Abstract
Background and Aims The involvement of cellular immunity in the development of hepatitis E virus (HEV) infection is rare. We aimed to study the roles of viral load and Th cell responses in acute hepatitis E (AHE) and HEV-related acute liver failure (HEV-ALF). Methods We evaluated viral load and Th1/Th2 cytokine levels in 34 patients with HEV infection, including 17 each with AHE or HEV-ALF. Seventeen healthy controls (HCs) were also included who were negative for anti-HEV IgM and IgG. Results There was no significant difference in viral load and HEV RNA in the AHE and HEV-ALF groups (both P > 0.05). The Th lymphocyte levels (CD3+, CD4+) in the AHE and HEV-ALF groups were significantly higher than those in the HC group (both P < 0.05), but there was no significant difference between the AHE and HEV-ALF groups (P > 0.05). Both IFN-γ and IL-10 showed gradual upward trend from the HC group to the AHE (both P < 0.01), but IFN-γ showed a sharp downward trend from the AHE group to the HEV-ALF group (P < 0.01) and IL-4 showed gradual upward trend from the AHE group to the HEV-ALF group (P < 0.01).There was no significant difference in Th1 and Th2 cytokines between the HEV RNA(+) group and HEV RNA(-) group (all P > 0.05). Th2 bias was observed from the AHE (ratio = 58.65) to HEV-ALF (ratio = 1.20) groups. The level of IFN-γ was associated with the outcome of HEV-ALF patients. Conclusions HEV viral load was not associated with aggravation of AHE, and the HEV-ALF patients showed significant Th2 bias, which may be involved in the aggravation of AHE.
Highlights
Hepatitis E is an infectious disease of the digestive tract caused by hepatitis E virus (HEV) [1, 2]
There was no significant difference among the three groups (P = 0:095), but the average age was 55:8 ± 7:3 years in the HEV-related acute liver failure (HEV-ALF)
There were no pregnant women in the acute hepatitis E (AHE) and HEV-ALF groups
Summary
Hepatitis E is an infectious disease of the digestive tract caused by hepatitis E virus (HEV) [1, 2]. We evaluated viral load and Th1/Th2 cytokine levels in 34 patients with HEV infection, including 17 each with AHE or HEV-ALF. The Th lymphocyte levels (CD3+, CD4+) in the AHE and HEV-ALF groups were significantly higher than those in the HC group (both P < 0:05), but there was no significant difference between the AHE and HEV-ALF groups (P > 0:05) Both IFN-γ and IL-10 showed gradual upward trend from the HC group to the AHE (both P < 0:01), but IFN-γ showed a sharp downward trend from the AHE group to the HEV-ALF group (P < 0:01) and IL-4 showed gradual upward trend from the AHE group to the HEVALF group (P < 0:01).There was no significant difference in Th1 and Th2 cytokines between the HEV RNA(+) group and HEV RNA(-) group (all P > 0:05). HEV viral load was not associated with aggravation of AHE, and the HEV-ALF patients showed significant Th2 bias, which may be involved in the aggravation of AHE
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