HBV-specific T-cell function is nonenhanced by tenofovir-induced decline in HBV viremia or HBsAg titer in chronic hepatitis B
Bibliographic record
Abstract
BACKGROUND: Chronic hepatitis B is associated with virus-specific and global T-cell dysfunction. We hypothesized that therapeutic reduction in serum HBV DNA, ALT, and HBsAg would restore HBV-specific T-cell function and modify T-cell regulatory phenotype, with associated posttreatment ALT flare. METHODS: HBV-specific T-cell lymphoproliferative responses and global T-cell phenotype were prospectively examined at baseline, weeks 24, 48, 192, 216, and 240 in 34 adults with immune-active chronic hepatitis B treated with 192 weeks of tenofovir alone (n=21) or combined with pegylated interferon (PegIFN) in the first 24 weeks (n=13). HBV-specific T-cell IFNγ responses at weeks 0, 24, and 48 were examined by ELISpot assay ex vivo in 24 patients. Posttreatment flare was defined by serum ALT >5 times the upper limit of normal. RESULTS: Tenofovir therapy did not promote sustained induction of HBV-specific T-cell proliferative responses, regardless of PegIFN therapy or decreased serum HBsAg, HBV DNA, or ALT levels. Instead, HBV-specific T-cell IFNγ responses declined significantly by 48 weeks of therapy (p=0.008). Posttreatment ALT flare was associated with higher baseline %PD1+/CD8 (p=0.019), %PD1+/CD4 (p=0.039), and %CTLA4+/CD4 (p=0.003) T cells compared to non-flares, but without associated HBsAg loss or increased HBV-specific T-cell responsiveness. CONCLUSION: HBV-specific T-cell function was not restored after 192 weeks of tenofovir therapy and did not correlate with HBsAg levels before, during, or after therapy. Baseline global T-cell regulatory phenotype was a predictor for ALT flare post-therapy without associated HBsAg decline. These findings support the need for more novel immune-modulatory approaches to enhance HBV-specific T-cell responsiveness.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".