Journal ArticleDOI
Sequential combination therapy with interferon, interleukin-2 and therapeutic vaccine in entecavir-suppressed chronic hepatitis B patients: the Endeavor study.
Di Wu,Peng Wang,Meifang Han,Yongping Chen,Xinyue Chen,Qi Xia,Weiming Yan,Xiaoyang Wan,Chuanlong Zhu,Qing Xie,Jiaji Jiang,Lai Wei,Deming Tan,Xiaoguang Dou,Yanyan Yu,Jinlin Hou,Xiaoping Luo,Qin Ning +17 more
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TLDR
For ETV-suppressed patients, particularly those with low baseline HBsAg levels, combination therapy with IFN and other immunomodulators may enhanceHBsAg loss, while successful response correlates with partial restoration of NK cells and Tregs.Abstract:
Switching from nucleos(t)ide analogues to interferon (IFN) improves hepatitis B surface antigen (HBsAg) loss. We aimed to evaluate whether combining immunomodulators such as interleukin-2 (IL-2) and therapeutic vaccine with IFN enhances HBsAg loss in entecavir (ETV)-suppressed patients. Ninety-four patients exhibiting virological suppression and hepatitis B e antigen (HBeAg) loss following ETV treatment were randomized 1:1:1 to receive ETV (group I) or IFN (group II) for 48 weeks, or IFN and vaccine for 48 weeks plus IL-2 for 12 weeks (group III). The primary endpoint was HBsAg loss at week 48. Peripheral natural killer (NK) cells and regulatory T cells (Treg) were measured as immune checkpoint indicators. Mean HBsAg decline at week 48 was significantly greater in group III (0.85 log 10 IU/mL) and group II (0.74 log 10 IU/mL), than in group I (0.13 log 10 IU/mL). At week 48, 9.38%, 3.03%, and 3.70% of subjects in group III, II, and I, respectively, achieved HBsAg loss. Among patients with baseline HBsAg titers ranging from 100 to 1500 IU/mL, HBsAg loss rate was 27.3, 7.1, and 0% in group III, II, and I, respectively. Responders in group III showed a significantly higher increase in CD56bright CD16−NK cells from week 24 to 36, and a significant decline in Treg from week 12 to 24 than non-responders. For ETV-suppressed patients, particularly those with low baseline HBsAg levels, combination therapy with IFN and other immunomodulators may enhance HBsAg loss, while successful response correlates with partial restoration of NK cells and Tregs.read more
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APASL guidance on stopping nucleos(t)ide analogues in chronic hepatitis B patients.
Jia-Horng Kao,Wen-Juei Jeng,Wen-Juei Jeng,Qin Ning,Tung-Hung Su,Tai-Chung Tseng,Yoshiyuki Ueno,Man-Fung Yuen +7 more
TL;DR: In this article, the authors proposed a very intensive follow-up strategy and identification of low-risk patients for virological/clinical relapse by different biomarkers are the keys to stop the nucleoside analogs (NAs) treatment safely.
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Toward a Functional Cure for Hepatitis B: The Rationale and Challenges for Therapeutic Targeting of the B Cell Immune Response.
TL;DR: A combined strategy including a reduction of the HBsAg load via the above treatments and the therapeutic targeting of B cells by vaccination may induce the appearance of anti-HBs antibodies and lead to a functional cure of CHB.
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Guidelines for Prevention and Treatment of Chronic Hepatitis B.
Guiqiang Wang,Zhongping Duan +1 more
TL;DR: Wang et al. as mentioned in this paper proposed guidelines for the prevention and treatment of chronic hepatitis B (CHB) infection in China, which cover recent advances in basic, clinical, and preventive studies of CHB infection.
Journal ArticleDOI
Interferon-Induced Macrophage-Derived Exosomes Mediate Antiviral Activity Against Hepatitis B Virus Through miR-574-5p.
Wen-Yu Wu,Di Wu,Weiming Yan,Yong-Li Wang,Jie You,Xiaoyang Wan,Dong Xi,Xiaoping Luo,Meifang Han,Qin Ning +9 more
TL;DR: Exosomes can transfer IFN-α-related miRNAs from macrophages to HBV-infected hepatocytes, and exhibit antiviral activities against HBV replication and expression.
Journal ArticleDOI
End-of-treatment HBcrAg and HBsAb levels identify durable functional cure after Peg-IFN-based therapy in patients with CHB.
Da Huang,Di Wu,Peng Wang,Yong-Li Wang,Wei-Gang Yuan,Danqing Hu,Junjian Hu,Yaqi Wang,Ran Tao,Fang Xiao,Xiaoping Zhang,Xiaojing Wang,Meifang Han,Xiaoping Luo,Weimin Yuan,Qin Ning +15 more
TL;DR: In this article , the authors aim to identify biomarkers associated with a durable functional cure and to dissect potential immunological mechanisms, and they show that low levels of hepatitis B core-related antigen and higher levels of liver surface antibodies at the end of treatment are linked to immunological responses and are associated with durable functional cures.
References
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EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection.
Pietro Lampertico,Kosh Agarwal,Thomas Berg,Maria Buti,Harry L.A. Janssen,George V. Papatheodoridis,Fabien Zoulim,Frank Tacke +7 more
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Norah A. Terrault,Natalie Bzowej,Kyong-Mi Chang,Jessica P. Hwang,Maureen M. Jonas,M. Hassan Murad +5 more
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Journal ArticleDOI
Peginterferon Alfa-2a, Lamivudine, and the Combination for HBeAg-Positive Chronic Hepatitis B
George K. K. Lau,Teerha Piratvisuth,Kang Xian Luo,Patrick Marcellin,Satawat Thongsawat,Graham Cooksley,Edward Gane,Michael W. Fried,Wan Cheng Chow,Seung Woon Paik,Wen Yu Chang,Thomas Berg,Robert Flisiak,Philip McCloud,Nigel Pluck +14 more
TL;DR: In patients with H beAg-positive chronic hepatitis B, peginterferon alfa-2a offers superior efficacy over lamivudine, on the basis of HBeAg seroconversion, HBV DNA suppression, and HBsAg serconversion.
Journal ArticleDOI
A comparison of entecavir and lamivudine for HBeAg-positive chronic hepatitis B
Ting-Tsung Chang,Robert G. Gish,Robert A. de Man,Adrián Gadano,Jose D. Sollano,You Chen Chao,Anna S. Lok,Kwang Hyub Han,Zachary Goodman,J. Zhu,Anne Cross,Deborah DeHertogh,R B Wilber,Richard J. Colonno,David Apelian +14 more
TL;DR: Among patients with HBeAg-positive chronic hepatitis B, the rates of histologic, virologic, and biochemical improvement are significantly higher with entecavir than with lamivudine, and the safety profile of the two agents is similar.
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