synlab has ip-10 and hbsag quant available

[stef2011]

for european patients, synlab has both ip-10 and hbsag quantification in iu/ml available, both tests are makers of immune activation and response on both nucs or pegintf, ip-10 levels correlates with hbsag decrease and loss but on nucs better after 1 year

[StephenCastlecrag]

In the same issue of Journal of Hepatology, there is a paper by Sinpapore scientists.

Reduction of HBV replication prolongs the early immunological response to IFNα therapy
Original Research Article
Pages 54-61
Anthony T. Tan, Long Truong Hoang, Daniel Chin, Erik Rasmussen, Uri Lopatin, Stefan Hart, Hans Bitter, Tom Chu, Lore Gruenbaum, Palani Ravindran, Hua Zhong, Ed Gane, Seng Gee Lim, Wan Cheng Chow, Pei-Jer Chen, Rosemary Petric, Antonio Bertoletti, Martin Lloyd Hibberd

It paints a very complicated relationship between hbv replication, IFNα, innate and T cell immune responses. It seems to support or explain combination therapy. Wish there are more systematic studies like this one.

[stef2011]

on that study they found this:
baseline ip-10>350pg/ml
hbsag decline>0.5log after hbvdna undetectable
57% predictive of hbsag loss

although very few on nucs can have this figure, this ip-10 marker can help define better those going to lose hbsag

i guess we can use this marker also for pegintf add earlier than 3 years, i mean high ip-10 levels after 1 year of etv or tdf might define those who will responde to pegintf add on

[stef2011]

thanks for the link, i m checking also for studies on pegintf and ip-10

correlation is complicated on this unless hbvdna is undetactable from long time because hbv is able to suppress pegintf genes when activated.
so on pegintf monotherapy when endogenous intf genes were already activated ip-10 levels might be useless because hbv is already suppressing intf

while on those with no activated endogenous intf genes (high hbsag, high hbvdna, hbeag pos) and no hbv intf suppression yet both ip-10 and pegintf monotherapy might work

anyway i think that any immune modulation is wasted if hbvdna is not already undetectable because hbv is able to mutate or suppress that immune activation

[stef2011]

http://www.intmedpress.com/serveFile.cfm?sUID=7b6490d7-baac-40af-8166-f0574f9fd3d5

it is full of trials like this, this is on antivirals, median ip-10 levels for hbsag decline/loss >350pg/ml
ip-10<350pg/ml no loss/decline

[StephenCastlecrag]

This paper may be relevant:
http://www.sciencedirect.com/science/journal/01688278/60/1

Changes of HBsAg and interferon-inducible protein 10 serum levels in naive HBeAg-negative chronic hepatitis B patients under 4-year entecavir therapy
Original Research Article
Pages 62-68
George Papatheodoridis, John Goulis, Spilios Manolakopoulos, Aikaterini Margariti, Xenofon Exarchos, Georgios Kokkonis, Emilia Hadziyiannis, Christos Papaioannou, Emanuel Manesis, Dimitrios Pectasides, Evangelos Akriviadis

"In HBeAg-negative CHB patients, 4-year entecavir therapy decreases serum HBsAg levels, but the rate of decline is rather slow. Serum IP10 levels represent a promising predictor of HBsAg decline in this setting."


Please, most of the patients in this study are Greek, so results may not apply to all genotypes.