Immunomodulation and Molecular Diagnostic Aspects in Individuals with Hepatitis B Virus Infection

Background: Hepatitis B virus (HBV) is a major global health issue associated with severe liver complications. Outcomes depend on the immune response, which can sometimes fail, and are associated with chronic disease. Improved diagnostics and understanding of immune markers are crucial for more effective management and treatment of HBV infection. Aims: The study aimed to investigate the association between the HBV viral load, viral antigens, including Hepatitis B surface antigen (HBsAg), Hepatitis B core antigen (HBcAg), Hepatitis B enveloped antigen (HBeAg), and pro-inflammatory cytokines, including Human Interferon γ (INF-γ), Human Tumour Necrosis Factor α (TNF-α), Soluble Human Leukocyte Antigen class I (sHLA-A), an antigen-presenting molecule, and Human soluble Cluster of Differentiation 8 (sCD8), a soluble T-cell activation marker. This study provides additional regional information on the associations between virological and immunological parameters in patients with HBV infection from the Kurdistan Region of Iraq. Methodology: The study was a case-control study conducted on 120 individuals in the Kurdistan Region of Iraq, comprising 60 patients with HBV infection and 60 healthy controls. The investigation included both sexes aged 25 to 74 years, during the period from March to July 2025. RT-PCR was used to assess viral load, and ELISA was used to evaluate immunological markers. Results: According to the study findings, Patients with HBV infection exhibited significantly higher immunological markers than healthy controls (p < 0.0001). Significant positive correlations were observed in the study between viral load and HBeAg (r=0.9051), as well as inflammatory cytokines IFN-γ (r=0.9189), TNF-α (r=0.832), sCD8 (r=0.888), and HLA-A (r=0.801). The obtained results demonstrated significant positive correlations between viral load and immune activation markers. Conclusion: Overall, the current study demonstrated significant positive correlations among viral load, viral antigens, and immunological markers in patients with chronic HBV infection and provides additional evidence of the immunological characteristics.