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However, the immune mechanism of this therapy is unclear. Forty NA-experienced CHB patients were enrolled into this study. The frequencies of peripheral blood natural killer (NK) cells, dendritic cells (DCs), CD4+ T cells, CD8+ T cells, T helper (Th) cells, regulatory T cells (Treg), B cells and follicular T helper (Tfh) cells were evaluated by flow cytometry. Seven of the 40 patients converted to peg-IFN-\u03b1 combined with NA treatment, while the other 33 continued to NA therapy. The decrease in HBsAg was more pronounced in the combination treatment group, and only patients receiving combination treatment achieved HBsAg loss. The frequency and absolute number of CD56bright NK cells in the combination treatment group increased significantly compared with the NA treatment group, whereas the CD56dim NK cells were decreased. In the NA treatment group, the proportions of CD4+ TN, CD8+ TN, CD19+ B and cytotoxic T lymphocyte antigen-4 (CTLA-4)+CD4+ T cells were increased, while the proportions of CD4+ TEM, CD8+ TEM, CD25+CD4+ Treg, CD25highCD4+ Treg, CD127lowCD25+ Treg, programmed cell death 1 (PD-1)+CD4+ T, PD-1+CD8+ T, CTLA-4+CD8+ T, CCR4+CD25+ Treg and CCR4+CD25high Treg cells were decreased after therapy. For NA-experienced CHB patients who achieved low HBsAg levels, combination treatment is more likely to result in HBsAg decline and HBsAg clearance by increasing the activity of CD56brightNK cells.<\/jats:p>","DOI":"10.1111\/cei.13486","type":"journal-article","created":{"date-parts":[[2020,7,8]],"date-time":"2020-07-08T00:20:17Z","timestamp":1594167617000},"page":"80-92","source":"Crossref","is-referenced-by-count":23,"title":["Combination of pegylated interferon-alpha and nucleos(t)ide analogue treatment enhances the activity of natural killer cells in nucleos(t)ide analogue experienced chronic hepatitis B patients"],"prefix":"10.1093","volume":"202","author":[{"given":"X","family":"Pang","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Institute for Viral Hepatitis, The Key Laboratory of Molecular Biology for Infectious Diseases, Chinese Ministry of Education, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 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Infectious Diseases, Chinese Ministry of Education, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Z","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Institute for Viral Hepatitis, The Key Laboratory of Molecular Biology for Infectious Diseases, Chinese Ministry of Education, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Institute for Viral Hepatitis, The Key Laboratory of Molecular Biology for Infectious Diseases, Chinese Ministry of Education, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Institute for Viral Hepatitis, The Key Laboratory of Molecular Biology for Infectious Diseases, Chinese Ministry of Education, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Institute for Viral Hepatitis, The Key Laboratory of Molecular Biology for Infectious Diseases, Chinese Ministry of Education, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Institute for Viral Hepatitis, The Key Laboratory of Molecular Biology for Infectious Diseases, Chinese Ministry of Education, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8481-0841","authenticated-orcid":false,"given":"P","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Institute for Viral Hepatitis, The Key Laboratory of Molecular Biology for Infectious Diseases, Chinese Ministry of Education, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,7,24]]},"reference":[{"key":"2021121023213159400_cei13486-bib-0001","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1016\/j.jhep.2015.03.013","article-title":"Slow decline of hepatitis B burden in general population: results from a population-based survey and longitudinal follow-up study in 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