Euroasian journal of hepato-gastroenterology

Register      Login

VOLUME 4 , ISSUE 2 ( July-December, 2014 ) > List of Articles

REVIEW ARTICLE

Immunotherapy for Chronic Hepatitis B using HBsAg-based Vaccine Formulations: From Preventive Commercial Vaccines to Therapeutic Approach

Y Lobaina, Julio Cesar Aguilar

Citation Information : Lobaina Y, Aguilar JC. Immunotherapy for Chronic Hepatitis B using HBsAg-based Vaccine Formulations: From Preventive Commercial Vaccines to Therapeutic Approach. Euroasian J Hepatogastroenterol 2014; 4 (2):92-97.

DOI: 10.5005/jp-journals-10018-1109

License: CC BY-NC 4.0

Published Online: 01-07-2013

Copyright Statement:  Copyright © 2014; The Author(s).


Abstract

Despite the existence of effective prophylactic vaccines, hepatitis B virus (HBV) infections remain a major public health problem. It has been estimated that about 370 million people are chronically infected with this virus worldwide. These individuals act as a reservoir for viral spread and chronic infection also increases the risk of liver diseases, such as cirrhosis and hepatocellular carcinoma. Current antiviral therapies fail to control viral replication in the long term in most patients. Viral persistence has been associated with a defect in the development of HBV-specific cellular immunity. The limitations of the current available therapies underline the need for alternative therapies. Specific immunotherapeutic strategies target not only the induction or stimulation of CD4(+) and CD8(+) T-cell responses but also the induction of proinflammatory cytokines capable of controlling viral replication. Therapeutic vaccination has been extensively studied in chronic hepatitis B (CHB) based in the properties of hepatitis B surface antigen (HBsAg) and taking advantage of its previous use in preventive vaccination. In this sense, pioneer studies were carried out employing HBsAgbased vaccines, including prophylactic commercial vaccines and HBsAg-based formulations with novel adjuvants. The results and general knowledge coming from these studies are discussed in the present review. The decision on developing new generations of vaccines including new antigens or formulations should take into account the experience with HBsAg-based vaccine formulations in order to decide about changing the vaccine antigen or adding new antigens to improve the composition.


