血清IL-10对慢性乙型肝炎患者抗病毒治疗后e抗原转阴的预测作用

肝脏 ›› 2023, Vol. 28 ›› Issue (9): 1053-1056.

血清IL-10对慢性乙型肝炎患者抗病毒治疗后e抗原转阴的预测作用

顾达, 童聪, 王维钊, 向晓星, 赵祥安

215000 江苏苏州大学附属独墅湖医院(苏州市独墅湖医院)急诊医学科(顾达);225009 扬州大学医学院(童聪);江苏省苏北人民医院消化内科(童聪,王维钊,向晓星,赵祥安);南京市鼓楼医院感染科(赵祥安)

收稿日期:2022-07-30 出版日期:2023-09-30 发布日期:2023-10-24
基金资助:
中国博士后科学基金(2020T130049ZX);江苏省自然科学基金青年项目(SBK2020040678);扬州市科技计划项目(YZ2020101);江苏省博士后科研资助项目(2021K536C)

Predictive effect of serum IL-10 level on HBeAg conversion in chronic HBV-infected patients undergoing nucleos(t)ide analogues treatment

GU Da¹, TONG Cong², WANG Wei-zhao³, XIANG Xiao-xing³, ZHAO Xiang-An^3,4

1. Department of Emergency Medicine, Dushuhu Hospital Affiliated to Suzhou University (Suzhou Dushuhu Hospital), Jiangsu 215000, China;
2. Department of Gastroenterology, Northern Jiangsu People's Hospital, Yangzhou,Jiangsu 225001;
3. Medical College of Yangzhou University, Yangzhou, Jiangsu 225009,China;
4. Department of Infection, Nanjing Drum Tower Hospital, Nanjing, Jiangsu 210000,China

Received:2022-07-30 Online:2023-09-30 Published:2023-10-24

摘要/Abstract

摘要： 目的观察慢性乙型肝炎病毒感染引起血清IL-10变化,探讨血清IL-10对慢性乙型肝炎(CHB)患者抗病毒治疗后e抗原(HBeAg)转阴的预测作用。方法纳入2008年5月—2013年9月于江苏省苏北人民医院和南京鼓楼医院就诊的90例CHB患者,包括6例非活动携带者(IC)、22例免疫耐受患者(IT)、44例HBeAg阳性患者(EPH)和18例HBeAg阴性患者(ENH)。同时,纳入11名健康人(HC)作为对照。对比健康人与CHB患者血清IL-10含量以及不同免疫状态的CHB患者IL-10血清含量。并对EPH患者中30例接受抗病毒治疗的患者进行随访,共5年。检测其抗病毒治疗后第0周、第4周、第12周、第24周和第48周血清ALT、HBV DNA和IL-10水平。观察抗病毒治疗后2年、3年和5年血清HBeAg是否转阴,并将其分为HBeAg转阴组和HBeAg仍阳性组,比较两组基线血清HBeAg和IL-10水平。结果 CHB患者血清IL-10水平显著高于健康献血者。同时在CHB患者中,IT组、EPH组和ENH组患者血清IL-10含量明显高于IC组患者。抗病毒治疗后,血清ALT、HBV DNA、IL-10水平逐渐下降。通过随访发现,在抗病毒治疗后的2年、3年和5年内,分别有9人、10人、13人实现了HBeAg转阴。进一步分析发现,与HBeAg仍阳性组患者相比,在2年、3年和5年内实现HBeAg转阴的患者基线IL-10水平明显更高[(6.49±2.16) vs (3.33±1.22) pg/mL,P=0.062;(5.88±1.99) vs (2.27±1.36) pg/mL,P=0.026;(6.01±1.91) vs (1.15±0.63)pg/mL,P=0.027]。结论慢性乙型肝炎病毒感染可引起患者血清IL-10含量升高,抗病毒治疗可以降低血清IL-10含量,同时抗病毒治疗前血清IL-10含量较高的患者往往能够获得更好的治疗结局。

关键词: 慢性乙型肝炎, 乙型肝炎e抗原, 抗病毒治疗, 核苷类药物, 白细胞介素10

Abstract: Objective To explore the predictive effect of serum IL-10 level on the e-antigen seroconversion in patients with chronic hepatitis B after antiviral therapy.Methods Ninety-seven patients with chronic hepatitis B were included, including 6 inactive carriers (IC), 22 immunotolerant patients (IT), 44 HBeAg positive patients (EPH) and 18 HBeAg negative patients (ENH). Meanwhile, 11 healthy people (HC) were included as controls. The serum levels of IL-10 in healthy people and patients with chronic hepatitis B, and the serum levels of IL-10 in patients with chronic hepatitis B with different immune status were compared. Thirty EPH patients who received antiviral therapy were followed-up for 5 years. The changes of serum liver enzymes, HBV DNA, and IL-10 were detected in the 0th, 4th, 12th, 24th and 48th weeks after antiviral treatment. The baseline serum e-antigen and IL-10 levels were compared between the patients with and without e-antigen seroconversion in the first, second, third, and fifth years after antiviral treatment. Results The serum IL-10 level in patients with chronic hepatitis B was significantly higher than that in healthy blood donors, and the serum IL-10 levels in the IT group, EPH group and ENH group were significantly higher than those in the HC group and IC group. After antiviral treatment, the serum levels of alanine transaminase (ALT), HBV DNA load, and IL-10 gradually decreased. During follow-up, it was found that a total of 9, 10, and 13 patients achieved e-antigen negative conversion in the 2nd, 3rd, and 5th years after antiviral treatment. By a further analysis it was found that when compared with the HBeAg-positive group, the HBeAg-negative group had significantly higher levels of IL-10 at 2, 3, and 5 years (6.49±2.16 vs 3.33±1.22 pg/mL,P=0.062;5.88±1.99 vs 2.27±1.36 pg/mL,P=0.026;6.01±1.91 vs 1.15±0.63 pg/mL,P=0.027). Conclusion Serum IL-10 levels were significantly elevated in patients with chronic hepatitis B. Antiviral therapy could reduce serum IL-10 levels. Higher levels of serum IL-10 before antiviral therapy predicted better treatment outcomes.

Key words: Chronic Hepatitis B, Hepatitis B e antigen, Antiviral therapy, Nucleos(t)ide analogues, Interleukin-10

顾达, 童聪, 王维钊, 向晓星, 赵祥安. 血清IL-10对慢性乙型肝炎患者抗病毒治疗后e抗原转阴的预测作用[J]. 肝脏, 2023, 28(9): 1053-1056.

GU Da, TONG Cong, WANG Wei-zhao, XIANG Xiao-xing, ZHAO Xiang-An. Predictive effect of serum IL-10 level on HBeAg conversion in chronic HBV-infected patients undergoing nucleos(t)ide analogues treatment[J]. Chinese Hepatolgy, 2023, 28(9): 1053-1056.

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