T-Cells Expression in HBV Infected Subjects in Port Harcourt, Rivers State, Nigeria

Hepatitis B virus infection is a potential life-threatening liver infection caused by hepatitis B virus capable of causing chronic infection and puts people at high risk of death from cirrhosis and liver cancer. This study was a comparative cross sectional study carried out on 260 hepatitis B patients and blood donors attending hepatitis B clinics and blood banks in Rivers State University Teaching Hospital, Military Hospital, and University of Port Harcourt Teaching Hospital. The aim of this study was to evaluate T-Cells expression in HBV Infected Subjects in Port Harcourt, Rivers state, Nigeria. HBV 5-parameter (panel) Rapid Test kit was used to assess HBV serological markers; BD Fascount automated machine was used in determining CD4, CD8, CD3, and CD4/CD8 ratio. SOP, GLP, External/Internal Quality Control were used accordingly and Quality Assurance ensued. All statistical tests conducted were 2-tailed, and probability value of < 0.05 was used as the threshold for declaring statistical significance. Data management and statistical analyses were conducted using Statistical Analyses System SAS 9.4 (SAS Institute, Cary, North Carolina, USA). 84.2% participants were males, 15.8% females aged between 19 and 65 years, Mean ±SD age 30.57±9.70. Participants from 20 states, South-South, South-East, and other Geo-political Zones of Nigeria, resident in the cosmopolitan city of Port Harcourt were recruited for the study. Result obtained showed serological markers among test subjects as 77.3% HBsAg, 43.97% HBsAb, 48.94% HBcAg, 36.17% HBcAb, and 46.81% HBeAg. The serological markers were grouped into four (4) categories based on HBsAg positivity: (i) HBV positive 1 – ‘Occult HBV prior to treatment’ (naïve previously unknown HBV: HBsAg -ve, other HBV markers +ve) 7.8% positive, [n=11]; (ii) HBV positive 2 (HBsAg +ve, other HBV markers +ve) 73.76% positive, [n=104]; (iii) HBV positive 3 – ‘chronic or post treatment occult HBV’ (known HBV case now occult’: HBsAg -ve, other markers +ve) 14.18% positive, [n=20]; (iv) HBV positive 4 (HBsAg +ve, other markers -ve) 4.26% positive, [n=6]. CD3 and CD8 were significantly decreased in HBV infected subjects compared to healthy controls. CD4/CD8 ratio was significantly increased in HBV infected subjects compared to control group. CD4 count was decreased in HBV infected subjects than in healthy control though it was not statistically significant. CD3 and CD8 were significantly decreased (p<0.0207 and P<0.0041 respectively), in HBV positive subjects who were HBsAg negative but positive for other HBV serological markers, (HBV positive 3), when test subjects were compared by HBV panel assay. CD3 and CD4 showed very strong positive correlation (p<0.0001) among test subjects. CD8 and CD4, DC8 and CD3 also showed strong positive correlations (p=0.0070 and p<0.0001 respectively); CD4/CD8 ratio showed strong positive correlation with CD4, (p=0.0002). CD4, CD3, CD8, and CD4/CD8 ratio showed no statistically significant difference when compared by demographic indices including sex partner(s), marital status, and age group. CD4, CD3, CD8, and CD4/CD8 ratio may serve as prognostic markers in HBV infected subjects. Regular evaluation of these markers in HBV patients is advocated as it could be helpful for improved patient care/management. Periodic screening of some target population for HBV infection is recommended for our environment to check spread. Cost of diagnostic assays and treatment should be subsidized by government and capable cooperate organizations to help patients access regular and comprehensive health care.