Serum interleukin 6 level correlates with outcomes of acute exacerbation of chronic hepatitis B

Abstract

Acute exacerbation (AE) of chronic hepatitis B virus (HBV) infection is common and negatively impacts the clinical outcome. Factors predicting outcomes after exacerbations were only partly clarified. We investigated the host immune parameters associated with long-term outcomes. We prospectively examined the profiles of serum cytokines and chemokines in 36 consecutive hepatitis B e antigen (HBeAg)-positive patients (male 72%, age 40.8±9.9years, genotype B/C 75%/25%) who developed AE in a medical center. The patients were followed up for a median of 4years (range 2-6years) post-AE. The impact of six cytokines (tumor necrosis factor alfa, interferon gamma, IL-2, IL-4, IL-6, and IL-10) and five chemokines (CXCL10/IP-10, CCL2/MCP-1, CXCL9/MIG, CCL5/RANTES, and CXCL8/IL-8) at the onset of AE activity on the long-term outcomes were analyzed. Of 36 patients, 22 (61.1%) developed HBeAg seroconversion during follow-up (Group I), and the remaining 14 patients did not obtain HBeAg seroconversion (Group II). Baseline characteristics were generally similar between two groups of patients. In Group I patients, the frequency of undetectable serum IL-6 level (<3pg/mL) at the onset of AE was significantly higher in comparison with Group II patients in multivariate analysis (86.4 vs. 42.9%, P=0.016). Our findings indicate that undetectable serum IL-6 level at the early stage of AE correlated with the long-term outcomes and may serve as a useful clinical predictor.