Abstract: Objective To investigate the expression of interleukin-37 (IL-37) in patients with hepatitis B virusrelated acute-on-chronic liver failure (HBV-ACLF) and its clinical significances. Methods Eighty-one patients with HBV-ACLF admitted to our hospital from June 2015 to June 2017 were enrolled as study subjects (HBV-ACLB group), and 30 patients with chronic hepatitis B (CHB) were used as CHB group and 30 healthy people with physical examination were used as control group. In HBV-ACLB group there were 25 patients at early stage, 32 cases at middle stage and 24 cases at advanced stage at admission. Markers of liver function and serum levels of IL-37 were compared between three groups of patients. Pearson or Spearman correlation analysis were used to analyze the correlation between IL-37 level and markers of liver function, and the prognosis of HBV-ACLF. Results There was significantly higher serum level of IL-37 in HBVACLF group than that of CHB and control groups (P＜0.05). Among the patients with HBV-ACLF, those in the advanced stage had significantly higher levels of IL-37 than those in the patients with middle stage and early stage,and those in the middle stage had significantly higher levels of IL-37 than those in the early stage (P＜0.05). There were positive correlation between IL-37, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in HBV-ACLF group (rs values were 0.52 and 0.72, respectively). Among 81 cases of HBV-ACLF, 22 cases acquired infection and 39 cases died during the 2-month follow-up period. The serum levels of IL-37 were significantly higher in the infected cases and death cases than those in the non-infected cases and survival cases (P＜0.05). Conclusion The serum level of IL-37 is associated with the severity of HBV-ACLF, and which can be used as an important prognostic marker for ACLF.

Key words: acute-on-chronic liver failure, hepatitis B virus, interleukin-37, prognosis