In vivo Immunization Following Suppression of HBV

雪绒花

In vivo Immunization Following Suppression of HBV: A New Approach for Inducing Immune Control in Chronic Hepatitis B

Antiviral treatment of patients with active chronic hepatitis B may lead to a significant reduction in morbidity and mortality. However, after stopping nucleoside analogue therapy, relapse rates are high in those without acquired specific immunity.
Researchers at the University Medical Center Rotterdam, The Netherlands have treated two chronic hepatitis B patients with in vivo immunization. In vivo immunization aims to optimize conditions for an effective immune response: following rapid and profound virus suppression by interferon-lamivudine combination therapy, lamivudine is withdrawn intermittently for 4 weeks during continued interferon therapy.

In both patients with profound virus suppression a rapid rebound in viral replication was observed after lamivudine withdrawal, despite continued interferon. These periods of renewed viral replication were followed by rises in hepatitis activity.

After re-introduction of lamivudine, HBV DNA became undetectable by PCR followed by normalization of serum ALT. These observations are a stimulus to further explore the concept of in vivo immunization as a novel therapeutic approach for chronic hepatitis B.

Clearly, these results in two patients require confirmation in a larger study.

08/18/03

Reference
D. Sprengers and others. In vivo immunization following virus suppression: a novel approach for inducing immune control in chronic hepatitis B (Opinion). Journal of Viral Hepatitis 10(1): 7-9. January 2003.