alexa Induction of Functional Control in Chronic Hepatitis B Patients with Low Level HBsAg Using a Combination of a PreS1/S2/S HBV Vaccine (Sci-BVacTM) and a Nucleoside Analogue| Abstract
ISSN: 2332-0877

Journal of Infectious Diseases & Therapy
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  • Research Article   
  • J Infect Dis Ther 2019, Vol 7(1): 390
  • DOI: 10.4172/2332-0877.1000390

Induction of Functional Control in Chronic Hepatitis B Patients with Low Level HBsAg Using a Combination of a PreS1/S2/S HBV Vaccine (Sci-BVacTM) and a Nucleoside Analogue

Hedwig Roggendorf1*, Adalbert Krawczyk2,3, Monika Lindemann4, Daniel Shouval5, Thomas Michler6, Michael Roggendorf6 and Guido Gerken7
1Department of Molecular Immunology, University Hospital TUM, Germany
2Department of Virology, University Hospital Essen, Germany
3Department of Infectious Diseases, University of Duisburg Essen, University Hospital of Essen, Germany
4Institute of Transfusion Medicine, University Hospital Essen, Germany
5Hadassah Medical Centre, Jerusalem, Israel
6Institute of Virology, Munich, Germany
7Department of Gastroenterology and Hepatology, University Hospital Essen, Germany
*Corresponding Author : Hedwig Roggendorf, Department of Molecular Immunology, University Hospital TUM, Germany, Tel: 089-4140-4460, Email: [email protected]

Received Date: Nov 29, 2018 / Accepted Date: Jan 22, 2019 / Published Date: Jan 29, 2019

Abstract

Background: Treatment regimens for chronic hepatitis B virus (HBV) infection are efficient in suppressing viral load and improving hepatocellular injury and its complications. However, current antiviral agents such as nucleos(t)ide analogues or interferon-alpha are inefficient to reconstitute immunologic control of a persistent HBV infection or mediate clearance of HBV-DNA. It was hypothesized that high levels of circulating HBV surface antigens (HBsAg) produced by episomal and integrated HBV-DNA lead to immune tolerance of HBV and contribute to chronic HBV infection. Hence, low level HBsAg in a fraction of patients may create a window for the reconstitution of an HBV-specific immune response and control of infection. Previous studies in transplant patients indicate that antiviral therapy, in combination with a third generation PreS/S vaccine, may control HBV viremia and induce seroconversion to anti-HBs.
Methods: We determined the frequency of low level HBsAg (<500 IU/mL) carriers by a data request in two diagnostic laboratories. Three HBsAg positive, NUC treated, low level HBsAg carriers were immunized with 6 to 11 doses of Sci-B-VacTM. The kinetics of HBsAg reduction, anti-HBs seroconversion and T cell response after vaccination was determined.
Results: Approximately 30% of patients with chronic hepatitis B in two large cohorts showed low HBsAg concentrations of <500 IU/mL. Three low level HBsAg carriers with baseline concentrations of 448, 20.2 and 19.2 IU/mL HBsAg seroconverted to anti-HBs after being vaccinated with Sci-B-VacTM. Two years after vaccination, the anti-HBs titer was 100, 600 and 260 IU/L, respectively.
Conclusion: These preliminary data suggest that combining NUC´s with PreS1/PreS2/S vaccination in low level carriers of HBsAg may provide a new therapy to achieve functional control of chronic hepatitis B by seroconversion to anti-HBs.

Keywords: Hepatitis B; Therapeutic vaccination; HBV PreS1/S2/S

Citation: Roggendorf H, Krawczyk A, Lindemann M, Shouval D, Michler T, et al (2019) Induction of Functional Control in Chronic Hepatitis B Patients with Low Level HBsAg Using a Combination of a PreS1/S2/S HBV Vaccine (Sci-B-VacTM) and a Nucleoside Analogue. J Infect Dis Ther 7:390. Doi: 10.4172/2332-0877.1000390

Copyright: © 2019 Roggendorf H, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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