[Research advances in the role of interleukin-21 in chronic hepatitis B virus infection]

Interleukin-21 receptor gene polymorphism is associated with hepatitis B virus-related hepatocellular carcinoma in Chinese patients

Background

We investigated the relationship between hepatitis B virus (HBV)‐related pathogenesis and single nucleotide polymorphisms (SNPs) in interleukin‐21 (IL‐21)‐JAK‐STAT signaling pathway genes.

Methods

We used the high‐resolution melting (HRM) method to genotype five SNPs (IL‐21 rs2221903, IL‐21 rs4833837, IL‐21 receptor (IL‐21R) rs2285452, JAK3 rs3008, and STAT3 rs1053023) in 546 HBV‐infected patients and 353 healthy Chinese subjects. The HBV‐infected patients were further divided into subgroups based on the HBV‐related pathologies: chronic hepatitis B (CHB), HBV‐related liver cirrhosis (LC), and HBV‐related hepatocellular carcinoma (HCC).

Results

There were no significant differences in the genotype and allele distributions of the five SNPs between the HBV‐infected patients and healthy subjects. The genotype and allele frequencies were similar in the two groups for IL‐21 rs2221903 (A>G, P = 0.83 and 0.67), rs4833837 (A>G, P = 0.80 and 0.49), IL‐21R rs2285452 (G>A, P = 0.25 and 0.68), STAT3 rs1053023 (A>G, P = 1.00 and 0.96), and JAK3 rs3008 (C>T, P = 0.32 and 0.54). However, patients with the IL‐21R rs2285452 AA genotype were more susceptible to HBV‐related HCC than those with the IL‐21R rs2285452 GA/GG genotype (P = 0.03, OR = 3.27, 95% CI = 1.16‐9.20). The serological marker model of “HBsAg+, HBeAg+, HBcAb+” was predominant among patients with HBV infection. However, there was no association between the genotype's distribution of the five SNPs and the serological marker models (P > 0.05).

Conclusions

These findings demonstrate that the IL‐21R rs2285452 AA genotype increases the risk of HBV‐related HCC in Chinese patients.

Effect of entecavir in the treatment of patients with hepatitis B virus-related compensated and decompensated cirrhosis

Chronic hepatitis B virus (CHB) infection is a burden on global healthcare and is associated with a higher risk of serious sequelae, including cirrhosis and hepatocellular carcinoma. The clinical application of entecavir as a treatment for CHB has produced positive outcomes, and so is an attractive form of pharmacological therapy. However, little data exists comparing the safety and efficacy of entecavir for the treatment of hepatitis B virus (HBV)-related compensated, and decompensated cirrhosis, respectively. The aim of the present study was to evaluate entecavir therapy as a treatment for patients with HBV-related compensated and decompensated cirrhosis. A retrospective analysis of 46 compensated patients (compensated group) and 51 decompensated cirrhotic patients (decompensated group) treated with entecavir was conducted. Baseline demographics, clinical outcomes, and adverse events during the treatment were compared. Treatment with entecavir for 96 weeks resulted in significant improvements in serum levels of HBV DNA (P=0.002), albumin (P=0.014), cholinesterase (CHE; P=0.001), HBV DNA negativity rate (P=0.004), Child-Turcotte-Pugh score (P=0.030), alanine aminotransferase normalized rate (P=0.039), and the degree of esophageal varices liver stiffness (P=0.002) in the two groups. However, statistical analysis revealed that the improvements were significantly higher in the compensated group compared with the decompensated group (P<0.05). The complement component (C)3 and C4 levels were also significantly increased in the compensated group compared with the decompensated group at weeks 24, 48 and 96 (P<0.05). In addition, the incidences of hepatocellular carcinoma, upper digestive tract hemorrhage and ascites were significantly higher in the decompensated group compared with the compensated group (P<0.05). In conclusion, treatment with 96-week entecavir therapy produced similar clinical outcomes in compensated and decompensated cirrhotic patients via inhibiting HBV-DNA viral load and recovering complement C3 and C4; however, entecavir exerts a better effect on patients with compensated cirrhosis, and so this therapy may improve the prognosis of such patients.