探讨干扰素抗病毒疗效与慢性乙型肝炎（CHB）患者外周血CD8⁺T细胞程序性死亡受体1（PD-1）和T细胞免疫球蛋白黏蛋白分子3（Tim3）表达的关系。

以72例HBeAg阳性CHB患者作为研究对象，分别采集干扰素治疗前和治疗12个月的抗凝外周静脉血，同期以30例健康人作为研究对照，用流式细胞技术检测CD8⁺T细胞PD-1和Tim3的表达。

干扰素治疗前，CHB患者外周血CD8⁺T细胞PD-1和Tim3表达的中位百分率分别为35.5%和4.8%，均显著高于健康对照组（29.3%和3.6%），差异均具有统计学意义（U= 805.0、P = 0.043，U= 741.5、P= 0.013）。干扰素治疗12个月时，患者CD8⁺T细胞PD-1和Tim3的表达分别为32.7%和4.1%，较治疗前显著下降，差异具有统计学意义（Z= 3.305、P= 0.001，Z= 2.065、P = 0.039）；在获得HBeAg血清学转换者中，CD8⁺T细胞PD-1和Tim3表达的中位百分率均显著低于无转换者，差异均具有统计学意义（U= 209.0、P <0.001，U = 302.0，P <0.001）；在ALT复常与异常者之间，两项指标的中位百分率差异无统计学意义（U= 229.5、P = 0.635，U= 209.5、P= 0.405）；在HBV DNA载量低于检测下限者中，CD8⁺T细胞PD-1表达的中位百分率显著低于病毒仍可检测的患者（U= 371.5、P= 0.011），而CD8⁺T细胞Tim3的表达两者差异无统计学意义（U= 558.0、P= 0.727）。

CHB患者外周血CD8⁺T细胞PD-1和Tim3呈高表达状态，干扰素治疗可以下调其表达，并且其表达降低与干扰素疗效有关。

To investigate the association of interferon-alpha (IFN-α) antiviral efficacy and the expression of programmed death 1 (PD-1) and T-cell immunoglobulin and mucin domain-containing molecule 3 (Tim3) on peripheral blood CD8⁺T cells in patients with chronic hepatitis B (CHB).

Total of 72 CHB patients with HBeAg positive were collected, and their anti-coagulation peripheral venous blood were collected from each patient at the beginning and the end of 12 months of IFN-α therapy. Thirty cases of healthy individuals were enrolled as controls. PD-1 and Tim3 on CD8⁺T cells were detected by flow cytometry.

Before IFN-α treatment, the median percentage of PD-1 and Tim3 on peripheral blood CD8⁺T cells was 35.5% and 4.8% in CHB, respectively, and both were higher than the corresponding index in healthy control group (29.3% and 3.6%), with significant differences (U = 805.0,P = 0.043;U = 741.5,P= 0.013). At the end of 12 months of IFN-α therapy, the median percentage of PD-1 and Tim3 on CD8⁺T cells was 32.7% and 4.1% in CHB patients, respectively, and significantly decreased than those before treatment (Z= 3.305,P= 0.001;Z= 2.065,P= 0.039). The median percentage of the two molecule expression was significantly lower in patients who achieved HBeAg seroconversion than those of patients without HBeAg seroconversion, with significant differences (U= 209.0,P < 0.001;U= 302.0,P <0.001). The two median percentages were without significant difference between ALT normalization and abnormalization groups (U = 229.5,P = 0.635;U= 209.5,P = 0.405). The median percentage of PD-1 on CD8⁺T cells was significantly lower in patients with HBV DNA undetectable than those with detectable HBV DNA (U= 371.5,P = 0.011), which was not significantly different between the two groups of patients (U = 558.0,P = 0.727).

A higher expression of PD-1 and Tim3 on peripheral blood CD8⁺T cells was presented in CHB patients, which could be downregulated by IFN-α therapy, and the decreased expression was associated with the efficacy of IFN-α treatment.