OBJECTIVE To explore the levels of helper T lymphocytes (Th) in patients with hepatitis B virus (HBV) infection who were treated with entecavir and observe the impact on viral clearance.

METHODS A total of 149 patients with HBV infection who were treated with entecavir in Yan′an Hospital of Kunming City from Jan. 2020 to Jan. 2024 were enrolled in the study, 82 of whom were chronic hepatitis B (CHB), and 67 were chronic hepatitis B virus carriers. The enrolled patients were divided into the clearance group with 64 cases and the no clearance group with 85 cases according to the levels of serum hepatitis B surface antigen (HBsAg) at Week 72 of the treatment. The clinical data were compared between the two groups, and the changes of Th1 and Th2 levels during the treatment were analyzed. Multivariate linear regression analysis was performed for the association between virological change during the treatment and immune level. The risk factors for failed clearance of viruses were analyzed by logistic regression model.

RESULTS There were significant differences in the age, the levels of alanine aminotransferase (ALT) and HBV DNA between the baseline and Week 24, the levels of aspartate transaminase (AST) at the baseline and Week 12, the HBsAg level at Week 24, and the baseline levels of Th1, Th1/Th2 between the CHBc treatment group and the CHB treatment group (P < 0.05). There were linear correlations between the HBV DNA, HBsAg, hepatitis E antigen (HBeAg) and the Th1, Th2 and Th1/Th2, respectively (P < 0.05). Totally 64 patients were accumulatively eradicated with HBsAg on Week 72, with the eradication rate 42.95%. After the confounding factors were adjusted, multivariate analysis showed that the high levels of Th1, Th2 and Th1/Th2 were the risk factors for the failed clearance of viruses (P < 0.05).

CONCLUSIONS Among the patients with HBV infection, there is difference in the immune level between the CHB patients and the CHB virus carriers. The levels of Th1, Th2 and Th1/Th2 are strongly correlated with the HBV DNA, HBsAg, HBeAg and efficiency of viral clearance during the treatment with entecavir.