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INDUCTION OF HBS ANTIBODY PRODUCTION AFTER ELIMINATION OF HBS ANTIGEN IN PATIENTS TREATED WITH NUCLEOSIDE(TIDE) ANALOGS

http://www1.easl.eu/easl2011/program/Posters/Abstract166.htm

INDUCTION OF HBS ANTIBODY PRODUCTION AFTER ELIMINATION OF HBS ANTIGEN IN PATIENTS TREATED WITH NUCLEOSIDE(TIDE) ANALOGS AND AGUMENTED IMMUNO-ENHANCEMENT THERAPY AS A PRELUDE TO CURE

D. Chan1*, N.R. Chan2
1University of British Columbia, 2Medicine, University of British Columbia, Vancouver, BC, Canada. ****@****


Background: Curremt treatment of Chronic hepatitis B aims at clearance of circulating viral load reducing HBV DNA to undetectable level.This is followed by more recent advances in eliminating HBs antigen which is a reflection of the amount of intracellular cccDNA. Elimination of HBS antigen is regarded as an ideal end point of Hepatitis B treatment. However, HBS antigen loss does not imply total eradication of cccDNA which can still act as a template for viral replication. Only when protective levels of HBS antibodies are produced in such patients can we then safely declare them as under permanent hepatitis B control.
Aim: To demonstrate the induction of Hepatitis B antibodies production in Chronic hepatitis B patient cleared of HBS antigen with Nuclotide(side) analog with or without immuno-enhancement therapy with augmented doses of Recombinant HBV vaccine together with immuno-vaccine enhancer.
Method: 8 patients : 7 male and 1 female, age 29-53, median age 38 who were successfully treated with entacavir or tenofovir with or without interferon or thymosin achieved negative serological detection of HBS antigen, They were given augmented doses of Triple Recombinant Hepatitis B vaccine (Engerix B) IM toghether with immuno-vaccine enhancer Thymalfasin 3.2 mg SC.on Day 0, Day 30, and Day 180. Hepatitis B surface antibody were then measured on each patient on Day 210.
Results: 6 of the 8 patients demonstrated positive response with protective tires of HBS antibodies ranging from 50-600mIU/ml. One patient showed no response and one patient´s results are pending.
Conclusion: Induction of antibody against HBS antigen is achievable in patients with Chronic hepatitis B after HBS antigen elimination. This is definitely a prelude to the permanent control of Chronic hepatitis and probably a cure for this incurable disease of the past.
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Avatar universal
http://onlinelibrary.wiley.com/doi/10.1111/j.1432-2277.2010.01104.x/abstract

Keywords:
hepatitis B immunoglobulins;hepatitis B virus – prophylaxis;liver transplantation;monophosphoryl-lipid-A;recombinant S HBV vaccine
Summary
Conflicting results have been reported on vaccination against hepatitis B virus (HBV) as a prophylaxis against viral recurrence after liver transplantation. We investigated the efficacy of 1-year, monthly vaccination using an adjuvant 3-deacylated monophosphoryl-lipid-A (MPL) recombinant S vaccine initially administered together with hepatitis B immunoglobulins (HBIg) in 18 patients transplanted for HBV-related cirrhosis. All received 12 vaccine doses (HBsAg, 20 mcg plus MPL, 50 mcg): the initial six doses (phase I) were administered within 7 days after intravenous HBIg (2000 IU), while the last 6 (phase II) following HBIg withdrawal. All patients received lamivudine during the study. Anti-HBs titers were determined before each dose and then for 1 year after vaccination. After phase I anti-HBs titers were greater than 100 IU/l in all patients and in three (16.6%) were greater than 500 IU/l. After phase II 10 patients (55.5%) achieved anti-HBs titers greater than 100 IU/l and five (27.7%) greater than 500 IU/l. One year after vaccination eight patients (44.4%) maintained anti-HBs titers greater than 100 IU/l, with a median titer of 234 IU/l (102–1205), and 2 (11.1%) greater than 500 IU/l. One-year extended monthly vaccination with a MPL-adjuvant recombinant vaccine induces a sustained protective anti-HBs response in approximately half of transplant recipients.
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Avatar universal

normal vaccine doesn t work for sure

there is also a trial done in rome several years ago for transplanted patients with a boosted vaccine.
transplanted patients are in similar situation with hbsag negative but weaker immune system than normal carriers

they did vaccine monthly and most gained hbsab by 1 year.i have to look for the trial again to see doses and type of vaccine

the ideal vaccine needs both hbcag and hbsag and boosting substances
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Avatar universal
They just take the ordinary vaccine.
Even with the above paper, it can still be argued that these patients will eventually gain the antibodies without injecting the vaccine. Still, it does not seem to do any harm, I hope.
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i guess boosting vaccine is needed, are they using the new vaccines with boosting ubstances and both hbsag, hbcag?

in pisa they told me about vaccines too but they also said it doesn t work.i think that thisomsin alpha, gcmaf and similar substances are needed to boost the vaccine

i ve heard of a vaccine from israel too to be used with rep9ac and myrcludex but i have no name of this new vaccine

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Avatar universal
This is interesting because some patients in China, on their own initiative, get vaccinated when they lose the S antigen without gaining S antibodies.
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