Abstract
BackgroundThe clearance of hepatitis B virus (HBV) is a complex process which may be influenced by many factors including polymorphisms in the tumor necrosis factor <alpha> (TNF-<alpha>) gene promoter. However, previous reports regarding the relationship between polymorphisms in the TNF-<alpha> promoter and HBV clearance have been inconsistent. Therefore, we performed a meta-analysis on a large population to address this inconsistency.MethodsA meta-analysis was performed to examine the association between TNF-<alpha> promoter polymorphisms (-1031T/C, -863C/A, -857C/T, -308G/A and-238G/A) and chronic hepatitis B infection. Odds ratio (OR) and its 95 % confidence interval (CI) were used.ResultsTwelve studies were chosen in our meta-analysis, involving 2,754 chronic HBV infection cases and 1,630 HBV clearance cases. The data showed that TNF-<alpha>-863 CC genotype was significantly associated with HBV clearance (-863 CC vs. AA: OR, 0.64; 95% CI, [0.42, 0.97]; p = 0.04) while patients carrying -308 GG genotype had a significantly increased risk of HBV persistence compared with those with GA or AA genotype (GG vs. GA+AA: OR, 1.35; 95% CI, [1.08, 1.70]; p = 0.01). For the other polymorphisms, no association with HBV infection outcome was found.ConclusionsThe data showed that polymorphisms -863 A and -308 G in the TNF-<alpha> gene promoter region might be risk factors for HBV persistence. Furthermore, ethnicity might play an important role in HBV infection outcome, leading to conflicting results. More studies on individuals from various ethnic groups will be necessary to determine the role of TNF-<alpha> promoter polymorphisms in the outcome of HBV infection.
Highlights
5–10% of patients infected with hepatitis B virus (HBV) as adults are unable to clear the virus, developing chronic HBV infections[1]
Seventy-six studies that not focused on chronic HBV(e.g. Severe Hepatitis B infection, Hepatitis C or D infection, liver fibrosis, hepatocellular carcinoma, intrauterine infection, etc.)
Twelve studies were excluded after abstract review, three of them were not focusing on chronic HBV and eight lacked HBV clearance (HC) cases and one was a review article
Summary
5–10% of patients infected with hepatitis B virus (HBV) as adults are unable to clear the virus, developing chronic HBV infections[1]. The virus itself, environment factors, ethnic differences, and genetic susceptibility have been reported to have some influence on the progression of this liver disease [2]. Cytokine genetic polymorphisms have been found to be related factors that affect the progression of HBV infection [1]. Can stimulate cytokine secretion, increase the expression of adhesion molecules as well as activate neutrophils. It fulfills the role as a principal mediator of cellular immune response and inflammation, and may play an importance role in non-cytolytic and cytolytic clearance of HBV [3,4,5]. The clearance of hepatitis B virus (HBV) is a complex process which may be influenced by many factors including polymorphisms in the tumor necrosis factor ,alpha.
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