[英语，临床，推荐]儿童: 干扰素+拉米夫定

StephenW

J Virol. 2011 Mar;85(5):2416-28. Epub 2010 Dec 8.

Immune and viral profile from tolerance to hepatitis B surface antigen
clearance: a longitudinal study of vertically hepatitis B virus-infected
children on combined therapy.

Carey I, D'Antiga L, Bansal S, Longhi MS, Ma Y, Mesa IR, Mieli-Vergani G,
Vergani D. Institute of Liver Studies, King's College Hospital, London SE5
9RS, UK.

Abstract
The aim of the study was to investigate longitudinally hepatitis B virus
(HBV)-specific T-cell reactivity and viral behavior versus treatment
response in tolerant children during combined antiviral therapy.
Twenty-three children with infancy-acquired hepatitis B (HBeAg(+))
belonging to a published pilot study of 1-year treatment with
lamivudine/alpha interferon (IFN-α) were investigated. Five seroconverted
to anti-HBs (responders). Nine were HLA-A2(+) (4 responders and 5
nonresponders). Mutations within the HBV core gene were determined at
baseline in liver and in serial serum samples by direct sequencing at
baseline; during treatment week 2 (TW2), TW9, TW28, and TW52; and after
follow-up week 24 (FUW24) and FUW52. HBV-specific reactivity was evaluated
by T-cell proliferation with 16 HBV core 20-mer overlapping peptides and by
HLA-A2-restricted core(18-27) pentamer staining and CD8(+) IFN-γ
enzyme-linked immunospot (ELISPOT) assay. HBV core-specific T-cell
proliferative and CD8 responses were more vigorous and broader among
responders than among nonresponders at TW28 and TW52, while the number of
mutations within HBV core gene immunodominant epitopes was lower at TW28
and was negatively associated with HBV-specific T-cell proliferative
responses at both time points. The HBV DNA viral load was negatively
associated with HBV-specific T-cell proliferative and CD8 responses during
treatment, especially at TW28. Treatment-induced transition from
immunotolerance to HBV immune control is characterized by the emergence of
efficient virus-specific immune responses capable of restraining mutations
and preventing viral evasion.

PMID: 21147914 [PubMed - indexed for MEDLINE]

StephenW

病毒学杂志。 2011年3月; 85（5）:2416 - 28。 EPUB的2010年12月8日。

免疫耐受和配置文件，以B型肝炎病毒表面抗原
关：一垂直乙肝病毒感染的纵向研究
儿童的综合治疗。

凯里我，德Antiga L时，班萨尔秒，隆吉质谱，马Ÿ，梅萨红外光谱，Mieli - Vergani克，
Vergani四研究所肝研究，国王学院医院，伦敦SE5
9RS，英国。

摘要
这项研究的目的是探讨乙肝病毒纵向
（HBV）的特异性T细胞活性和病毒的行为与治疗
在容错性反应过程中的儿童联合抗病毒治疗。
二十三个婴儿期的孩子获得的乙型肝炎（HBeAg阳性（+））
属于1年的试验研究与治疗出版
拉米夫定/α干扰素（IFN -α）的影响。血清阳转五
以抗- HBs（反应）。九为HLA - A2号（+）（4和5反应
无反应）。在乙肝病毒核心基因突变，测定了
基线肝脏和血清直接测序序列样品，
基线;在治疗2周（<巫师2>），TW9，TW28，并TW52及以后
随访24周（FUW24）和FUW52。 HBV特异性反应进行了评估
由T - 16细胞HBV核心20个碱基重叠肽增殖和
的HLA - A2限制性芯（18〜27）和CD8五聚体染色（+）干扰素-γ
酶联免疫斑点（酶联免疫斑点法）检测。乙肝病毒核心特异性T细胞
增殖和CD8反应更有力和更广泛的各
中比在TW28和TW52无反应反应，同时数
在乙肝病毒核心基因突变，免疫表位较低，TW28
并负相关乙肝病毒特异性T细胞增殖
在这两个时间点的反应。乙型肝炎病毒DNA病毒载量呈负
乙肝病毒特异性T细胞增殖和CD8反应过程中有关
治疗，特别是在TW28。治疗引起的过渡
乙肝病毒免疫耐受免疫控制的特点是出现了
有效的病毒特异性免疫反应抑制突变能力
逃税和防止病毒。

结论：21147914 [PubMed的 - 对于数据库索引]