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

doi:10.3748/wjg.v22.i18.4529

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Basic Study

World J Gastroenterol. May 14, 2016; 22(18): 4529-4537
Published online May 14, 2016. doi: 10.3748/wjg.v22.i18.4529

Table 1 Demographic and clinical characteristics of study subjects at baseline

Parameters	Patients with CHB (n = 46)	Healthy controls (n = 43)
Age (yr)	34.5 (23.75-38.25)	34 (22-40)
Sex (M/F)	38/8	34/9
HBV DNA load (log₁₀ IU/mL)	7.71 (6.98-8.10)	NA
ALT level (U/L)	117.35^a (74.50-241.48)	14 (6-22)
AST level (U/L)	96.75^a (57.25-176.25)	12 (10-30)
HBsAg level (IU/mL)	7821.43 (3337.23-20737.14)	NA
HBsAg, pos/neg	46/0	0/43
HBeAg, pos/neg	46/0	0/43

Data are represented as median and interquartile range (IQR) or real case number. Normal values: ALT ≤ 50 IU/L; AST ≤ 40 IU/L; HBV DNA ≤ 1.78 log₁₀ IU/mL (60 IU/mL).

^aP < 0.05 vs the HCs. The undetectable HBV DNA loads were recorded as those ≤ 60 IU/mL. CHB: Chronic hepatitis B; HBV: Hepatitis B virus; NA: Not applicable; ALT: Alanine transferase; AST: Aspartate transferase; HBsAg: Hepatitis B surface antigen; HBeAg: Hepatitis B e antigen; pos: Positive; neg: Negative.

Table 2 Dynamics of clinical parameters in patients with chronic hepatitis B during LdT treatment

Parameters	Baseline	3 mo	6 mo	9 mo	13 mo
HBV DNA load (log₁₀ IU/mL)	8.41 (7.68-8.80)	3.79^a (3.20-5.14)	3.04^a (2.48-3.98)	2.81^a (2.48-3.10)	2.48^a (2.48-3.50)
ALT level (U/L)	117.35 (74.50-241.48)	36.00^a (23.93-85.50)	27.00^a (22.00-38.00)	27.50^a (23.00-34.25)	29.50^a (24.00-55.00)
AST level (U/L)	96.75 (57.25-176.25)	34.00^a (28.00-55.25)	26.00^a (22.00-31.25)	24.50^a (19.75-30.00)	27.00^a (22.75-43.25)
HBsAg level (IU/mL)	7821.43 (3337.23-20737.14)	4214.99^a (2034.48-10170.46)	5153.19^a (2039.45-10671.30)	4414.88^a (2317.96-10084.21)	4210.48^a (1664.73-9823.78)

Data are represented as median and interquartile range (IQR). Normal values: ALT ≤ 50 IU/L; AST ≤ 40 IU/L; HBV DNA ≤ 1.78 log₁₀ IU/mL (60 IU/mL).

^aP < 0.05 vs baseline value. The undetectable HBV DNA loads were recorded as those ≤ 60 IU/mL. CHB: Chronic hepatitis B; HBV: Hepatitis B virus; ALT: Alanine transferase; AST: Aspartate transferase; HBsAg: Hepatitis B surface antigen.

Table 3 Comparison of demographic and clinical characteristics of patients with high and low interleukin-38 levels before treatment

Parameter	High IL-38 levelbefore treatment (n = 27)	Low IL-38 levelbefore treatment (n = 19)
Age (yr)	35 (23-38)	34 (25-40)
Sex (M/F)	22/5	16/3
HBV DNA load (log₁₀ IU/mL)	7.74 (6.89-8.10)	7.69 (7.14-8.36)
ALT level (U/L)	130.00 (71.00-246.50)	108.00 (81.00-147.00)
AST level (U/L)	156.00^c (76.00-193.00)	74.00 (49.00-147.00)
HBsAg level (IU/mL)	6641.55 (4437.10-18631.33)	10222.92 (2657.06-24877.19)

Data are represented as median and interquartile range (IQR) or real case number. Normal values: ALT ≤ 50 IU/L; AST ≤ 40 IU/L; HBV DNA ≤ 1.78 log₁₀ IU/mL (60 IU/mL).

^cP < 0.05 vs the group of patients with low serum IL-38 levels before LdT treatment. The undetectable HBV DNA loads were recorded as those ≤ 60 IU/mL. High IL-38 level: Serum IL-38 ≥ 250 pg/mL; Low IL-38 level: Serum IL-38 < 250 pg/mL; IL-38: Interleukin-38; HBV: Hepatitis B virus; ALT: Alanine transferase; AST: Aspartate transferase; HBsAg: Hepatitis B surface antigen; M: Male; F: Female.

Table 4 Comparison of treatment outcomes between patients with high and low baseline interleukin-38 levels

Parameters	Week 24			Week 52
Parameters	HG (n = 27)	LG (n = 19)	P value	HG (n = 27)	LG (n = 19)	P value
HBV DNA ≤ 60 IU/mL	13 (48.1)	3 (15.8)	0.023	18 (66.7)	7 (36.8)	0.044
HBeAg seroconversion	4 (14.8)	2 (10.5)	0.516	8 (29.6)	4 (21.1)	0.382
ALT normalization	25 (92.6)	15 (78.9)	0.182	21 (77.8)	12 (63.2)	0.225
HBsAg loss	0 (0.0)	0 (0.0)	NA	1 (3.7)	1 (5.3)	0.661

Normal values: ALT ≤ 50 IU/L; AST ≤ 40 IU/L; HBV DNA ≤ 1.78 log10 IU/mL (60 IU/mL). The undetectable HBV DNA loads were recorded as those ≤ 60 IU/mL. HG: High IL-38 level group, basement serum IL-38 ≥ 250 pg/mL; LG: Low IL-38 level, basement serum IL-38 < 250 pg/mL; IL-38: Interleukin-38; HBV: Hepatitis B virus; ALT: Alanine transferase; AST: Aspartate transferase; HBsAg: Hepatitis B surface antigen; HBeAg: Hepatitis B e antigen; NA: Not applicable.

Citation: Wang HJ, Jiang YF, Wang XR, Zhang ML, Gao PJ. Elevated serum interleukin-38 level at baseline predicts virological response in telbivudine-treated patients with chronic hepatitis B. World J Gastroenterol 2016; 22(18): 4529-4537
URL: https://www.wjgnet.com/1007-9327/full/v22/i18/4529.htm
DOI: https://dx.doi.org/10.3748/wjg.v22.i18.4529