Objective To evaluate the function of peripheral blood hepatitis B virus(HBV)-specific CD8 +T cells from patients with chronic hepatitis B(CHB),and assess its relationship with clinical relative parameters.Methods The HBV-specific CD8 +T cells were detected by staining of major histocompatibility complex (MHC)-peptide tetramers in patients with CHB.The HBV-specific CD8 +T cells were analyzed for cytokine secretion ability.The relationship of HBV-specific CD8 +T cells with clinical biochemical and viral indices was analyzed.Results A total of 9 of 35 patients with human leukocyte antigen (HLA )-A02 genotype or A24 genotype had HBV-specific CD8 + T cells recognized by tetramers in peripheral blood.The HBV-specific CD8 +T cells expressed significantly lower interleukin 2 (IL-2)and interferon gamma (IFN-γ)than their counterpart CD8 +T cells.The patients who can be found HBV-specific CD8 +T cells had higher level of alanine aminotransferase(ALT)and lower HBV DNA load than those without HBV-specific CD8 +T cells.Conclusions Persistent stimulation of HBV antigen is one of the causes of HBV-specific CD8 +T cell dysfunction in patients with CHB.The patients who can be found HBV-specific CD8 +T cells in peripheral blood could have strong anti-virus immunity.%目的：评价慢性乙型肝炎（CHB）患者外周血抗原特异性CD8＋T细胞的功能及与临床相关指标的关系。方法采用主要组织相容性复合物（MHC ）-抗原肽四聚体标记技术检测CHB患者外周血乙型肝炎病毒（HBV）抗原特异性CD8＋T细胞，并对其细胞因子分泌能力进行检测，分析其与临床生化和病毒学指标的关系。结果35例人类白细胞相关抗原（HLA）-A基因型为A02或A24的患者中有9例患者至少检出1种被四聚体识别的HBV抗原特异性CD8＋T细胞，其白细胞介素2（IL-2）和γ干扰素（IFN-γ）的分泌能力明显低于其自身的外周血总CD8＋T细胞。检出抗原特异性CD8＋T细胞患者的血清丙氨酸氨基转移酶（ALT）水平明显高于阴性患者，而HBV DNA水平低于阴性患者。结论 CHB患者外周血抗原特异性CD8＋T细胞存在明显的功能缺陷，可能因病毒抗原持续刺激造成功能耗竭，但外周血出现抗原特异性CD8＋T细胞仍表明患者体内出现较强抗病毒免疫反应。
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