The serum IL-23 level predicts the response to pegylated interferon therapy in patients with chronic hepatitis B

Liver Int. 2015 May;35(5):1549-56. doi: 10.1111/liv.12701. Epub 2015 Jan 17.

Abstract

Background & aims: This study investigated the possible use of interleukin (IL)-23 and IL-17 serum levels as indicators for anti-hepatitis B virus (HBV) therapy.

Methods: A total of 127 patients with chronic hepatitis B (CHB) who received pegylated interferon (PegIFN) therapy, 20 chronic asymptomatic HBV carriers (AsCs) and 32 healthy controls were recruited. The serum levels of IL-23 and IL-17 were detected by ELISA. The predictive value of baseline and early on-treatment changes in the levels of IL-23 and IL-17 for therapeutic response were evaluated by receiver operating characteristic analysis. Multivariate logistic regression models were generated to identify independent factors that affect the clearance of hepatitis B e antigen (HBeAg) and the decline in hepatitis B surface antigen (HBsAg).

Results: The baseline serum levels of IL-23 and IL-17 were higher in patients with CHB than in normal controls and in AsCs. High levels of pre-treatment IL-23 and IL-17 and more significant on-treatment reductions in IL-23 and IL-17 levels were observed in patients with CHB who achieved HBeAg clearance or a decline in HBsAg >1 log10 IU/ml compared with patients who were persistently HBeAg-positive or who experienced a decline in HBsAg <1 log10 IU/ml. The predictive cut-off value of IL-23 for HBeAg clearance was 135 pg/ml, and the specificity and sensitivity were 71.4% and 70% respectively. A high pre-treatment level of IL-23 was an independent factor for the prediction of the therapeutic response in patients with HBeAg-positive CHB. Early on-treatment changes of IL-23 and IL-17 showed no predictive value.

Conclusions: A high pre-treatment serum IL-23 level predicts the therapeutic response in HBeAg-positive CHB patients during PegIFN therapy.

Keywords: chronic hepatitis B; hepatitis B virus; interleukin-17; interleukin-23; pegylated interferon therapy.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Antiviral Agents / therapeutic use*
  • Case-Control Studies
  • Cohort Studies
  • DNA, Viral / blood
  • Female
  • Hepatitis B Surface Antigens / blood
  • Hepatitis B e Antigens / blood
  • Hepatitis B virus
  • Hepatitis B, Chronic / drug therapy*
  • Humans
  • Interferon-alpha / therapeutic use*
  • Interleukin-17 / blood*
  • Interleukin-23 / blood*
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Polyethylene Glycols / therapeutic use*
  • Predictive Value of Tests
  • Prognosis
  • Recombinant Proteins / therapeutic use
  • Treatment Outcome
  • Young Adult

Substances

  • Antiviral Agents
  • DNA, Viral
  • Hepatitis B Surface Antigens
  • Hepatitis B e Antigens
  • Interferon-alpha
  • Interleukin-17
  • Interleukin-23
  • Recombinant Proteins
  • Polyethylene Glycols
  • peginterferon alfa-2a