Discuss IL-21、IL-2 Predicting HBeAg Serum Conversion After ETV Treatment

Objective: To discuss predictors of HBeAg serum conversion and the relationship between HBe Ag serum conversion and IL-21、IL-2 in HBeAg positive chronic hepatitis B patients after ETV treatment of 96 weeks.Methods:Retrospective study is adopted and 100 hepatitis B HBeAg positive CHB patients were observed in this experiment,who received entecavir(ETV) 0.5mg once daily for at least 96 weeks,.There are 20 cases resulting HBeAg seroconversion after or before treatment of 96 weeks,and select these 20 patients as experimental group 1, meanwhile select 20 patients from the cases who have no HBeAg seroconversion during the treatment as experimental group 2,and 15 cases of healthy subjects as control group.serum levels of IL-21, IL-2 in the experimental groups before and after treatment(4, 12, 24 and 48 weeks) and in healthy control group are detected by ELISA method, the two cytokines difference between experimental group and control group and the correlation of the two cytokines are analysised, and analysis the changes in serum levels of IL-21, IL-2 of the two experimental group in different times including baseline and 4, 12, 24 and 48 weeks after treatment and the differences between the two groups, analyzing relationship between IL-21, IL-2levels and HBe Ag seroconversion,what is more, whether serum levels of IL-21 after treatment at 12 weeks could be used to predict HBe Ag seroconversion rate, at the same time we also discusses the relationship between HBeAg seroconversion and baseline HBeAg, HBsAg quantitaty、HBV DNA and ALT level and factors such as gender, age, family infected history, infection going-on time in HBe Ag positive chronic hepatitis B patients.Results:1) The level of serum IL-21 of experimental group is significantly higher than the healthy controls(p < 0.001), and IL- 2 levels is significantly lower than healthy controls(p < 0.05);Experimental group 1 baseline IL-21 level is obviously higherthan that of the experimental group 2(p < 0.01), there is no statistically significant difference about baseline level of IL-2 between the two group, the difference of baseline HBe Ag, HBs Ag, ALT levels between the two groups have statistical significance, baseline HBeAg level of experimental group 1 is lower than that of experimental group 1(p < 0.05), baseline HBsAg, ALT level is higher thanthat of group 2(p < 0.01), and there is no statistical significance about the difference of baseline level of HBV- DNA between the two groups;2) As the treatment going on, IL-21 level of the two groups is in a downward trend, but IL-21 level of experimental group 1 after treatment at 12 weeks is significantly increased(p < 0.01), serum IL-21 level of experimental group 1 at each time after treatment is higher than group 2(p < 0.01); As treatment going on,IL-2level of two groups is on the rise in general, serum levels of IL-2 in experimental group 1 at 12 weeks,24 weeks and 48 weeks after treatment are higher than that of group 2(p < 0.05);There is no significant correlation between serum IL-21 and IL-2level in Experimental group patients(R=-0.075 P=0.273);3)As antiviral treatment going on, HBsAg, HBeAg, HBV DNA levels of the two experimental groups are declining, the HBeAg level of experimental group 1 is lower than group 2 at every time point after treatment(p < 0.05).4) There is no statistically significant difference between the two experimental groups in gender, age(p>0.05), and difference is statistically significant about family infected history, infection going-on time between the two groups;5) The correlation between serum levels of HBsAg and HBeAg in experimental groups is statistical significant(R=0.539 P<0.001);6) The levels of serum HBeAg, IL-21 at 12 weeks could effectively predict HBeAg seroconversion rate after 96 weeks of ETV treatment in HBeAg positive chronic hepatitis B patients.Conclusions:The HBeAg seroconversion in HBeAg positive chronic hepatitis B patients after Entecavir treatment is related to patients’ baseline ALT level, HBe Ag quantity,infection on-going time, family infected history of patients, but not obviously related to the baseline HBsAg quantity,HBV DNA levels, gender, age of patientss, and,it is concerned with serum levels of IL- 21, IL – 2 about HBe Agseroconversion, serum level of IL – 21 and HBeAg quantity at 12 weeks of ETV treatment in patients could effectively and accurately predict the HBeAg seroconversion rate for the treatment of 96 weeks.