Abstract:
Background: The host immune response to hepatitis B viral (HBV) infection affect the
clinical outcome. Cytokines inhibit HBV replication and influences the clinical outcome of HBV
infection. This study sought to determine the disease pattern of Th1, Th2 and immunosuppressive
cytokines and their diagnostic accuracy in classifying or staging HBV infection.
Method: In a case control study, patients with HBV infections and healthy blood donors were screened
for HBsAg profile, HCV and HIV. Those positive with HCV and HIV were excluded. Finally, 120 HBV
infected patients and 105 healthy blood donors were recruited as cases and control. Th1 cytokines (IL-
12p70, IFN-γ and TNF-α), Th2 cytokines (IL-4, IL-6) and immunosuppressive cytokine (IL-10) were
assayed by ELISA. Their diagnostic performance were determined using the ROC curve.
Results: The HBsAg serological profile results gave 3 acute infections, 12 HBV recovery, 5 positive
chronic hepatitis B (CHB) and 100 negative CHB. Median levels of IL-12p70, TNF-α and IFN-γ were
elevated in HBV infections compared to controls (p>0.05). Median levels of IL-4 was significantly
elevated in HBeAg negative CHB and HBV recovery compared to controls (p=0.0196) whilst IL-10 was
significantly elevated in HBeAg negative CHB infection (p=0.0253). At 95% confidence interval, the
best diagnostic markers with AUC, sensitivity and specificity were IL-10 (0.72, 66.67% and 86.67%) for
acute infection and 0.66, 67.0% and 60.0% for HBeAg negative CHB. IL-4 (0.72, 66.67% and 84.44%)
for HBV recovery and IL-6 (0.75, 80.0% and 71.1%) respectively for HBeAg positive CHB respectively.
Conclusion: Th2 cytokines (IL-4, IL-6) and immunosuppressive cytokine (IL-10) are better diagnostic
markers for classifying the various stage of HBV infections. Increased IL-4 is associated with both
HBV recovery and HBeAg negative CHB whilst increased IL-10 is related to HBeAg negative CHB.
The measurement of these cytokines may lead to improvements in the clinical management of HBV
infected patients based on their defined cytokine profiles.
