Pan Corinna Jen-Hui, Wu Hui-Lin, Kuo Stephanie Fang-Tzu, Kao Jia-Horng, Tseng Tai-Chung, Liu Chen-Hua, Chen Pei-Jer, Liu Chun-Jen, Chen Ding-Shinn
Melbourne University, Melbourne, Australia.
Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine and National Taiwan University Hospital, 1 Chang-Te Street, Taipei, 10002, Taiwan.
Hepatol Int. 2012 Jun;6(3):591-7. doi: 10.1007/s12072-011-9299-2. Epub 2011 Jul 16.
Acute exacerbation (AE) of chronic hepatitis B virus (HBV) infection is common and negatively impacts the clinical outcome. Factors predicting outcomes after exacerbations were only partly clarified. We investigated the host immune parameters associated with long-term outcomes.
We prospectively examined the profiles of serum cytokines and chemokines in 36 consecutive hepatitis B e antigen (HBeAg)-positive patients (male 72%, age 40.8 ± 9.9 years, genotype B/C 75%/25%) who developed AE in a medical center. The patients were followed up for a median of 4 years (range 2-6 years) post-AE. The impact of six cytokines (tumor necrosis factor alfa, interferon gamma, IL-2, IL-4, IL-6, and IL-10) and five chemokines (CXCL10/IP-10, CCL2/MCP-1, CXCL9/MIG, CCL5/RANTES, and CXCL8/IL-8) at the onset of AE activity on the long-term outcomes were analyzed.
Of 36 patients, 22 (61.1%) developed HBeAg seroconversion during follow-up (Group I), and the remaining 14 patients did not obtain HBeAg seroconversion (Group II). Baseline characteristics were generally similar between two groups of patients. In Group I patients, the frequency of undetectable serum IL-6 level (<3 pg/mL) at the onset of AE was significantly higher in comparison with Group II patients in multivariate analysis (86.4 vs. 42.9%, P = 0.016).
Our findings indicate that undetectable serum IL-6 level at the early stage of AE correlated with the long-term outcomes and may serve as a useful clinical predictor.
慢性乙型肝炎病毒（HBV）感染的急性加重（AE）很常见，且会对临床结局产生负面影响。关于急性加重后预测结局的因素仅得到部分阐明。我们研究了与长期结局相关的宿主免疫参数。
我们前瞻性地检测了一家医疗中心36例连续发生AE的乙型肝炎e抗原（HBeAg）阳性患者（男性占72%，年龄40.8±9.9岁，B/C基因型分别占75%/25%）的血清细胞因子和趋化因子谱。这些患者在AE发生后中位随访4年（范围2 - 6年）。分析了AE活动开始时六种细胞因子（肿瘤坏死因子α、干扰素γ、IL - 2、IL - 4、IL - 6和IL - 10）和五种趋化因子（CXCL10/IP - 10、CCL2/MCP - 1、CXCL9/MIG、CCL5/RANTES和CXCL8/IL - 8）对长期结局的影响。
36例患者中，22例（61.1%）在随访期间发生HBeAg血清学转换（I组），其余14例患者未实现HBeAg血清学转换（II组）。两组患者的基线特征总体相似。在多变量分析中，I组患者在AE开始时血清IL - 6水平不可检测（<3 pg/mL）的频率显著高于II组患者（86.4%对42.9%，P = 0.016）。
我们的研究结果表明，AE早期血清IL - 6水平不可检测与长期结局相关，可能是一个有用的临床预测指标。
