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The aim of this study was to (i) determine the CD<\/jats:styled-content>3+<\/jats:sup> T\u2010lymphocyte count and the balance between CD<\/jats:styled-content>4+<\/jats:sup> regulatory T (Tregs) and conventional T cells (Tconv) in hepatitis B virus (HBV<\/jats:styled-content>)\u2010related ACLF<\/jats:styled-content> patients; (ii) analyse the frequencies of Tregs subpopulations; and (iii) assess the suppressive potency of CD<\/jats:styled-content>4+<\/jats:sup> Tregs and each fraction.<\/jats:p><\/jats:sec>Methods<\/jats:title>We enrolled 20 HBV<\/jats:styled-content>\u2010ACLF<\/jats:styled-content> patients, 10 septic shock subjects, 20 chronic hepatitis B (CHB<\/jats:styled-content>) patients and 20 healthy volunteers (HC<\/jats:styled-content>). Based on flow cytometry, we performed the absolute counting of circulating T lymphocytes and phenotyping of CD<\/jats:styled-content>4+<\/jats:sup> Tregs and quantified the effects of Tregs and each subpopulation on Tconv proliferation by CFSE<\/jats:styled-content> staining.<\/jats:p><\/jats:sec>Results<\/jats:title>Compared with CHB<\/jats:styled-content> patients and HC<\/jats:styled-content>, we observed an equal reduction in peripheral T subsets in HBV<\/jats:styled-content>\u2010ACLF<\/jats:styled-content> and septic shock subjects; the number of CD<\/jats:styled-content>4+<\/jats:sup> Tregs remained unchanged and the Tconv count declined, promoting elevation of the Treg\u2010to\u2010Tconv ratio. The frequencies of Treg\u2010II and \u2010III were elevated in HBV<\/jats:styled-content>\u2010ACLF<\/jats:styled-content>. Functional studies showed that the suppressive capacity of Tregs was preserved in the HBV<\/jats:styled-content>\u2010ACLF<\/jats:styled-content> group and Treg\u2010II came first.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Similar to septic shock subjects, in HBV<\/jats:styled-content>\u2010ACLF<\/jats:styled-content> patients there exists a reduction in CD<\/jats:styled-content>4+<\/jats:sup> T lymphocytes, predominantly CD<\/jats:styled-content>4+<\/jats:sup> Tconv, and the development of suppressive CD<\/jats:styled-content>4+<\/jats:sup> Tregs greatly prevails over Tconv, constituting important characteristics of adaptive immune dysfunction of HBV<\/jats:styled-content>\u2010ACLF<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.12248","type":"journal-article","created":{"date-parts":[[2013,6,19]],"date-time":"2013-06-19T11:53:49Z","timestamp":1371642829000},"page":"1517-1526","source":"Crossref","is-referenced-by-count":35,"title":["Imbalance between 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