Immune regulation of chronic hepatitis B virus infection

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More than 350 million people worldwide are infected with the hepatitis B virus, causing a death toll of approximately 750.000 a year. This makes the hepatitis B virus worldwide one of main causes for liver-associated mortality.A distinct immunologic reaction of the infected individual is essential for the resolving of an acute, self-limiting hepatitis B infection. CD8+-T-cells and the cytokines released by T-cells are known to play a crucial role in this immunologic reaction 3,4. But despite many investigations concerning the immune response during an acute hepatitis B, little is known about the influence of T-cells during a chronic hepatitis B. Additionally the gut microbiome is identified as a major influence on the induction, training and function of the host immune system and thus regulating the extent of systemic inflammation. With the proposed study I would like to investigate the hypothesis that the gut microbiome majorly impacts the intrahepatic immune response during a chronic hepatitis B and thus takes influence on the disease activity and progression. My intention is to investigate the adaptive and innate immune response during different phases of chronic hepatitis B infection und during disease flares in both cross-sectional and prospective patient cohorts.