Plasma interleukin‐10 predicts short‐term mortality of acute‐on‐chronic hepatitis B liver failure

Summary Background Interleukin ( IL )‐10 is a pleiotropic cytokine with anti‐inflammatory and immunosuppressive properties in liver failure. Biomarkers are urgently needed to predict prognosis of acute‐on‐chronic hepatitis B liver failure ( ACHBLF ). Aim To investigate the potential diagnostic value of plasma IL ‐10 as a biomarker for predicting the mortality of ACHBLF . Methods This prospective study consisted of 115 newly diagnosed ACHBLF patients from May 2009 to October 2013 as a training cohort and 54 ACHBLF patients from November 2013 to March 2015 as a validating cohort. Plasma IL ‐10 level was measured using enzyme‐linked immunosorbent assay. Results In the training cohort, the plasma IL ‐10 level of nonsurvivals [median (centile25; centile75): 12.38 (8.76; 15.52) pg/mL] was significantly higher than that in survivals [6.55 (5.43; 7.65) pg/mL, P < 0.001]. Plasma IL ‐10 (hazard ratio = 1.205, 95% confidence interval: 1.145–1.267, P < 0.001) was identified as an independent risk factor for mortality of ACHBLF patients. Furthermore, plasma IL ‐10 showed higher area under the curve of receiver operating characteristic ( AUROC ) than model for end‐stage liver diseases ( MELD ) for predicting 1‐month (0.887 vs. 0.779, P < 0.05), 2‐month (0.878 vs. 0.779, P < 0.05) and 3‐month (0.917 vs. 0.776, P < 0.001) mortality. However, we did not find significant differences in AUROC between IL ‐10 and IL ‐10 plus MELD for 1‐, 2‐ and 3‐month mortality. ACHBLF patients with plasma IL ‐10 > 9.6 pg/mL showed poor survival time than patients with plasma IL ‐10 ≤ 9.6 pg/mL at the end of 1 month in the training and validation cohorts. Conclusions Plasma IL ‐10 performed better than MELD in predicting the prognosis of acute‐on‐chronic hepatitis B liver failure. Furthermore, plasma IL ‐10 > 9.6 pg/mL predicts a poor 1‐month mortality.