The Expression Level Of IFN-λ3 In Chronic HBV Patients And The Influence Of Different Antiviral Treatment Regimens

Objective:This study aims to detect the clinical function of serum IFN-λ3 expression levels in chronic HBV infection patients with different immune stages,as well as the effect of interferon、nucleoside and nucleotide analogues treatment on serum IFN-λ3 levels and their correlation with treatment outcomes.The ultimate goal is to provide reliable and effective clinical observation indicators and treatment strategies for chronic hepatitis B patients to achieve clinical cure.Methods:From November 2021 to January 2023,a total of 201 patients with chronic HBV infection were recruited from the Department of Infectious Diseases at The First Affiliated Hospital of Nanchang University.Additionally,40 HBs Ag-negative healthy individuals form medical examination center were selected as the healthy control group.Serum IFN-λ3 levels were measured by ELISA to compare differences between chronic HBV infection patients and healthy individuals.The relationship between serum IFN-λ3 levels and serological and hepatic enzyme indicators in chronic HBV infection patients was also analyzed,along with the expression of IFN-λ3 in different immune stages.Furthermore,we selected 48 patients with abnormal liver function who received initial antiviral therapy for chronic hepatitis B at The First Affiliated Hospital of Nanchang University during the same period.Patients who were lost to follow-up or had incomplete follow-up data were excluded from the study.The remaining patients were divided into three treatment groups: entecavir plus pegylated interferon alpha(ETV+Peg-IFNα)group(n=18),entecavir(ETV)group(n=17),and tenofovir alafenamide fumarate(TAF)group(n=13).All patients were followed up for 24 weeks,and peripheral blood serum IFN-λ levels were measured at 0 and 24 weeks to analyze the relationship between IFN-λ3 levels among the different groups.Results:1.The serum IFN-λ3 level of patients with chronic HBV infection patients was significantly lower than that of the healthy control group,and there was a statistical difference between the two groups(P-value<0.05).2.The expression level of serum IFN-λ3 in the immune control period was lower than that in the immune tolerance period,immune clearance period,and reactivation period,and there was a statistical difference between each pair of groups(P-value<0.05).3.The expression level of serum IFN-λ3 in the immune stable period was lower than that in the immune unstable period,and there was a statistical difference between the two groups(P-value<0.05).4.The expression level of serum IFN-λ3 in the chronic HBV infection patients and healthy control group was lower than that in the clinically cured group,and there was a statistical difference between the two groups(P-value<0.05).5.The expression level of serum IFN-λ3 in patients with chronic HBV infection patients was positively correlated with ALT and AST(r=0.145,P-value=0.04;r=0.57,P-value=0.026);there was no correlation between IFN-λ3 expression level and DNA,log HBV DNA,HBs Ag,HBs Ab,HBe Ag,HBc Ab,TBIL,and DBIL(P-value>0.05).6.The IFN-λ3 level in the TAF treatment group was significantly higher after treatment than before treatment,with a statistical difference(P-value<0.05).The ETV group and the ETV+Peg-IFNα group showed an increase after treatment compared to before treatment,but there was no statistical difference between the two groups(P-value>0.05).Conclusion:1.The serum level of IFN-λ3 in patients with chronic HBV infection patients is significantly lower than that of healthy individuals.Among them,patients in the immune control stage have lower serum levels of IFN-λ3 than those in other immune stages.Patients in the immune stable group have lower serum levels of IFN-λ3 than those in the immune unstable group.It can predict the protective effect of IFN-λ3 on the natural course of chronic HBV infection2.The serum expression level of IFN-λ3 in patients with chronic HBV infection patients is positively correlated with the levels of ALT and AST.It can be inferred that the level of IFN-λ3 expression has an effect on liver enzymes3.Antiviral drugs may enhance antiviral activity by inducing the expression of IFN-λ3.4.The expression level of IFN-λ3 is the highest in clinically cured patients,suggesting that IFN-λ3 is expected to become a treatment strategy for achieving clinical cure in patients with chronic hepatitis B in the future.