PDF Share
  1. Hilleman MR. Overview of the pathogenesis, prophylaxis and therapeusis of viral hepatitis B, with focus on reduction to practical applications. Vaccine 2001 Feb;19(15-16):1837-1848
  2. Telbivudine in the treatment of chronic hepatitis B. Adv Ther 2009 Feb;26(2):155-169
  3. The maze of treatments for hepatitis B. New Engl J Med 2005 Jun;352(26):2743-2746
  4. Hepatitis B vaccine administered to chronic carriers of hepatitis B surface antigen. Ann Intern Med 1982 May;96(5):575-579
  5. Efficacy of immunotherapy with vaccination against hepatitis B virus on virus B multiplication. CR Acad Sci III 1993 Jul;316(7):688-691
  6. Multicenter study group. Efficacy and limitations of a specific immunotherapy in chronic hepatitis B. J Hepatol 2001 Jun;34(6):917-921
  7. Specific hepatitis B vaccine therapy in inactive HBsAg carriers: a randomized controlled trial. Infection 2003 Aug;31(4):221-225
  8. Failure of therapeutic vaccination using hepatitis B surface antigen vaccine in the immunotolerant phase of children with chronic hepatitis B infection. J Gastroenterol Hepatol 2003 Feb;18(2):218-222
  9. A novel, recombinant triple antigen hepatitis B vaccine (Hepacare). Intervirology 2001; 44(2-3):88-97
  10. A new pre-S containing recombinant hepatitis B vaccine and its effect on non-responders: a Immunotherapy for Chronic Hepatitis B using HBsAg-based Vaccine Formulations Euroasian Journal of Hepato-Gastroenterology, July-December 2014;4(2):92-97 97 EJOHG preliminary observation. Ann Acad Med Singapore 1996 Jan;25(1):120-122
  11. Immune response to a new hepatitis B vaccine in healthcare workers who had not responded to standard vaccine: randomized double blind dose-response study. BMJ 1997 Feb;314(7077):329
  12. T-cell and antibody response characterization of a new recombinant pre-S1, pre-S2 and SHBs antigen-containing hepatitis B vaccine; demonstration of superior anti-SHBs antibody induction in responder mice. Vaccine 1999 Jun;17(20- 21):2528-2537
  13. Evaluation of B and T-cell responses in chimpanzees immunized with Hepagene, a hepatitis B vaccine containing pre-S1, pre-S2 gene products. Vaccine 1998 Apr;16(6):543-550
  14. Efficacy of a third generation preS1/preS2 containing HBV carrier (Hepagene) as immunotherapy for HBeAg positive chronic hepatitis. J Hepatol 2001;34:917-921
  15. Result from immunotherapy trial in asian patients. Consulted in www.investegate.co.uk/article.aspx [Accessed on April 8, 2011]
  16. Immunological monitoring during therapeutic vaccination as a prerequisite for the design of new effective therapies: induction of a vaccine-specific CD4+ T-cell proliferative response in chronic hepatitis B carriers. Vaccine 2002 Oct 4;20(29-30):3598-61212
  17. Cytokine-dependent anti-viral role of CD4-positive T cells in therapeutic vaccination against chronic hepatitis B viral infection. J Med Virol 2003 Nov;71(3):376-384
  18. Heberbiovac HB in chronic hepatitis B patients. Clinical Trial Final Report 2007. Center for Genetic Engineering and Biotechnology, Cuba
  19. Therapeutic vaccination and novel strategies to treat chronic HBV infection. Expert Rev Gastroenterol Hepatol 2009 Oct;3(5):561-569
  20. Clinical and immunological efficacy of intradermal vaccine plus lamivudine with or without interleukin-2 in patients with chronic hepatitis B. J Med Virol 2002 Apr;66(4):452-460
  21. In vivo immunization by vaccine therapy following virus suppression by lamivudine: a novel approach for treating patients with chronic hepatitis B. J Clin Virol 2005 Feb;32(2):156-161
  22. Therapeutic HBV Vaccine Group of Investigators. Therapeutic vaccination of chronic hepatitis B patients with virus suppression by antiviral therapy: a randomized, controlled study of co-administration of HBsAg/AS02 candidate vaccine and lamivudine. Vaccine 2007 Dec 12;25(51):8585-8597
  23. Hepatitis B virus (HBV)-specific cytotoxic T-cell (CTL) response in humans: characterization of HLA class II-restricted CTLs that recognize endogenously synthesized HBV envelope antigens. J Virol 1992 Feb;66(2):1193-1196
  24. HLA-A2 restricted cytotoxic T-lymphocyte responses to multiple hepatitis B surface antigen epitopes during hepatitis B virus infection. J Immunol 1993 May;150(10):4659-4671
  25. Detection of a new antibody system reacting with Dane particles in hepatitis B virus infection. Br Med J 1978 Oct; 138:625-638
  26. The serology of chronic hepatitis B infection revisited. J Clin Invest 1993 Jun;91(6):2586-2595
  27. Functional implications of hepatitis B surface antigen (HBsAg) in the T cells of chronic HBV carriers. J Viral Hepat 1997 Jul;4(4):221-230
  28. Identification of immunodominant T cell epitopes of the hepatitis B virus nucleocapsid antigen. J Clin Invest 1991 Jul;88(1):214-222
  29. Induction of T-helper cell response to hepatitis B core antigen in chronic hepatitis B: a major factor in activation of the host immune response to the hepatitis B virus. Hepatology 1995 Oct; 22(4):1040-1049
  30. Acute exacerbations of chronic type B hepatitis are accompanied by increased T cell responses to hepatitis B core and e antigens. J Clin Invest 1992 Jan;89(1):87-96.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.