- Email: [email protected]
P0585 : Difference of serum cytokines expression between HBeAg-positive and HBeAg-negative chronic hepatitis B
POSTERS Conclusions: Secondary infection including SBP and pneumonia frequently occurred in patients with HBV-ACLF and significantly increased mortality. Early identification and intervention of the risk factors may improve the survival. P0584 GENDER DIFFERENCES IN HEPATOCELLULAR CARCINOMA (HCC) SURVEILLANCE ADHERENCE PATTERNS IN PATIENTS WITH CHRONIC HEPATITIS B (CHB) IN A MULTICENTER ACADEMIC AND COMMUNITY COHORT STUDY L. Nguyen1 , C. Wang1 , J. Hoang2 , H.N. Trinh3 , J. Li4 , J.Q. Zhang5 , M. Nguyen2 . 1 Stanford University, Stanford, 2 Division of Gastroenterology and Hepatology, Stanford University, Palo Alto, 3 San Jose Gastroenterology, San Jose, 4 Gastroenterology, Palo Alto Medical Foundation, Mountain View, 5 Chinese Hospital, San Francisco, United States E-mail: [email protected] Background and Aims: HCC surveillance is associated with improved survival of CHB patients. Although HCC risk is higher in males than females, it is not known if there are gender differences in HCC surveillance adherence. Our goal is to examine HCC surveillance adherence in males versus females and to determine surveillance adherence predictors. Methods: We performed a retrospective cohort study of 1098 consecutive CHB patients without prior history of HCC and at least 12 months follow-up at a university medical center and 3 community gastroenterology and primary care sites in the U.S from 10/98–10/13. Patients were identified using ICD-9 diagnosis codes. Adherence to HCC screening by AASLD 2010 guidelines was categorized by imaging: optimal (every 6 months), suboptimal (6–12 months), poor (>12 months) and none.
Figure: Clinical characteristics and screening adherence patterns of cohort by gender.
per year (20% vs. 14%, p = 0.047) compared to females. According to AASLD HCC screening guidelines, males were more likely to undergo optimal or suboptimal screening (60% vs. 53%, p = 0.046) compared to females. On multivariate logistic regression also inclusive of age, sex, cirrhosis status, independent predictors for optimal screening adherence were anti-HBV therapy (OR = 2.3, p < 0.0001) and more frequent clinical visits per year (OR = 13.4, p < 0.0001). Conclusions: In this large multicenter cohort study consisting of consecutive CHB patients followed at either academic or community practices, males were significantly more likely to have more severe progression of CHB, to receive antiviral treatment for CHB, to have more frequent clinic visits for CHB, and to have better HCC screening adherence relative to females. More frequent clinical visits may improve HCC screening adherence in both male and female patients with CHB, which ultimately can improve survival for HCC in patients of both genders. P0585 DIFFERENCE OF SERUM CYTOKINES EXPRESSION BETWEEN HBeAg-POSITIVE AND HBeAg-NEGATIVE CHRONIC HEPATITIS B D. He1 , S. Guo2 , M. Li2 , X. Zeng2 , H. Huang2 , Z. Tan2 , Y. Wang2 . 1 The 88th hospital of PLA, Tai’an, 2 The third military medical university, Chongqing, China E-mail: [email protected] Background and Aims: The pattern of cytokines in sera was consistent with the level of inflammation during chronic hepatitis. By observing the difference of cytokines expression between HBeAg-positive and HBeAg-negative chronic hepatitis B (CHB), we aimed to explore the immune pathogenesis of HBeAg-negative CHB. Methods: We investigated the expression of 30 cytokines (IFN-g, IL-1b, IL-2, IL-4, IL-6, IL-7, IL-9, IL-10, IL-12p40, IL-12p70, IL-15, IL-17A, IL-17C, IL-21, IL-22, IL-23p19, IL-28A, IL-29, CCL5, CCL16, CCL20, CCL22, CXCL9, CXCL10, CXCL11, TNFRSF8, TNFRSF18, IL-6R, gp130, and TGF-b1) associated with HBV immune in sixty treatment-naïve CHB (30 with HBeAg-positive and 30 with HBeAgnegative) by a protein array. Cytokines expression among different ALT levels group and the correlation between cytokines and ALT levels were observed. Protein-protein interactions were analyzed by STRING. Results: IFN-g, IL-29, IL-7, IL-9, IL-15, and IL-6 with significant difference among different ALT groups in HBeAg-positive patients were not found significant difference among ALT groups in HBeAg-negative patients. IL-21 was the opposite. IFN-g, TNFRSF18, IL-12p40, IL-17C, IL-1b, IL-12p70, IL-6, IL-15, and IL-10 with significant correlation in HBeAg-positive patients were not found significant correlation in HBeAg-negative patients. IL-21 and TGF-b1 were the opposite. Protein-protein interactions indicated that a close relationship between IFN-g and STAT1, IL-6 up-regulating SOCS3, a close relationship between IL-21 and STAT3, IL-29 upregulating Mx1. Conclusions: Defection of IFN-g, IL-29, and IL-6 expression and compensatory up-regulation of IL-21 is the characteristic of HBeAgnegative CHB and may be associated with the immune pathogenesis of HBeAg-negative CHB.
