Pathogenic Interaction between Natural Killer (NK) and T cells in chronic Hepatitis B Virus Infection

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Hepatitis B virus (HBV) persistently infects more than 400 million people worldwide. Chronic (longterm) infection carries a risk of serious complications including severe liver disease and liver cancer and is responsible for more than 1 million deaths per year. The body combats the virus using a number of specialised cell types. The main cell type fighting the virus, called the T cell, is severely impaired in chronic infection. In this study we will be looking at the ability of another type of cell called Natural Killer (NK) cell, to kill the beneficial T cells. NK cells have already been shown to be able to cause liver damage in viral hepatitis and we have found increased numbers in patients with chronic hepatitis B. Malfunctioning NK cells may also attack healthy T cells, causing chronic disease instead of fighting it. The purpose of this study is to identify the possible NK cell-mediated death pathways leading to T cell ‘exhaustion‘. We will use blood and liver samples obtained during routine clinical care of patients infected with HBV following informed consent. Blocking these harmful death pathways will boost the immune system leading to improved viral control and prevention of chronic disease and liver damage.