Abstract: Objective To evaluate the effect and significance of plasma exchange on T-Lymphocyte subsets in chronic severe hepatitis patients infected with HBV (CSHB). Methods We recruited 26 cases of CSHB treated with plasma exchange and 47 cases of chronic HBV hepatits (CHB) in this study. The total number and percentage of T-lymphocyte subsets in peripheral blood before and after plasma exchange were detected in CSHB and CHB patients by a FACSCalibur flow cytometer. The differences between CSHB and CHB patients and between recover group and death group in CSHB patients were analyzed. Results Total number of T-lymphocytes and percentage of CD4+ cells were significantly lower, and percentage of CD8+ cells was significantly higher in CSHB patients than in CHB patients (P＜0.01). In CSHB patients, the survival rate in the 3 months after plasma exchange was 53.85% (14/26). In survival CSHB patients after plasma exchange, the total number of T-lymphocytes and percentage of CD4+ cells were significantly higher, and percentage of CD8+ cells was significantly lower than those before the treatment and those in death patients after plasma exchange (P＜0.05 or 0.005). Conclusions The derangement of immune function in CSHB patients can be improved by plasma exchange. The examination of immune function is helpful for the evaluation of prognosis and therapeutic effects in CSHB patients.

Key words: Hepatitis B virus, Plasma exchange, T-lymphocyte subsets