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Peripartum cytokine flares in a multiethnic cohort of chronic hepatitis B carriers does not correlate with hepatitis B virus suppression or increased risk of liver disease
Author(s) -
Joshi Shivali S.,
Wong Daniel,
Castillo Eliana,
Swain Mark G.,
Coffin Carla S.
Publication year - 2017
Publication title -
american journal of reproductive immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.071
H-Index - 97
eISSN - 1600-0897
pISSN - 1046-7408
DOI - 10.1111/aji.12707
Subject(s) - medicine , transient elastography , hepatitis b virus , immunology , viral load , immune system , liver disease , alanine transaminase , hepatitis b , fibrosis , virus , chronic hepatitis
Problem In chronic hepatitis B ( CHB ) carriers, alanine transaminase ( ALT ) flares are common in the peripartum period. There are limited data on immunological changes of pregnancy in CHB . We hypothesize that in pregnant CHB carriers, the Th1/Th2 cytokine ratio is altered resulting in changes in biochemical/virological and liver fibrosis markers. Study methods Serum from 38 pregnant/post‐partum CHB carriers (median age 32 years, 53% Asian, 8 HB eAg + ) was tested for HBV DNA , quantitative HBV surface antigen, ALT and liver fibrosis by transient elastography ( TE ). Serum cytokines were analyzed using a Luminex assay. Results Untreated CHB cases had mild ALT flares post‐partum, but showed normal TE , and no change in viral markers despite increased Th1 cytokines compared to healthy controls ( P <.05). Conclusion CHB carriers show increased Th1 cytokines in the peripartum period albeit with no effect on viral load or liver disease suggesting an aborted antiviral immune response.