Results: The overall cohort was 51% male, 96% foreign-born, 97% medically insured, 92% Asian, and 61% from community practices. Males were slightly older (51.7 vs. 50.7, p = 0.17), had longer mean follow-up time (62.5 vs. 58.9, p = 0.11) but these differences were not statistically significant; however, and males were significantly more likely to receive anti-HBV treatment for CHB (57.5% vs. 45.0%, p < 0.001). Males had more severe progression of CHB such as cirrhosis diagnosis (13% vs. 6.4%, p < 0.0001) and HCC incidence (4.2% vs. 0.7%, p < 0.001) during follow-up compared to females. Males were also more likely to have two or more clinic visits Journal of Hepatology 2015 vol. 62 | S263–S864
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Figure: Clinical characteristics and screening adherence patterns of cohort by gender.
per year (20% vs. 14%, p = 0.047) compared to females. According to AASLD HCC screening guidelines, males were more likely to undergo optimal or suboptimal screening (60% vs. 53%, p = 0.046) compared to females. On multivariate logistic regression also inclusive of age, sex, cirrhosis status, independent predictors for optimal screening adherence were anti-HBV therapy (OR = 2.3, p < 0.0001) and more frequent clinical visits per year (OR = 13.4, p < 0.0001). Conclusions: In this large multicenter cohort study consisting of consecutive CHB patients followed at either academic or community practices, males were significantly more likely to have more severe progression of CHB, to receive antiviral treatment for CHB, to have more frequent clinic visits for CHB, and to have better HCC screening adherence relative to females. More frequent clinical visits may improve HCC screening adherence in both male and female patients with CHB, which ultimately can improve survival for HCC in patients of both genders. P0585 DIFFERENCE OF SERUM CYTOKINES EXPRESSION BETWEEN HBeAg-POSITIVE AND HBeAg-NEGATIVE CHRONIC HEPATITIS B D. He1 , S. Guo2 , M. Li2 , X. Zeng2 , H. Huang2 , Z. Tan2 , Y. Wang2 . 1 The 88th hospital of PLA, Tai’an, 2 The third military medical university, Chongqing, China E-mail: [email protected] Background and Aims: The pattern of cytokines in sera was consistent with the level of inflammation during chronic hepatitis. By observing the difference of cytokines expression between HBeAg-positive and HBeAg-negative chronic hepatitis B (CHB), we aimed to explore the immune pathogenesis of HBeAg-negative CHB. Methods: We investigated the expression of 30 cytokines (IFN-g, IL-1b, IL-2, IL-4, IL-6, IL-7, IL-9, IL-10, IL-12p40, IL-12p70, IL-15, IL-17A, IL-17C, IL-21, IL-22, IL-23p19, IL-28A, IL-29, CCL5, CCL16, CCL20, CCL22, CXCL9, CXCL10, CXCL11, TNFRSF8, TNFRSF18, IL-6R, gp130, and TGF-b1) associated with HBV immune in sixty treatment-naïve CHB (30 with HBeAg-positive and 30 with HBeAgnegative) by a protein array. Cytokines expression among different ALT levels group and the correlation between cytokines and ALT levels were observed. Protein-protein interactions were analyzed by STRING. Results: IFN-g, IL-29, IL-7, IL-9, IL-15, and IL-6 with significant difference among different ALT groups in HBeAg-positive patients were not found significant difference among ALT groups in HBeAg-negative patients. IL-21 was the opposite. IFN-g, TNFRSF18, IL-12p40, IL-17C, IL-1b, IL-12p70, IL-6, IL-15, and IL-10 with significant correlation in HBeAg-positive patients were not found significant correlation in HBeAg-negative patients. IL-21 and TGF-b1 were the opposite. Protein-protein interactions indicated that a close relationship between IFN-g and STAT1, IL-6 up-regulating SOCS3, a close relationship between IL-21 and STAT3, IL-29 upregulating Mx1. Conclusions: Defection of IFN-g, IL-29, and IL-6 expression and compensatory up-regulation of IL-21 is the characteristic of HBeAgnegative CHB and may be associated with the immune pathogenesis of HBeAg-negative CHB.
Results: The overall cohort was 51% male, 96% foreign-born, 97% medically insured, 92% Asian, and 61% from community practices. Males were slightly older (51.7 vs. 50.7, p = 0.17), had longer mean follow-up time (62.5 vs. 58.9, p = 0.11) but these differences were not statistically significant; however, and males were significantly more likely to receive anti-HBV treatment for CHB (57.5% vs. 45.0%, p < 0.001). Males had more severe progression of CHB such as cirrhosis diagnosis (13% vs. 6.4%, p < 0.0001) and HCC incidence (4.2% vs. 0.7%, p < 0.001) during follow-up compared to females. Males were also more likely to have two or more clinic visits Journal of Hepatology 2015 vol. 62 | S263–S864
S535