Difference in T helper responses during hepatitis flares in hepatitis B e antigen (HBeAg)-positive patients with genotypes B and C: implication for early HBeAg seroconversion

The underlying mechanisms for earlier hepatitis B e antigen (HBeAg) seroconversion in patients with chronic hepatitis B virus (HBV) genotype B when compared with genotype C are unknown. We aimed to determine whether there were any differences in the T helper (Th) responses during hepatitis flares in HBeAg‐positive patients with genotypes B and C. Proliferative response measured by 3H‐thymidine uptake and Th responses measured by Enzyme‐Linked Immunosorbent Spot assays for interleukin (IL)‐2, interferon‐gamma (IFN‐γ), IL‐4, IL‐5 and IL‐10 were performed in 10 patients with genotype B and 10 with genotype C with hepatitis flares. HBV genotypes, core promoter, precore mutations, sequence of HBV core region and HBV DNA levels were determined. There was no difference in the HBV DNA levels during hepatitis flares between patients with genotypes B and C. Patients with genotype B had a significantly higher number of IFN‐γ producing cells [with hepatitis B core antigen (HBcAg) stimulation] and lower number of IL‐10 producing cells (with HBcAg and HBeAg stimulation) compared with patients with genotype C (P = 0.011, =0.043,