Elevated serum interleukin-38 level at baseline predicts virological response in telbivudine-treated patients with chronic hepatitis B

Figure 1 Kinetic changes in serum interleukin-38 levels of patients with chronic hepatitis B during treatment with telbivudine and association of serum interleukin-38 with serum aspartate transferase, alanine transferase, hepatitis B virus DNA loads prior to treatment. A: Kinetic changes in the levels of serum IL-38 in HCs and patients with CHB at baseline and at 12, 24, 36, and 52 wk of LdT treatment. IL-38 levels were higher in patients with CHB compared with HCs at baseline [306.97 (123.26-492.79) pg/mL vs 184.50 (135.56-292.16) pg/mL; P = 0.019]. They were reduced at week 12, 24, 36, and 52 of LdT treatment (P < 0.001, P = 0.003, P = 0.027, P = 0.019), and the levels of serum IL-38 in patients with CHB were no longer different from that of the HCs after 12 wk of LdT treatment. B: Serum AST levels correlated with serum IL-38 levels at baseline. C and D: Serum IL-38 levels did not correlate with serum ALT levels or with serum HBV DNA loads at baseline. IL-38: Interleukin-38; HCs: Healthy controls; CHB: Chronic hepatitis B; LdT: Telbivudine; ALT: Alanine transferase; AST: Aspartate transferase; HBV: Hepatitis B virus.

Figure 2 Comparison of serum hepatitis B virus DNA loads (A) and hepatitis B surface antigen levels (B) between high level group and low level group at baseline and at 12, 24, 36, and 52 wk of LdT treatment. A: The serum HBV DNA loads in HG were lower than those in LG at week 12, 24, 36, and 52 post initial LdT treatment (P = 0.041, 0.003, 0.003, 0.020). B: No significant difference in serum HBsAg levels was noted between the groups during LdT therapy. LdT: Telbivudine; HBV: Hepatitis B virus; HG: High level group; LG: Low level group; HBsAg: Hepatitis B surface antigen.

Figure 3 Comparison of serum interleukin-38 levels between patients with primary non-response and primary response at 12 wk post initial telbivudine treatment. The levels of serum IL-38 in patients with CHB who showed PR were higher than those of CHB patients showed PNR at 12 wk after LdT treatment [190.54 (121.35-355.28) pg/mL vs 64.44 (49.85-172.08) pg/mL, P = 0.036]. IL-38: Interleukin-38; CHB: Chronic hepatitis B; LdT: Telbivudine; ALT: Alanine transferase; AST: Aspartate transferase; HBV: Hepatitis B virus; PNR: Primary non-response; PR: Primary response.

Figure 4 Correlation of serum interleukin-38, Th1- and Th2-type cytokines levels. A-E: Serum IL-38 levels correlated with serum IL-6 levels in patients with CHB during LdT treatment at baseline, and at 12, 24, 36, and 52 wk, respectively; F-H: Serum IL-38 levels correlated with serum IL-12 levels in patients with CHB during LdT treatment at 24, 36, and 52 wk, respectively. IL-38: Interleukin-38; CHB: Chronic hepatitis B; LdT: Telbivudine.