Clinical and immunological efficacy of intradermal vaccine plus lamivudine with or without interleukin-2 in patients with chronic hepatitis B

• Published in: Journal of medical virology 2002-04, Vol.66 (4), p.452-460
• Main Authors: Dahmen, Anja, Herzog-Hauff, Sabine, Böcher, Wulf O., Galle, Peter R., Löhr, Hanns F.
• Format: Article
• Language: English
• Subjects: Antiviral Agents - administration & dosage; Antiviral Agents - immunology; Antiviral Agents - therapeutic use; Biological and medical sciences; chronic hepatitis B; Drug Therapy, Combination; ELISPOT; Fundamental and applied biological sciences. Psychology; HBs antigen; Hepatitis B Vaccines - administration & dosage; Hepatitis B Vaccines - immunology; Hepatitis B Vaccines - therapeutic use; Hepatitis B virus - immunology; Hepatitis B, Chronic - drug therapy; Hepatitis B, Chronic - immunology; Hepatitis B, Chronic - virology; Humans; Injections, Intradermal; interleukin-2; Interleukin-2 - administration & dosage; Interleukin-2 - immunology; Interleukin-2 - therapeutic use; lamivudine; Lamivudine - administration & dosage; Lamivudine - immunology; Lamivudine - therapeutic use; Lymphocyte Activation - immunology; Microbiology; Reverse Transcriptase Inhibitors - administration & dosage; Reverse Transcriptase Inhibitors - immunology; Reverse Transcriptase Inhibitors - therapeutic use; T and B cells; therapeutic vaccine; Treatment Outcome; Vaccination; Vaccines, Synthetic - administration & dosage; Vaccines, Synthetic - immunology; Vaccines, Synthetic - therapeutic use
• ISSN: 0146-6615; 1096-9071
• DOI: 10.1002/jmv.2165

To evaluate therapeutic immunostimulation nine chronic hepatitis B patients received six monthly intradermal vaccinations with HBsAg in combination with daily lamivudine. Another five patients received six doses of the vaccine and daily lamivudine together with daily Interleukin‐2 (IL‐2) s.c. within 3 months in an open‐labeled trial. Clinical efficacy was assessed by alanine transaminase levels and HBV serology. The induction of specific T and B cell responses was analyzed serially by 3H‐thymidine uptake, ELISA and ELISPOT assays. After the therapy was stopped, seven of nine vaccine/lamivudine and two of five vaccine/lamivudine/IL‐2 recipients did not have detectable HBV DNA. Four complete responders cleared the virus and had normalized ALT levels, however, one of these patients showed transient disease reactivation followed by spontaneous viral clearance and normal ALT five months later. Low frequencies of anti‐HBs producing B cells and HBV specific T helper cells secreting predominantly interferon‐γ were induced by i.d. vaccine therapy. The ELISPOT technique demonstrated transient induction of HBV peptide specific cytotoxic T cells in seven HLA‐A2 positive chronic HBV carriers. The preliminary data from this study demonstrate that the HBV surface antigen vaccine in combination with antiviral or immunomodulating drugs induced antiviral immune responses and consequently viral elimination may be achieved in patients with unfavorable prognosis. J. Med. Virol. 66:452–460, 2002. © 2002 Wiley‐Liss, Inc.