19Neutrophils, an important component of the innate immune system, release 20 extracellular traps (NETs) to eliminate invaded pathogens by trapping and killing 21 microbes. A dysfunctional innate immune response is a major cause of persistent 22 hepatitis B virus (HBV) infection. HBV has been shown to reduce neutrophil 23 responses. The objectives of the present study were to determine whether HBV 24 influenced NETs release and to identify the underlying mechanisms. Primary 25 neutrophils and circulating blood samples were collected from 40 patients with a 26 chronic hepatitis B infection (CHB) and 40 healthy controls to detect NETs release 27 using a Quant-iT Pico Green dsDNA assay and to determine the levels of HBV-DNA 28 and HBV markers. NETs release was decreased in patients with a CHB infection, and 29 hepatitis B surface antigen, hepatitis B e antigen and hepatitis B core antibody levels 30 negatively correlated with NETs release. The Quant-iT Pico Green dsDNA assay and 31 western blotting were used to examine the effect of HBV proteins (HBV X protein, 32 HBV C protein, HBV E protein and HBV S protein) on NETs release in vitro. Based 33 on the flow cytometry and western blot data, HBV C protein and HBV E protein34 inhibited NETs release by decreasing reactive oxygen species (ROS) production and 35 autophagy. Overall, HBV may inhibit NETs release by modulating ROS production 36 and autophagy to escape the immune system and promote the establishment of a 37 chronic infection. 38 39 40 41 Hepatitis B virus (HBV) infection is a serious liver disease. Owing to its chronicity 42 and the increased risk of hepatocellular carcinoma, it has become a global burden. 43 HBV has infected 2 billion people, 360 million chronically, and leads to 44 approximately 600,000 deaths each year(1). A dysfunctional innate immune response 45 is a major cause of persistent HBV infection(2). Neutrophils [polymorphonuclear 46 neutrophil granulocytes (PMNs)] are effector cells involved in innate antimicrobial 47 defence and are also related to liver disease, since have key functions in the 48 pathogenesis of alcoholic hepatitis(3). Neutrophils employ three major strategies to 49 combat microbes: phagocytosis, degranulation, and the release of neutrophil 50 extracellular traps (NETs), a process referred to as NETsosis(4), which differs from 51 apoptosis and necrosis(5). NETs are extracellular fibrous structures composed of 52 chromatin, histones, and several proteins, such as neutrophil elastase (NE), 53 myeloperoxidase (MPO), cathepsin G, and proteinase 3 (PR3)(6-9). These large 54 extracellular structures trap and kill a variety of microbes by exposing them to high 55 concentrations of NETs-associated microbicidal factors and providing a physical 56 barrier to prevent microbial dissemination(6, 10). In addition to their roles in infection, 57 NETs were recently shown to have roles in various sterile diseases, such 58 autoinflammatory and autoimmune diseases(11). 59 The intracellular signalling pathways that regulate NETs formation are s...