HBV Core-specific CD4+T cells correlate with sustained viral control upon off-treatment in HBeAg-positive chronic hepatitis B patients

Authors：Wen, Chunhua; Zhou, Yang; Zhou, Yongjun; Wang, Yiyue; Dong, Zheyu; Gu, Shuqin; Wang, Weibin; Guo, Ling; Jin, Zihan; Zhong, Shihong^*; Tang, Libo^*; Li, Yongyin^*

Source：Antiviral Research, 2023, 213: 105585.

DOI：10.1016/j.antiviral.2023.105585

• chronic HBV infection
• Core
• CD4+T cells
• NA withdrawal
• viral control

Background & aims: Treatment with nucleos(t)ide analogue (NA) efficiently suppresses viral replication in pa-tients with chronic HBV infection, yet HBV relapses frequently upon NA withdrawal; the detailed immuno-modulatory compounds for sustained viral control of HBV upon NA interruption have yet to be fully clarified. This study aimed to elucidate the role of T cells specific for distinct HBV peptides in sustained response upon discontinuation of antiviral treatment. Methods: A total of 48 patients with HBeAg-positive chronic hepatitis B receiving NA treatment and withdrawal were included longitudinally in a retrospective and prospective cohort. Enzyme-linked immunosorbent spot (ELISpot) and intracellular cytokine staining (ICS) assays were performed to detect IFN-gamma producing HBV-specific T cells following stimulation with overlapping peptides covering the whole HBV genome after 10 days of in vitro expansion. Results: ICS assays revealed that T cells specific for HBV Core and Polymerase induced more robust IFN-gamma re-sponses compared to Envelope and HBx. Notably, at the time of NA discontinuation, the intensity and breadth of HBV Core peptides-induced responses, predominately targeted by CD4+ T cells but not CD8+ T cells, were associated with sustained viral control upon off-treatment. Further exploration of longitudinal features in pa-tients with sustained viral control revealed that the breadth of HBV-specific T cell responses does not increase following treatment cessation. Conclusion: This report emphasizes the essential role of HBV Core-specific CD4+ T cells in sustained response after therapy withdrawal, indicating it is a potential candidate for immunotherapeutic approaches in chronic HBV patients.

• Institution
  北京大学; 南方医科大学