Expression of IP-10 mRNA in peripheral blood mononuclear cells is correlated with serum levels of HBsAg and HBV DNA and of value for prognosis in patients with HBV-related acute on chronic liver failure

Abstract

Objective To investigate the correlations of expression of interferon inducible protein 10 (IP-10) mRNA in peripheral blood mononuclear cells (PBMCs) with serum levels of HBsAg and HBV DNA in patients with HBV-related acute on chronic liver failure (HBV-ACLF), and to assess its value in predicting disease prognosis. Methods Eighty patients with HBV-ACLF, 60 patients with chronic hepatitis B (CHB), and 25 healthy subjects were enrolled during October 2013 and February 2015. IP-10 mRNA in PBMCs was measured by real time quantitative polymerase chain reaction (RT-qPCR), and the difference in IP-10 mRNA expression among three groups was compared by ANOVA. Serum levels of HBsAg and HBV DNA were also measured in patients with HBV-ACLF, and Pearson correlation test was performed to analyze the correlations of IP-10 mRNA with HBsAg and HBV DNA levels. t test was used to analyze the differences in IP-10 mRNA, HBsAg and HBV DNA levels between fatal and surviving cases after 3-month entecavir therapy in HBV-ACLF group. Receiver operating characteristic curves (ROC) was used to evaluate the prognostic value of IP-10 mRNA, HBsAg and HBV DNA in HBV-ACLF patients. Results IP-10 mRNA level in HBV-ACLF group was 0.998±0.186, which was higher than those in CHB patients and healthy controls (0.641±0.083 and 0.412 ±0.062, t=3.841 and 16.661, P<0.01). Pearson correlation analysis showed that IP-10 mRNA level was negatively correlated with HBsAg level in HBV-ACLF patients (r=-0.576, P<0.01), but positively correlated with HBV DNA level (r=0.547, P<0.01). After 3-month entecavir therapy, IP-10 mRNA level in surviving cases of HBV-ACLF group was 0.894±0.164, which was lower than that in fatal cases (1.103±0.177, t=-4.328, P<0.01); HBsAg level in surviving cases was higher than that in fatal cases (3.303±0.565 vs. 2.605±0.844, t=3.251, P<0.01). The area under ROC of IP-10 mRNA in evaluating prognosis of HBV-ACLF was 0.820, which was higher than those of HBsAg (0.663) and HBV DNA (0.570). Conclusions IP-10 mRNA in patients with HBV-ACLF is over-expressed and is correlated with HBsAg and HBV DNA levels. It may be used for predicting the prognosis of patients with HBV-ACLF. Key words: Hepatitis B virus; Liver failure; Interferon-inducible protein-10; Hepatitis B surface antigens; Viral load; Prognosis