{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T23:43:37Z","timestamp":1790898217979,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,9,9]],"date-time":"2024-09-09T00:00:00Z","timestamp":1725840000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003803","name":"University of Hong Kong","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003803","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001692","name":"Croucher Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001692","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100018831","name":"Lo Ying Shek Chi Wai Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100018831","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Viral Hepatitis"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Cigarette smoking is associated with worse clinical outcomes in patients with chronic hepatitis B (CHB) infection, but the effects on hepatitis B surface antigen (HBsAg) seroclearance are unclear. This study aimed to investigate the effect of active smoking on HBsAg seroclearance (SC) and its impact on peripheral blood lymphocytes in patients with CHB infection. Longitudinal follow\u2010up data was retrieved in 7833 antiviral\u2010treated CHB subjects identified from a centralised electronic patient record database (Part 1). Phenotypic analysis of peripheral blood mononuclear cells (PBMCs) from 27 CHB\u2010infected patients (6 active smokers; 13 with SC) was performed by flow cytometry to assess programmed death\u20101 (PD\u20101) expression and proportion of regulatory T cells (CD4<jats:sup>+<\/jats:sup>CD25<jats:sup>+<\/jats:sup>CD127<jats:sup>lo<\/jats:sup>). Effector function of HBV\u2010specific T cells was examined by comparing granzyme B (GZMB) and transforming growth factor beta (TGF\u03b2) production in undepleted PBMCs and Treg\u2010depleted PBMCs after 7\u2009days in\u00a0vitro stimulation with HBV envelope protein overlapping peptides (Part 2). Over a median follow\u2010up of 5\u2009years, smoking was associated with lower probability of SC (aHR 0.70, 95% CI 0.57\u20130.87). PD\u20101 expression was increased in CD4<jats:sup>+<\/jats:sup> T cells, CD8<jats:sup>+<\/jats:sup> T cells and CD20<jats:sup>+<\/jats:sup> B cells among smokers compared to non\u2010smokers and positively correlated with pack years (all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Treg depletion led to partial functional recovery of HBV\u2010specific T cells, with significantly bigger magnitude in smokers (<jats:italic>p<\/jats:italic>\u2009=\u20090.0451, mean difference\u2009=\u20094.68%) than non\u2010smokers (<jats:italic>p<\/jats:italic>\u2009=\u20090.012, mean difference\u2009=\u20094.2%). Cigarette smoking is associated with lower chance of HBsAg seroclearance, higher PD\u20101 expression on lymphocytes, and impairment of effector functions of HBV\u2010specific T cells in CHB.<\/jats:p>","DOI":"10.1111\/jvh.14007","type":"journal-article","created":{"date-parts":[[2024,9,9]],"date-time":"2024-09-09T11:51:14Z","timestamp":1725882674000},"page":"847-856","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Cigarette Smoking Is Associated With Lower Chance of Hepatitis B Surface Antigen Seroclearance and Altered Host Immunity"],"prefix":"10.1111","volume":"31","author":[{"given":"Tsz\u2010Yan","family":"Kwok","sequence":"first","affiliation":[{"name":"Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine The University of Hong Kong  Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rex Wan\u2010Hin","family":"Hui","sequence":"additional","affiliation":[{"name":"Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine The University of Hong Kong  Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"XianHua","family":"Mao","sequence":"additional","affiliation":[{"name":"Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine The University of Hong Kong  Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guang\u2010Sheng","family":"Ling","sequence":"additional","affiliation":[{"name":"Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine The University of Hong Kong  Hong Kong"},{"name":"School of Biomedical Sciences, Li Ka Shing Faculty of Medicine The University of Hong Kong  Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9078-5005","authenticated-orcid":false,"given":"Danny 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