Clinical Significance Of -238G/A And -308G/A Polymorphisims Of TNF-a Gene Promoter Region In The Outcomes Of Patients With Chronic Hepatitis B Virus Infection

Objective:To investigate the relationship between the allels of TNF-α-238G/A,-308G/A and state,jaundice in the patients with chronic hepatitis B (CHB),chronic severe hepatitis B and liver cirrhosis subjects in Guangxi province,China.Methods:All the subjects were Chinese from Guangxi province including 84 chronic hepatitis B,20 chronic severe hepatitis,28 liver cirrhosis and 50 subjects with normal liver function;Besides,according to the level of T.BIL, including 76 normal T.BIL,49 light or midrange T.BIL,57 severe T.BIL.The diagnosis of all the subjects was made according to the criteria established on the Viral Hepatitis Conference held in 2000.Liver functions,including serum aminotransferase,ALB and GLB,bleeding time etc,were tested by automatic biochemical analyzer.TNF-α-238G/A,-308G/A alleles were detected by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).Result:(1)Comparison of TNT-α-238,-308 Polymorphism among each groups:TNF-α-238 GA were found including 2(2.4%)chronic hepatitis B,1(5%) chronic severe hepatitis,3(16.7%)liver cirrhosis and 1(2%)with normal liver function.There was no significant difference of the alleles in the 4 groups (P＞0.05).TNF-α-308 GA were found including 11(13.1%)chronic hepatitis B, 1(5%)chronic severe hepatitis,2(7.1%)liver cirrhosis and 2(4%)with normal liver function.The positive number of TNF-α-308 AA was 4(4.8%),1(5%), 1(3.6%),1(2%)in the four groups respectively.No significant difference of the alleles was seen in the 4 groups(P＞0.05).(2)Comparison of TNF-α-238,-308 Poly-morphism among each T.BIL groups:The positive rate of TNF-α-238 GA was found in the groups of normal,light or midrange,severe T.BIL groups was 2(2.6%),4(8.2%),1(1.8%)respectively.Therewas no significant frequency of the alleles in the 3 groups(P＞0.05).The positive rate of TNF-α-308GA and AA in groups of normal,light or midrange,severe T.BIL was 3(3.9%),7(14.3%), 6(10.5%)and 1(1.3%),1(2.0%),5(8.8%)respectively.The frequencies of the alleles in the 3 groups have significant difference(P=0.044).The positive rate of 308A alleles was significantly found higher in the light or midrange T.BIL groups,and severe T.BIL than those in normal T.BIL(P=0.048,P=0.001).The frequencies of the alleles in the light or midrange T.BIL groups was severe T.BIL groups have no significant difference(P=0.275).Conclusions:(1)-238G/A polymorphisms of TNF-a Gene Promoter Region have no relationship to the chronic hepatitis B,chronic severe hepatitis, liver cirrhosis and normal liver function.(2)-308G/A have no relationship to the persistent of HBV infection.(3)-238G/A polymorphisms of TNF-a Gene Promoter Region have no relationship to jaundice.(4)-308A allele have relation to jaundice because of the injury of liver cells in high immune state.