnancy outcome deserves to be further studied.