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Serum Th17 and TNF-α distinguish between patients with occult hepatitis B infection, chronic hepatitis B infection and healthy individuals Volume 32, issue 2, June 2021

Figures


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Tables

Authors
1 Laboratorio de Biología Molecular y Virología, Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social, Metepec, Puebla, México
2 Servicio de Gastroenterología, Unidad Médica de Alta Especialidad, Centro Médico Nacional “General de División Manuel Ávila Camacho”, Instituto Mexicano del Seguro Social, Puebla, México
3 Centro Interdisciplinario de Posgrados, Facultad de Medicina, Universidad Popular Autónoma del Estado de Puebla, Puebla, México
4 Coordinación de Enseñanza, Unidad Médica de Alta Especialidad, Centro Médico Nacional “General de División Manuel Ávila Camacho”, Instituto Mexicano del Seguro Social, Puebla, México
5 Banco de Sangre, Unidad Médica de Alta Especialidad, Centro Médico Nacional “General de División Manuel Ávila Camacho”, Instituto Mexicano del Seguro Social, Puebla, México
6 Unidad de Investigación Biomédica de Zacatecas, Instituto Mexicano del Seguro Social. Zacatecas, Zacatecas, México
7 División de Biología Molecular, Instituto Potosino de Investigación Científica y Tecnológica. San Luis Potosí, San Luis Potosí, México
8 Laboratorio Juárez, Medicina de Laboratorio Clínico de Alta Especialidad, Biología Molecular e Investigación Clínica, Oaxaca de Juárez, Oaxaca, México
9 Laboratorio de Biología Celular, Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social, Metepec, Puebla, México
* Correspondence

Chronic hepatitis B (CHB) is classified into five phases based on virus-host interactions: immune tolerance, immune clearance, inactive carrier state, reactive phase and occult hepatitis B infection (OBI). OBI is an uncommon asymptomatic phase of CHB that can be reactivated when the immune system is compromised, occasionally giving rise to severe liver disease. Host immune factors play essential roles in all phases of the CHB infection. Cytokines may alter infection course, influencing the propensity for and the progression of CHB and thus warrant study. Three clinical groups were studied: 48 healthy individuals (HI), 28 patients with persistent positive anti-HBc serological markers and negative HBsAg over time, who were diagnosed as OBI and 12 patients with active CHB. OBI patients were defined by three independent detections of the hepatitis B virus genome through nested PCR and real-time PCR. Quantitative measurement of 20 Th1, Th2 and Th17 human cytokines was performed in the sera of HI, OBI and CHB patients. Levels of IFN-γ, TNF-β, IL-28A, IL-4, IL-5, IL-13, IL-1β, IL-6, IL-21, IL-22, IL-23, GM-CSF and MIP-3α were similar between groups. IL-2, IL-12p70, IL-10, IL-17F and TGF-β1 were similar in HI and OBI, but higher in CHB. TNF-α and the IL-17A:IL-17F ratio were significantly different between the three groups. TNF-α was progressively higher in HI, OBI and CHB (P = 0.004), while the IL-17A:IL-17F ratio was 1.1 in HI, 3.4 in OBI and 0.4 in CHB. Detection and levels of these pro-inflammatory cytokines in OBI patients suggest that they are undergoing a silent hepatic inflammatory process.