Objective To investigate the clinical significance of cytokines in children with acute hepatitis A. Methods The children with acute hepatitis A who were hospitalized in the Specialized Hospital of Infectious Diseases in Hotan, Xinjiang, from September 2014 to January 2015 were enrolled as acute hepatitis A group, and healthy children matched for age and sex were enrolled as control group. The serum levels of related inflammatory cytokines were measured, including interleukin-6 ( IL-6) , interleukin-8 ( IL-8) , interleukin-10 ( IL-10) , interleukin-1β ( IL-1β) , and tumor necrosis factor-α ( TNFα) . Clinical indices such as liver function, coagulation function, and presence or absence of ascites were monitored, and the correlation between the serum cytokines and clinical features was analyzed.The two-independent-samples t test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups. The chi-square test was used for comparison of categorical data between two groups. A Spearman correlation analysis was used to investigate correlation. Results A total of70 children with acute hepatitis A and 30 healthy children were enrolled. The serological test showed that the acute hepatitis A group had a significantly higher serum level of IL-10 than the control group [19. 60 ( 15. 50-32. 08) pg/ml vs 5. 00 ( 5. 00-10. 30) pg/ml, Z =-6. 79, P < 0. 01]. In the children with acute hepatitis A, the serum level of IL-10 was positively correlated with alanine aminotransferase ( r = 0. 24, P = 0. 04) , total bilirubin ( r = 0. 32, P < 0. 01) , and prothrombin time ( r = 0. 29, P = 0. 01) . In addition, the serum level of IL-10 was 23. 20 ( 18. 04-45. 00) pg/ml in children with jaundice hepatitis and 18. 40 ( 14. 84-24. 80) pg/ml in those with non-jaundice hepatitis, and there was no significant difference between the two groups of children ( Z =-2. 30, P = 0. 02) . The children with ascites had a significantly higher serum level of IL-10 than those without ascites [42. 60 ( 19. 15-73. 35) pg/ml vs 19. 02 ( 15. 13-27. 33) pg/ml, Z =-2. 42, P = 0. 02]. There were no significant differences between the acute hepatitis A group and the control group in the ser-um levels of IL-6 ( Z =-0. 95, P = 0. 34) , IL-8 ( Z =-0. 97, P = 0. 33) , IL-1β ( Z =-1. 33, P = 0. 18) , and TNFα ( Z =-0. 34, P = 0. 73) , and there were also no significant differences in these cytokines between the children with jaundice hepatitis and those with non-jaundice hepatitis, as well as between the children with ascites and those without ascites ( all P > 0. 05) . Conclusion There is a significant increase in the serum level of IL-10 in children with acute hepatitis A, especially in those with jaundice hepatitis or ascites, suggesting that IL-10 plays an important role in immunologic injury induced by acute hepatitis A virus infection.
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