控制中断治疗改善的HBeAg阳性慢性乙型肝炎患者病毒感染宿主

StephenW

Viral Immunol. 2015 Oct 26. [Epub ahead of print]
Controlled Therapy Interruption Improves Host Immune Control of Chronic Hepatitis B Virus Infection in HBeAg-Positive Patients.
Lake-Bakaar GV1, Lau D1, Kuang PP1, Singh K1.
Author information

    1Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School , Boston, Massachusetts.

Abstract

Prolonged viral suppression with oral antiviral drugs allows partial immune reconstitution. Controlled therapy interruption (CTI), by leveraging secondary immune response, proposes further augmentation in chronic hepatitis B virus (HBV) infection. Transient treatment interruptions (TIs) at months 0, 1, and 3 during otherwise continuous oral antiviral therapy allow viremic bursts, simulating autovaccination. Four weekly injections of Hepatitis B Immunoglobulin are given before the second and third TI to simulate prime boosting, which specifically amplifies the immune response. Fourteen patients (10 males; four controls, four HBeAg positive, and six anti-HBe positive) aged 28-46 years were studied. The period between TI and reappearance of viremia, time to relapse (TTR) (weeks) estimated immune control. The other endpoints included reduction in serum HBsAg IU/mL and loss of HBeAg. TTR after the first TI was significantly shorter in HBeAg-positive patients, indicating low baseline immunity. TTR increased significantly after the second and subsequent TI in all four HBeAg-positive patients. One patient persistently lost HBeAg. Mean HBsAg levels fell significantly in three of four patients after the second TI. In contrast, in the anti-HBe-positive group, TTR was unchanged after all three TI. Furthermore, no significant changes in HBsAg levels were detected after the second or subsequent TIs. No significant differences in adverse events were noted between groups. HBeAg-positive patients have low baseline levels of host immune control against HBV. CTI consistently boosts this immunity. CTI did not influence immunity in anti-HBe-positive patients.

StephenW

病毒免疫。 2015年十月26 EPUB提前打印]
控制中断治疗改善的HBeAg阳性慢性乙型肝炎患者病毒感染宿主的免疫控制。
湖Bakaar GV1，刘D1，旷PP1，辛格K1。
作者信息

    医学教研室，贝斯以色列女执事医疗中心，哈佛大学医学院，马萨诸塞州波士顿。

抽象的

长期抑制病毒，口服抗病毒药物可以局部免疫功能重建。控制治疗中断（CTI），通过利用二次免疫反应，提出了进一步的增强在慢性乙型肝炎病毒（HBV）感染。短暂中断治疗（TIS）在个月0，1和3期间，否则连续口服抗病毒疗法允许病毒血症突发，模拟autovaccination。乙型肝炎免疫球蛋白的四每周注射，第二和第三的TI之前被给予模拟素升压，其特异性地放大的免疫反应。 14例患者（男10例;四控制，四HBeAg阳性和六抗-HBe阳性）年龄28-46年进行了研究。 TI和病毒血症再现之间的时间段，时间复发（TTR）（周）估计免疫控制。另一终点包括降低血清HBsAg IU /毫升和HBeAg的损失。 TTR第一TI后显著短于HBeAg阳性患者，这表明低基线免疫力。在所有四个HBeAg阳性患者的第二个和后续的TI后的TTR显著增加。一名患者持续HBeAg消失。平均HBsAg水平在三，四例患者的第二TI后显著下跌。与此相反，在抗-HBe阳性组，TTR是所有三个的TI后保持不变。此外，在HBsAg水平没有显著变化的第二个或后续的TI的之后进行检测。在不良事件没有显著差异，指出组之间。 HBeAg阳性患者有宿主抗HBV免疫控制的低基线水平。 CTI持续增强这种豁免。 CTI不影响免疫力的抗-HBe阳性患者。