International Session(Workshop)1(JSGE・JSH・JSGCS)
Thu. November 2nd   14:30 - 17:00   Room 11: Portopia Hotel South Wing Topaz
Impact of HBcAg-specific CTL on HBsAg reduction after therapeutic vaccine treatment in chronic hepatitis B patients
Kana Shiraishi1, Osamu Yoshida1, Yoichi Hiasa1
1Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine
Background: The treatment goal of chronic hepatitis B (CHB) is HBs antigen (HBsAg) elimination, however it is difficult to achieve the goal with interferon and nucleos(t)ide analogues (NAs). We have developed a nasal administrative therapeutic vaccine containing HBs/HBcAg mixed viscosity enhancer (CVP-NASVAC). We conducted clinical trials of CVP-NASVAC against CHB and reported its capacities of HBsAg reduction and anti-HBs induction. In this study, we explored the immunological mechanism of CVP-NASVAC on HBsAg reduction.
Methods: Fifty CHB patients (21 with NAs, 29 without NAs) received CVP-NASVAC via nose. We investigated the rate of HBsAg reduction/loss, anti-HBs induction including IgA-type by ELISA, and HBcAg-specific CTL by ELISPOT. The data or samples were obtained up to 54 months after the end of treatment.
Results: At the 18 months after CVP-NASVAC administration, HBsAg was reduced in 64.7% (11/17) patients with NAs and 75.0% (15/20) without NAs, and HBsAg loss was observed in 1/21 with NAs and 3/29 without NAs. Anti-HBs was induced in 14.3% (3/21) with NAs and 42.9% (12/28) without NAs. IgA-type anti-HBs and HBc-specific CTL were significantly elevated after treatment in both groups. Significant correlation was observed between the CTL increase and HBsAg reduction in patients with NAs (p<0.005).
Conclusion: HBcAg-specific CTL induction might be an important immunological mechanism for reducing HBsAg in CHB patients under NAs treatment.
Index Term 1: HBV
Index Term 2: vaccine
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