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Flow cytometry CD4+/CD8+ ratio of liver‐derived lymphocytes correlates with viral replication in chronic hepatitis B

T lymphocytes have been assumed to play an essential role in tissue injury in patients with chronic hepatitis B. As hepatitis B virus (HBV) is considered as a major factor controlling liver inflammation, we assessed whether a particular T lymphocyte subset could be preferentially detected in the liver in accordance with viral replication. Liver‐derived lymphocytes and peripheral blood lymphocytes were analysed by flow cytometry in 21 patients with histologically confirmed chronic hepatitis B without cirrhosis. Viral replication was quantified by hybridization of serum HBV DNA. Eleven patients exhibited an active viral replication with serum HBV DNA ranging from 10 to 388pg/ml at the time of the liver biopsy, whereas 10 patients had no detectable serum HBV DNA. In patients exhibiting viral replication. CD4+/CD8+ ratios of liver‐derived lymphocytes were significantly higher [P < 005) than those obtained in patients without viral replication. In contrast, the percentage of T cells expressing the γ/δ receptor and that of CD2±/ CD57+ cells were similar in both groups of patients. Furthermore, in patients exhibiting viral replication. CD4+/CD8+ ratios of liver‐derived lymphocytes correlated with serum HBV DNA levels (P<0.0001). No relationship between CD4+ CD8* ratio of liver‐derived and peripheral blood lymphocytes was observed. Our data indicate that, in patients with chronic hepatitis B. the CD4+/CD8+ ratio of liver‐derived lymphocytes correlates with viral replication. This suggests that in situ helper/inducer CD4+ T lymphocytes may positively regulate the cytoxic T cell activity in patients with HBV‐related chronic hepatitis.