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Significant depletion of T-cells was noted in cirrhotic patients (5.8 [0.5-20.1]) as compared to HCW (13.1 [1.6-31.3]) and unvaccinated individuals (12.3 [7.8-19.6]; (P=0.001 & P=0.000)
respectively. However, the ratio of CD4+T to CD8+T cells was not altered in any group. By analyzing expression of CD45RA and CD197 (CCR7), subsets of central memory (CM), effector memory (EM) and effector memory RA (EMRA) were identified in both CD4+ or CD8+ T-cell. From the CD45RA+CD197+ gate, CD95+ stem cell memory and CD95- naïve T cells were further identified. Significant difference was noted in various memory subsets [EMRA (P= 0.141, P= 0.000), EM (P= 0.000, P= 0.00), CM (P= 0.000, P= 0.00), SCM (P= 0.009, P= 0.08) and naïve (P= 0.000, P= 0.02)] of CD4+T and CD8+T in all three group respectively. (Table II)
On post-hoc analysis, directed at cirrhotic versus HCW, only T-cell distributions were found to be statistically different in the two groups (p<0.001; Kolmogorov-Smirnov Z = 2.119). The various memory cells subsets in cirrhotic and HCW group did not show any difference, though there was significantly raised in comparison to unvaccinated individual. (Figure-3)
CM and SCM are responsible for long term maintenance of memory cells which were absent in unvaccinated individuals as they were not vaccinated. All HCW and 89.47% cirrhotic patients developed CD4+TCM. 63.88% HCW and 47.36% cirrhotic patients developed CD4+TSCM . 36.11% HCW and 36.84% cirrhotic patients developed CD8+TCM. 41.66% HCW and 42.10% cirrhotic patients developed CD8+TSCM. There was no difference between memory cells on T-cells between vaccinated cirrhotic patients and vaccinated HCW.(Figure-4)