Research On Relations Between IL-10 Dynamic Changes And HBeAg Positive Serological Conversion In CHB Patients Cured By NAs

Objective:To explore the relationship between the IL-10-levels and HBeAg seroconversion after antiviral therapy for nucleoside (acid) analogues.And to further explore the possibility of prediction of HBeAg seroconversion of Hepatitis B patients with the IL-10-levels.Method:Take 66 HBeAg positive chronic hepatitis B patients who had been treated with nucleoside (acid) analogues for 2 years or more than 2 years as research object.34 cases among them occurred HBeAg seroconversion in 24 months-treatment,we take them as conversion-group; and take the other 32 cases which did not occur HBeAg seroconversion as no-conversion- group;and take other 32 healthy people who have no liver disease background as the control group. Using the ELISA test method to test the IL-10-levels in peripheral blood at 4 points (baseline,3rd,6th,12th months),and record the levels of HBV-DNA,ALT and HBeAg, HBeAb, included related information about HBV-DNA,disappearance of HBeAg and appearance of HBeAb, as well as the medical treatments.Compare the IL-10-levels in each group with SPSS 16.0 statistical software,and analysis factors that may affect IL-10-levels before and after treatment; compare the differences of the IL-10-levels in the two groups in different treatment time point dulling 2 years; use ROC curve to calculate the IL-10-levels at the baseline,3rd,6th,12th months; group again according to the Cut off value,and use the Log-rank test system comparing subgroups’ Seroconversion rates of HBeAg.Results:(1)66 patients were turned into the group of chronic hepatitis B in this study;the average age of them is 34.0+/-9.72 years(age from 15 to 63),including 44 men (66.7%) and 22 women (33.3%), the average age of 32 people in the control group is 33.5+/-10.9 years (age from20 to 54), including 16 men (50%) and 16 women (50%). in the treatment of HBeAg of Seroconversion rates of HBeAg of the Hepatitis-B-group at the 12th and 24th months were 17.33% and 48.60% respectively.(2) At the baseline treatment, group chronic-hepatitis-B’IL-10-level was obviously higher than that of the control group (P<0.05); The IL-10-levels in the no-conversion- gfoup ranks the highest, the conversion-group comes second, the control group rank last. The Subgroup’analysis shows that IL-10-level have no statistical significance (P> 0.05) at the early-cure/treated under different age, different gender; Baseline’ IL-10-level has no significant correlation with the baseline HBeAg,HBeAb, ALT, HBV DNA (lg)(all P values were greater than 0.05).(3) Bivariate partial correlation analysis shows no significant correlation between the IL-10-level and HBeAg,HBeAb, ALT, HBV DNA (1g) at each time points after treatment (all P value is greater than 0.05); the IL-10-level make no significant change in HBeAg-transformation-group and no-conversion-group within the various points in the longitudinal comparison (P>0.05); however, it has statistical significance because the IL-10-level in no-conversion-group are higher than that of transformation group in transverse comparison (P<0.05); and it has statistical significance comparing to the overall difference between the two groups (P< 0.001); the IL-10-levels rises obviously in ADV-drug-group,so does ADV-combination-group;it shows different IL-10-levels at the 3rd months; the levels of IL-10 go higher in the ADV-drug-group than that in the LAM group, ETV group, LDT group at 3rd,6th,12th months (P< 0.05). In NAs treatment process, transformation-group and no-conversion-group’s IL-10-levels, HBeAg-levels, HBV-DNA-levels and ALT levels are of a similar change trend at baseline, and the end of 3rd,6th month,they all drop obviously at the 3rd month. Contrast between groups but ALT and HBV - DNA (1g) contrast differences between groups was no statistical significance (P value is 0.068 and 0.476); In the whole process of change, the HBeAg, IL-10-levels decline obviously in transform group than no-conversion-group, and HBeAb level rise obviously in transform group than that in no-conversion group; IL-10-levels,HBeAg-levels, HBeAb-levels comparative the differences between groups were statistically significant (P< 0.001,0.009, respectiely, in,<0.001).(4) According of IL-10-levels at each time point, ROC curve shows:it reach its top under the ROC curve at 3rd month(maximum 0.743). predicting serology HBeAg conversion of sensitivity and specificity is 0.853,0.125 respectively.The Cut-off-value is 0.124. At 3rd month,patients’(IL-10-levels <0.124)Seroconversion rates of HBeAg is higher than significantly that the baseline(IL-10-levels≥0.124)in 2 years of accumulated(83.3% vs 50.82%, p=0.009);Conclusion:(1) The expression of IL-10 levels associated with the conversion result of HBeAg, the lower the IL-10 levels before and after the treatment, the greater the chance of HBeAg conversion after the treatment.(2) the NAs after treatment for 3 months of IL-10 level of the cut off value (0.124) forecast for 2 years HBeAg seroconversion, the highest sensitivity, integrated prediction efficiency is best, can be used as HBeAg seroconversion predictor.