Soluble programmed cell death 1 protein is a promising biomarker to predict severe liver inflammation in chronic hepatitis B patients

Abstract

Abstract Background and Aims: Liver inflammation is important in guiding the initiation of antiviral treatment and affect the disease progression of chronic hepatitis B(CHB). Soluble programmed cell death 1 protein(sPD-1) was upregulated in inflammatory, infectious diseases and correlated with disease severity. We aimed to investigate the correlation between serum sPD-1 and liver inflammation in CHB patients and role in indicating liver inflammation. Methods: 241 CHB patients who underwent a liver biopsy were enrolled. Correlation between sPD-1 levels and the degree of liver inflammation was analyzed. Univariate and multivariate logistic regression were performed to analyze independent variables of severe liver inflammation. Binary logistic regression was conducted to construct the predictive model for severe liver inflammation, and receiver operator characteristic curve(ROC) was used to evaluate the diagnostic accuracy of the predictive model. Results: sPD-1 was the highest in CHB patients with severe liver inflammation, which was higher than that in CHB patients with mild or moderate liver inflammation(P<0.001). Besides, sPD-1 was weakly correlated with AST(r=0.278, P<0.001). Multivariable analysis showed that sPD-1 was an independent predictor of severe liver inflammation. The predictive model contained sPD-1 had an area under the ROC(AUROC) of 0.917 and 0.921 in predicting severe liver inflammation in CHB patients and CHB patients with ALT≤1×upper limit of normal(ULN), respectively. Conclusions: Serum sPD-1 is associated with liver inflammation in CHB patients, and high levels of sPD-1 reflect severe liver inflammation. Serum sPD-1 is an independent predictor of severe liver inflammation and shows improved diagnostic accuracy when combined with other clinical indicators.