| Background & Objective: Currently,there are still many patients with chronic hepatitis B in the world,and developing countries are the most important.For the treatment of hepatitis B virus,currently the main antiviral drugs are entecavir(ETV)and tenofovir(TDF).However,HBV cannot be completely cured because HBV covalently closed circular DNA(ccc DNA)cannot be completely eliminated.Currently,there is strong evidence that IFN-λ3 levels are determinants of liver inflammation and fibrosis in both viral and non-viral liver diseases.TDF can improve the IFN-λ3 level in patients,so it is urgent to find a new basis and treatment plan in clinical practice.The serum levels of IFN-λ3 in 174 patients from the First Affiliated Hospital of Bengbu Medical College were detected to analyze the clinical significance of IFN-λ3 levels in different clinical stages of hepatitis B virus(HBV)infection and its relationship with tenofovir and entecavir treatment.At the same time,liver function,bilirubin,albumin and other related clinical examination indexes of patients were collected to analyze whether there was a statistical relationship with IFN-λ3,so as to provide certain clinical basis for tenofovir to reduce the risk of hepatocellular carcinoma.Methods: A total of 174 cases of HBV patients admitted to our hospital from January2019 to September 2020 were selected,including 85 cases of chronic hepatitis B(30 in untreated group and 55 in treated group).24 patients with hepatitis and cirrhosis(all untreated);65 cases of hepatocellular carcinoma(19 cases in untreated group and 46 cases in treated group).According to the Guidelines for Prevention and Treatment of Chronic Hepatitis B(2019),all enrolled patients with hepatocellular carcinoma were diagnosed with definite pathological reports or imaging diagnosis.Serum HBs Ag negative healthy people aged 18-60 years were collected at the same time.Collect patients serum,and at the same time,collection of patients with hepatitis b virus DNA(HBV DNA),alanine aminotransferase(ALT),aspertate aminotransferase(AST),gamma GGTP(gamma glutamyl transpeptidase)(GGT),alkaline phosphatase(ALP),total bilirubin,albumin,globulin,hepatitis b surface antigen(HBs Ag),hepatitis b e antigen(HBe Ag),antibody of second liver e(HBe Ab),hepatitis b core antibody(HBc Ab),interferon-lambda 3(IFN-lambda.3).The relationship between the data was analyzed,and the relationship between IFN-λ3 in each experimental group and the index of serological examination was compared.Main reagent: IFN-λ3 ELISA kit was purchased from Nanjing Zadi Biotechnology Co.,Ltd.Exclusion criteria: hepatitis patients treated with interferon injection,complicated with hepatitis C virus,HIV infection,alcoholic liver disease,autoimmune liver disease,drug-induced liver injury,etc.Statistical analysis software SPSS23.0 statistical analysis software was used to conduct variance analysis and t(or t ’)test on the measurement data.The correlation between the measurement data of the two groups was analyzed by PERSON correlation.Results :(1)We performed variance analysis on serum IFN-λ3 in the healthy group,the chronic hepatitis B group,the cirrhosis group and the hepatocellular carcinoma group,and no patients in each group received antiviral therapy.The level of IFN-λ3 decreased to the healthy group(252.81 ± 38.06pg/ml),hepatitis B group(186.47 ± 30.75pg/ml),cirrhosis group(178.16 ± 30.59pg/ml),and hepatocellular carcinoma group(95.20 ±14.00pg/ml).The serum IFN-λ3 in healthy group was significantly higher than that in other groups,and there was statistical significance between the two groups(P<0.01).The serum IFN-λ3 in hepatocellular carcinoma group was significantly lower than that in other groups(P<0.05).(2)Patients with chronic hepatitis B were divided into ETV group and TDF group.Patients in both groups were followed up,and the results showed that there was no significant difference in IFN-λ3(167.58±15.543pg/ml)in ETV group before treatment compared with that 6 months after treatment(176.80±37.473pg/ml)(P>0.05).The level of IFN-λ 3(155.77 ± 15.148pg/ml)in TDF group before treatment was significantly lower than that in TDF group 6 months after treatment(210.94 ± 25.999pg/ml),with statistical significance(P<0.05).Moreover,IFN-λ3 levels in patients treated with TDF were significantly higher than those in patients treated with ETV.(3)Hepatitis B associated hepatocellular carcinoma was divided into ETV group and TDF group according to drug use.IFN-λ 3 in ETV group(107.32 ±15.52pg/ml)was significantly lower than that in TDF group(130.42±16.92pg/ml),and the difference was statistically significant(P<0.05).(4)Because there was no significant difference in IFN-λ3 between the hepatitis B group and the cirrhosis group,no antiviral drugs were used for treatment.According to the results of Person correlation analysis,there was a weak positive correlation between serum IFN-λ3 levels and HBs Ag and Logh BVDNA levels in the two groups(R=0.091,P =0.027;R=0.099,P =0.021);There was no significant correlation with ALT,AST,GGT,ALP,TBil,ALB,GLOB,HBe Ag,HBe Ab,HBc Ab and other serum indexes(P>0.05).Conclusions: IFN-λ3 level is weakly positively correlated with HBs Ag and HBV-DNA values in patients with chronic hepatitis B and cirrhosis,and has no significant statistical relationship with clinical indicators such as liver function,bilirubin,albumin and globulin,suggesting that it is related to the progress of hepatitis B virus activity,but has nothing to do with liver function itself.With the development of viral hepatitis,the level of IFN-λ3decreased,and the serum expression of IFN-λ 3 in patients receiving tenofovir was higher than that of entecavir,which provided a certain clinical basis for tenofovir to reduce the risk of hepatocellular carcinoma. |
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