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From virological selection to immune stratification: Hepatitis B virus-specific T cells for precision pegylated interferon therapy in chronic hepatitis B
Bing Tian, Chen Tian, Qun Zhang, Department of Infectious Diseases, Zhongda Hospital, Southeast University, Nanjing 210009, Jiangsu Province, China
Bing Tian, Department of Infectious Diseases, Zhongda Hospital, Southeast University (Jiangbei, Nanjing Dachang Hospital), Nanjing 211500, Jiangsu Province, China
Chuan-Lai Shen, Department of Microbiology and Immunology, Southeast University Medical School, Nanjing 210009, Jiangsu Province, China
Co-first authors: Bing Tian and Chen Tian.
Author contributions: All four authors made equal substantial contributions to this review article; Zhang Q conceptualized the review framework, supervised the entire study, and made critical revisions to the manuscript; Tian B carried out literature retrieval, synthesized research evidence, and drafted the original manuscript; Tian B, Tian C, Shen CL, and Zhang Q reviewed and revised the manuscript and approved the final version for submission; Tian B and Tian C have made crucial and indispensable contributions towards the completion of the project and thus qualified as the co-first authors of the paper.
AI contribution statement: The authors used Grammarly to assist with language editing and refinement. All scientific content was critically reviewed and verified by the authors, who take full responsibility for the final manuscript.
Supported by Jiangsu Province High-Level Hospital Construction Funds of Zhongda Hospital, School of Medicine, Southeast University, No. 2024GSPKY23; and Chinese Foundation for Hepatitis Prevention and Control Muxin research fund of CHB, No. MX202413.
Conflict-of-interest statement: All authors have no conflicts of interest to declare.
Corresponding author: Qun Zhang, MD, PhD, Department of Infectious Diseases, Zhongda Hospital, Southeast University, No. 87 Ding Jia Qiao, Nanjing 210009, Jiangsu Province, China. slim888@163.com
Received: July 1, 2026
Revised: July 31, 2026
Accepted: August 14, 2026
Published online: September 27, 2026
Processing time: 83 Days and 23.3 Hours
Revised: July 31, 2026
Accepted: August 14, 2026
Published online: September 27, 2026
Processing time: 83 Days and 23.3 Hours
Core Tip
Core Tip: Currently, patient selection for pegylated interferon (PEG-IFN) therapy predominantly relies on virological markers, which fail to fully recapitulate host immune competence. This review highlights that hepatitis B virus-specific T cells constitute core immune biomarkers predictive of treatment response and functional cure. Synthesizing available evidence concerning T cell exhaustion, regenerative potential, effector function and comprehensive immune profiling, we propose that future patient selection algorithms should transition from virology-only criteria toward immune stratification strategies. This conceptual framework underpins the development of precision PEG-IFN therapy for chronic hepatitis B.