Differences and clinical significance of liver - kidney function parameters, inflammatory markers and peripheral blood T lymphocyte subsets in patients with HBV - related acute - on - chronic liver failure.

Objective: The study aimed to explore the changes and clinical significance of hepatic-renal functions, inflammatory markers, and peripheral blood T lymphocyte subsets in patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF).

Methods: 80 HBV treated in First Hospital of Shanxi Medical University from November 2020 to May 2023 were selected as the objects of study, and divided into observation group (n = 40) and control group (n = 40) based on whether ACLF occurred. The liver and kidney function parameters, inflammatory factors, and peripheral blood T lymphocyte subsets (CD3 + and CD4 + T-cell percentages) were detected in both groups, and the associations of HBV-DNA load with the changes in the liver cirrhosis index hyaluronic acid (HA), AST, BUN, high-sensitivity C-reactive protein (hs-CRP), and peripheral blood T lymphocyte index cluster of CD3⁺ percentage were analyzed.

Results: HBV-DNA load was significantly higher in the observation group than in the control group, HA and procollagen type III (PCIII) levels were higher, as were ALT, AST, TBIL, BUN, Cr, hs-CRP, and TNF-α levels, and the CD4 + and CD3 + percentages were lower in the observation group than in the control group. The amount of HBV-DNA was positively connected with the changes in HA, AST, BUN and hs-CRP, but negatively associated with the changes in CD3⁺ percentage. The increases in the HBV-DNA load, liver cirrhosis indexes, hepatic function indexes, renal function indexes and inflammatory factors were independent risk factors, while the increase in the peripheral blood T lymphocyte percentage was the safeguarding element for the pathogenesis of HBV-ACLF.

Conclusion: The risk of ACLF becomes higher in hepatitis B patients with the increase in HBV-DNA load and the inflammatory reaction of the body, and the decline in immune function of T lymphocytes.