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Increased viral replication in Group 3 resulted in significantly higher CD8 T cell and IFN-γ-producing CD8 T cell frequencies than Group 1. Immunosuppressant therapy increases viral replication in HBsAg-positive renal transplant recipients due to disabling or dysregulation of virus-specific CD8+ T cells. The higher cellular immune responses due to lower Treg/CD8+ T cell ratios in HBsAg-positive renal transplant recipients may be one of the reasons to induce liver pathology because of uncontrolled viral replication. Immunosuppressant the