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

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.