干扰素-α2b联合粒细胞-巨噬细胞集落刺激因子和乙肝疫苗对

StephenW

Viral Immunol. 2019 Dec 26. doi: 10.1089/vim.2019.0119. [Epub ahead of print]
Hepatitis B Surface Antigen Seroconversion by Interferon-α2b Combined with Granulocyte-Macrophage Colony-Stimulating Factor and Hepatitis B Vaccine: A Case Report.
Li S1, Luo S2, Lei Q2, Meng Z2,3.
Author information

1
    Department of Infectious Diseases, Yunyang Branch of Taihe Hospital, Hubei University of Medicine, Shiyan, China.
2
    Department of Infectious Diseases, Taihe Hospital, Hubei University of Medicine, Shiyan, China.
3
    Institute of Biomedical Research, Taihe Hospital, Hubei University of Medicine, Shiyan, China.

Abstract

Hepatitis B surface antigen (HBsAg) loss and/or seroconversion is the ideal endpoint for the treatment of patients with chronic hepatitis B (CHB), whereas the "functional cure" of hepatitis B virus (HBV) infection is hard to obtain with routine therapeutics. Thus, potential new strategies are explored to cure HBV infection. A combination immunomodulatory therapeutic regime was used in a 43-year-old female patient with hepatitis B e antigen (HBeAg)-negative CHB; the regimen included consecutive combination therapy with recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) plus HBV vaccine, in addition to ongoing normal interferon (IFN)-α2b treatment. The serum levels of alanine aminotransferase (ALT), HBV DNA, HBsAg, and hepatitis B surface antibody (HBsAb) were monitored every 6 months. The ALT level normalized and HBV DNA decreased to a level below the limit of detection within 3 months after the initiation of IFN-α2b therapy. After an entire year of IFN treatment, serum HBsAg decreased to a very low level (3.16 IU/mL), and HBsAb was still negative (0.78 mIU/mL). Then, rhGM-CSF and the HBV vaccine were applied, in addition to continuous IFN therapy. A steady decline in HBsAg was observed, and HBsAg loss with HBsAb seroconversion was achieved 12 months after initiation of the combination treatment with rhGM-CSF and HBV vaccine; the IFN-α2b was discontinued for the later 6 months. A therapeutic regimen with GM-CSF plus HBV vaccine could keep the immune system actively stimulated and trigger an HBV-specific immune response to control, or even clear the virus; this regimen may be helpful in the "cure" of HBV infection when combined with IFN-α.
KEYWORDS:

HBV vaccine; chronic hepatitis B; hepatitis B surface antigen; interferon; recombinant granulocyte–macrophage colony-stimulating factor

PMID:
    31880508
DOI:
    10.1089/vim.2019.0119

StephenW

病毒免疫。 2019年12月26日。doi：10.1089 / vim.2019.0119。 [Epub提前发布]
干扰素-α2b联合粒细胞-巨噬细胞集落刺激因子和乙肝疫苗对乙肝表面抗原的血清转化：一例报告。
李S1，罗S2，雷Q2，孟Z2,3。
作者信息

1个
    湖北医科大学附属太和医院云阳分院传染病科，十堰
2
    湖北医科大学附属太和医院传染病科，十堰
3
    湖北医科大学附属太和医院生物医学研究所，十堰

抽象

乙型肝炎表面抗原（HBsAg）丢失和/或血清转化是治疗慢性乙型肝炎（CHB）的理想终点，而常规治疗很难实现“功能性治愈”乙型肝炎病毒（HBV）感染。因此，探索了治疗HBV感染的潜在新策略。联合免疫调节治疗方案用于43岁乙型肝炎e抗原（HBeAg）阴性的女性患者。该方案除持续进行正常干扰素（IFN）-α2b治疗外，还包括采用重组人粒细胞-巨噬细胞集落刺激因子（rhGM-CSF）加上HBV疫苗的连续联合治疗。每6个月监测一次血清丙氨酸转氨酶（ALT），HBV DNA，HBsAg和乙型肝炎表面抗体（HBsAb）的水平。在开始IFN-α2b治疗后3个月内，ALT水平恢复正常，HBV DNA降至检测限以下。经过一年的干扰素治疗，血清HBsAg降至非常低的水平（3.16 IU / mL），而HBsAb仍为阴性（0.78 mIU / mL）。然后，除了连续的干扰素治疗外，还应用了rhGM-CSF和HBV疫苗。在开始用rhGM-CSF和HBV疫苗联合治疗后12个月，HBsAg稳定下降，并因HBsAb血清转化而导致HBsAg损失。在随后的6个月中停用IFN-α2b。 GM-CSF加HBV疫苗的治疗方案可以使免疫系统得到积极刺激，并触发HBV特异性免疫反应来控制甚至清除病毒。当与IFN-α联合使用时，该方案可能有助于“治愈” HBV感染。
关键字：

乙肝疫苗；慢性乙型肝炎乙型肝炎表面抗原；干扰素重组粒细胞-巨噬细胞集落刺激因子

PMID：
    31880508
DOI：
    10.1089 / vim.2019.0119