The role of interleukin-27 in predicting spontaneous HBeAg seroconversion in chronic hepatitis B infection.

BACKGROUND AND AIMS

Hepatitis B e seroconversion, associated with preceding hepatic inflammation, marks the transition from immune active to residual phase in the natural disease history of chronic hepatitis B. Recently, interleukin-27 has been reported to be associated with hepatic inflammation in hepatitis B infection. We aimed to evaluate the role of interleukin-27 in predicting spontaneous e seroconversion in chronic hepatitis B.

METHODS

A total of 142 treatment-naive hepatitis B patients with positive e antigen were recruited. Interleukin-27, hepatitis B viral DNA levels and liver function parameters, were measured on presentation. Patients who had spontaneous e seroconversion within 3 years of follow-up were compared with those without e seroconversion within the same period of time. Factors predictive of spontaneous e seroconversion were identified.

RESULTS

Of the 142 patients (M:F=80:62, median age: 31), 44 (31%) had spontaneous e seroconversion within 3 years of follow-up. Multivariate analyses revealed that younger age, lower viral DNA and lower interleukin-27 levels on presentation independently predicted spontaneous e seroconversion: the rate was significantly higher in patients aged <31 (OR: 11.022, 95% CI: 3.658-33.205; P<.001), viral DNA <5 log IU/mL (OR: 2.311, 95% CI: 1.049-5.091; P=.038) and interleukin-27 <67.3 pg/mL (OR: 3.276, 95% CI: 1.257-8.536; P=.015). Among patients with all these three favourable factors on presentation, 77% of them underwent spontaneous e seroconversion within 3 years.

CONCLUSIONS

Low interleukin-27 levels were associated with early e seroconversion. The combination of baseline interleukin-27 <67.3 pg/mL and viral DNA <5 log IU/mL in young patients was useful for predicting early spontaneous e seroconversion in treatment-naïve chronic hepatitis B patients.