We showed the status of T lymphocyte activation, reflected by the expression of HLA-DR of CD4+ T cells and CD8+ T cells, was elevated from patients with CHB, those with HBV-LC to those with HBV-PLC, and was significantly increased in patients with HBV-PLC compared with those with CHB and HBV-LC, respectively. Here, CD4 is linked to laryngotracheoesophageal cleft.