Background and Aims. The involvement of cellular immunity in the development of hepatitis E virus (HEV) infection is rare. We aimed to study the roles of viral load and Th cell responses in acute hepatitis E (AHE) and HEV-related acute liver failure (HEV-ALF). Methods. We evaluated viral load and Th1/Th2 cytokine levels in 34 patients with HEV infection, including 17 each with AHE or HEV-ALF. Seventeen healthy controls (HCs) were also included who were negative for anti-HEV IgM and IgG. Results. There was no significant difference in viral load and HEV RNA in the AHE and HEV-ALF groups (both ). The Th lymphocyte levels (CD3+, CD4+) in the AHE and HEV-ALF groups were significantly higher than those in the HC group (both ), but there was no significant difference between the AHE and HEV-ALF groups (). Both IFN-γ and IL-10 showed gradual upward trend from the HC group to the AHE (both ), but IFN-γ showed a sharp downward trend from the AHE group to the HEV-ALF group () and IL-4 showed gradual upward trend from the AHE group to the HEV-ALF group ().There was no significant difference in Th1 and Th2 cytokines between the HEV RNA(+) group and HEV RNA(-) group (all ). Th2 bias was observed from the AHE () to HEV-ALF () groups. The level of IFN-γ was associated with the outcome of HEV-ALF patients. Conclusions. HEV viral load was not associated with aggravation of AHE, and the HEV-ALF patients showed significant Th2 bias, which may be involved in the aggravation of AHE.

中文翻译：

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急性戊型肝炎和相关急性肝衰竭中的 Th1/Th2 细胞和相关细胞因子

背景和目标。细胞免疫参与戊型肝炎病毒 (HEV) 感染的发展是罕见的。我们旨在研究病毒载量和 Th 细胞反应在急性戊型肝炎 (AHE) 和 HEV 相关急性肝衰竭 (HEV-ALF) 中的作用。方法。我们评估了 34 名 HEV 感染患者的病毒载量和 Th1/Th2 细胞因子水平，其中包括 AHE 或 HEV-ALF 各 17 名。还包括 17 名抗 HEV IgM 和 IgG 阴性的健康对照 (HC)。结果。AHE 和 HEV-ALF 组的病毒载量和 HEV RNA 没有显着差异（均）。AHE 和 HEV-ALF 组的 Th 淋巴细胞水平（CD3+、CD4+）显着高于 HC 组（均)，但 AHE 和 HEV-ALF 组之间没有显着差异 (）。IFN- γ和 IL-10 均呈现从 HC 组到 AHE 逐渐上升的趋势（均)，但 IFN- γ从 AHE 组到 HEV-ALF 组呈急剧下降趋势 ()和 IL-4 从 AHE 组到 HEV-ALF 组呈逐渐上升趋势 (）。HEV RNA(+) 组和 HEV RNA(-) 组之间 Th1 和 Th2 细胞因子没有显着差异（所有）。从 AHE 观察到 Th2 偏差（)到 HEV-ALF ()组。IFN- γ水平与 HEV-ALF 患者的预后相关。结论。HEV病毒载量与AHE的加重无关，HEV-ALF患者表现出明显的Th2偏倚，这可能与AHE的加重有关。