Early Changes And Significance Of IL-17a?IL-23 In HBeAg Positive Chronic Hepatitis B Patients With Antiviral Treatment

IntroductionChronic hepatitis B is still a major problem in global public health,and it can further develop into liver cirrhosis,liver cancer or liver failure.The development of chronic hepatitis B is a complex result of the interaction between the body's immune system and the virus.Th 17 cells are newly identified T cell subsets that can secrete a variety of cytokines,including IL-17a?IL-21?IL-22,which drive the infection process of hepatitis B virus.IL-23 can amplifies Th17 cells,promoting their secretion of cytokines to mediate liver damage and viral clearance.Therefore,the IL-17a?IL-23 provides new evidence for the development of chronic hepatitis B.In the 12th Five-Year-Plan Major Research on National Science and Technology,we found that the antiviral efficacy of IFN-a combined with adefovir dipivoxil was superior to that of IFN-a monotherapy group,however,the specific mechanism was unknown now.In order to explore the relationship between antiviral therapy and cytokines,we observed the early changes of the levels of IL-17a and IL-23 in HBeAg-positive chronic hepatitis B patients who were on treatment with IFN-a and adefovir dipivoxil and preliminarily explored their role for antiviral activity.Methods130 patients with HBeAg-positive chronic hepatitis B received antiviral treatment of IFN-a and adefovir dipivoxil for 48 weeks,and HBV DNA,HBsAg,HBeAg,ALT levels were detected at week 0,4,12,24,36,48 and IL-17a,IL-23 were tested at week 0 and week 12.ResultsAfter 48 weeks antiviral treatment of IFN-a and adefovir dipivoxil,the rate of HBeAg loss was 29.2%(38/130)and the HBsAg loss rate was 3.1%(4/130),while the rate of HBV DNA response was 73.8%(96/130)and the rate of ALT normality is 78.4%(102/130).In the research,we found that IL-17a was positively correlated with the level of ALT and negatively correlated with the level of HBsAg(P<0.05),while IL-23 was positively correlated with the level of ALT and HBeAg and was negatively correlated with the level of HBV DNA(P<0.05).We also found the levels of IL-17a and IL-23 decreased slightly at week 12,but the difference was not founded statistically significant(P>0.05).The levels of IL-17a and IL-23 in the virological response group were higher than those non-responder group at week 0,and decreased at week 12(P<0.05),while the level of IL-17a of non-responder group increased,and the level of IL-23 was almost the same as that at week 0,however,there was no significantly difference(P>0.05).There was no significant difference in serum levels of IL-17a and IL-23 and amplitude between the group with HBeAg loss and the group with non HBeAg loss at week 0 and 12.ConclusionsIL-17a and IL-23 play an important role in the treatment of antiviral therpay with interferon-a and adefovir dipivoxil.