Assessment of cytotoxic T-lymphocyte antigen-4 (CD152) Levels Associated with HBV in Patients with Diabetes Mellitus

Abstract

Background: Diabetes mellitus is a chronic disease characterized by an imbalance in glucose homeostasis. The hepatitis B virus is a liver-attacking virus that can cause viral hepatitis, cirrhosis, and liver cancer. A cytotoxic T-lymphocyte antigen-4 called CTLA-4 is an immune checkpoint protein that is necessary for T cells to control immune responses and stop the HBV infection from spreading. It does this by acting as an inhibitory receptor, limiting liver damage during an acute infection, and making it easier for the infection to stay in the body during a chronic case. Objective: The study aims to assess CTLA-4 levels in relation to HBV infection in diabetes mellitus patients. Subjects and methods: A cross-sectional study was conducted from July to October 2023. The serum was obtained from 200 diabetic patients who were Iraqis. All of the patients were tested using an ELISA technique for CTLA-4 and HBc IgG. They were tested using a five-panel kit for HBsAb, HBsAg, HBcAb, HBeAg, and HBeAb and measured blood sugar levels. The statistical analysis approach was conducted using SPSS version 26. Results: Serum CTLA-4 levels were correlated with serum HBc IgG positivity (P = 0.000), total HBc Ab positivity (P = 0.000), and HBs Ab positivity (P = 0.000), and CTLA-4 level was correlated with diabetes mellitus (P = 0.034). Conclusions: The study concluded that elevated serum CTLA-4 levels in diabetic patients with HBV infection and type I diabetes compared to type II diabetes. This suggests that diabetes affects the immune system's response to HBV.