To investigate the changes in B cell immune responses following the discontinuation of nucleos(t)ide analogue (NA) therapy in patients with chronic hepatitis B (CHB).
Approach:
Patient Selection: 21 patients with HBeAg-negative CHB who had complete virological control for at least 3 years under NA therapy were included.
Study Design: Patients underwent liver biopsy before treatment withdrawal and had serum samples and PBMCs collected at baseline, 12 weeks, and 48 weeks after NA discontinuation.
Comparative Analysis: The study compared the frequencies and phenotypes of HBc and HBs-specific memory B cells (MBC) and activated circulating T follicular helper cells.
Key Findings:
Prolonged NA therapy equalizes frequencies of class-switched MBC specific for HBc and HBs.
PD-1 expression on HBs-MBC is reduced only after treatment withdrawal, with sustained reductions seen in those achieving HBsAg loss.
Increased activated MBC, plasmablasts, and functional potential of HBs-MBC are observed in patients with HBsAg loss.
Interpretation:
Limitations:
Small sample size of 21 patients may limit the generalizability of the findings.
The study only includes patients with HBeAg-negative CHB, which may not represent all CHB patients.
by Sabela Lens, Alice R Burton, Jessica Davies, Maelle Locatelli, Mireia García-López, Anna Pocurull, Anna Jeffery-Smith, Nikolai Novikov, Simon P Fletcher, Xavier Forns, Sofía Pérez-del-Pulgar, Mala K Maini
