| Objective:To explore the virological response, the serological response and the biochemical response of the patients with chronic hepatitis B after entecavir therapy and to explore the changes in the balance of Treg and Th17after entecavir therapy by researching IL-17, IL-10and TGF-β1.Method:Gathering the clinical data of20healthy adults and35patients with HBeAg-positive chronic hepatitis B who had used entecavir for the initial treatment. They all had seen doctors in infectious diseases department of The First Affiliated Hospital of Kunming Medical University during January2012to December2012. The patients were divided into two groups as follows:ETV group, control group. All the patients in two groups were analyzed for their clinical items including alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil) Interleukin-17(IL-17), Interleukin-10(IL-10), transforming growth factor-betal (TGF-β1), HBV-DNA viral load,Result:1. The levels of ALT (255.00,(246.00-290.00) IU/L), AST (216.00(132.00-259.00)IU/L) were significantly higher in the patients with chronic hepatitis B before entecavir therapy than in the healthy control group{ALT[28.00(22.75-31.75) IU/L], AST [22.00(18.25-25.75) IU/L)]. The differences in ALT and AST in the two groups were statistically significant (P<0.05). The levels of IL-17[408.03(391.97-432.60) pg/ml], IL-10[294.01(277.51-311.79) pg/ml] TGF-β1[600.68(481.72-757.13) pg/ml] were also all significantly higher in the patients with chronic hepatitis B than in the healthy control group{IL-17[159.52(141.56-188.34) pg/ml]、IL-10[141.31(129.88-158.61) pg/ml]、TGF-β1(273.12(247.04-300.01) pg/ml]}. The differences among IL-17, IL-10and TGF-β1in the two groups were statistically significant (P<0.05).2. The ratios of patients who had the virological response, or the serological response, or the biochemical response were high after entecavir therapy, and as the time extending with entecavir, the ratios of patients who had the virological response, or the serological response, or the biochemical response was gradually increased.3. As the time of therapy extending, the growth rate of the ratio of patients who had the virological response, or the serological response after using entecavir for antiviral therapy was lower than the growth rate of the ratio of patients who had the therapy to12weeks. But the growth rate of the HBeAg seroconversion had a suddenly rise. It had1person (3%) when we treat to24weeks, and had8people (23%) when we treat to48weeks.It seems had the accumulation of change to the qualitative change.4. The levels of ALT and AST both significantly declined in the patients with chronic hepatitis B who had used entecavir for antiviral therapy. The patients’level of ALT was [255.00,(246.00-290.00) IU/L] and the level of AST was (216.00(132.00-259.00) IU/L) before therapy.After12weeks’treatment, the level of ALT was (45.00(36.00-62.00) IU/L] and the level of AST was [36.00(31.00-42.00) IU/L]. The level of ALT was [38.00(32.00-48.00) IU/L] and the level of AST was [36.00(31.00-42.00) IU/L] when we had the therapy to24weeks. The level of ALT was [32.00(29.00-36.00) IU/L] and the level of AST was [28.00(26.00-34.00)] when we had the therapy to48weeks. The differences in ALT and AST before and after treatment were statistically significant (P<0.05). 5. After48weeks’antiviral treatment with entecavir, the levels of IL-17, IL-10and TGF-β1had varying degrees of decline when we compared with the levels before treatment. The IL-17of the patients with chronic hepatitis B was408.03(391.97-432.60) pg/ml before treatment, it declined to285.19(274.80-294.64) pg/ml after48weeks’ treatment; IL-10was294.01(277.51-311.79) pg/ml before treatment, it declined to174.01(156.23-186.07) pg/ml after48weeks’ treatment; TGF-β1was600.68(481.72-757.13) pg/ml before treatment, it declined to423.05(341.56-582.75) pg/ml after48weeks’treatment.6. After48weeks’ treatment with entecavir, the ratio of IL-10/IL-17declined when we compared with the ratio before treatment, but there was little change in the ratio of TGF-β1/IL-17before and after treatment. The two ratios are all lower than the ratio of the healthy control group. The ratio of IL-10/IL-17is0.72before treatment with entecavir in the patients. It declined to0.61after48weeks’treatment. But the ratio of TGF-β1/IL-17was1.47before treatment. It has little change when we compared with the ratio1.48after treatment. The ratios of IL-10/IL-17are all lower than the ratio of the control group0.89. The ratios of TGF-β1/IL-17are all lower than the ratio of the control group1.71.Conclusion:The levels of ALT、AST、IL-17、IL-10、TGF-β1were significantly higher in the patients with chronic hepatitis B before entecavir therapy than in the healthy control group. After48weeks’treatment with entecavir, the patients had significantly virological response, serological response and biochemical response. The levels of IL-17、IL-10、TGF-β1were significantly lower than the levels before treatment in the patients, but they are all higher than the levels of the healthy control group. After48weeks’treatment with entecavir, the ratios of IL-10/IL-17and TGF-β1/IL-17are all lower than the ratio of the healthy control group. But the ratio of IL-10/IL-17was declined when we compared with the ratio before treatment. There was little change in the ratio of TGF-β1/IL-17before and after treatment after48weeks’treatment with entecavir. So the ratio of Treg/Th17declined, the balance between Treg and Th17tend to the side of Th17. |
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