Longitudinal Profiles of Cytokines and Chemokines in Self-Limiting Hepatitis E

Hepatitis E virus infection typically results in a self-limited acute viral hepatitis (AVH-E), which is rapidly cleared by the host immune response. In this longitudinal study, temporal cytokine and chemokine profiles were analysed in AVH-E patients' sera using a multiplex immunoassay. HEV RNA became undetectable between 9 and 18 days, with a median of 13 days, occurring 3-20 days after symptom onset. In the AVH-E group, IFN-γ peaked significantly around days 6-9, which is prior to the HEV RNA clearance period, and declined during days 9-18. IL-2, IL-10, and TNF-α increased significantly during days 15-20, while IL-1β and IL-6 showed peak levels. CCL3, CXCL6, CXCL9, CXCL10 and MIF were significantly higher in the AVH-E group than in the healthy controls; CCL2 and CCL20 peaked non-significantly during days 12-17. CCL3, CXCL6, CXCL9 and CXCL10 levels were lower in the AVH-E group than in the AVH-B group. Compared to the AVH-B group and healthy controls, the AVH-E group showed distinct immune signatures. These findings highlight coordinated cytokine and chemokine responses during HEV infection and provide insights into the immunopathogenesis of self-limiting hepatitis E.