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.
Induction of curative immune responses by therapeutic vaccination in chronic viral infections such as chronic hepatitis B (CHB) is expected to be facilitated by reduction of viral load by antiviral treatment. In this open label, controlled, randomized study, 195 patients with HBeAg positive CHB were randomized to receive 12 doses of HBsAg with AS02B adjuvant candidate vaccine plus lamivudine daily for 52 weeks or lamivudine daily alone. The combined administration of vaccine and lamivudine was safe and well tolerated, but did not improve the HBe seroconversion rate (18.8%) when compared to treatment with lamivudine alone (16.1%) (p=0.6824). Despite induction of a vigorous HBsAg-specific lymphoproliferative response, cytokine production and anti-HBs antibodies, therapeutic vaccination with an adjuvanted HBsAg vaccine administered concomitantly with lamivudine did not demonstrate superior clinical efficacy in HBeAg positive CHB patients as compared to lamivudine therapy alone.
Vandepapelière
Pierre
P
GlaxoSmithKline Biologicals, 1330 Rixensart, Belgium. pierre.vandepapeliere@gskbio.com
Lau
George K K
GK
Leroux-Roels
Geert
G
Horsmans
Yves
Y
Gane
Edward
E
Tawandee
Tawesak
T
Merican
Mohd Ismail bin
MI
Win
Khin Maung
KM
Trepo
Christian
C
Cooksley
Graham
G
Wettendorff
Martine
M
Ferrari
Carlo
C
D000276:Adjuvants, Immunologic; D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000032:analysis / Q000096:biosynthesis; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D006514:Hepatitis B Surface Antigens / Q000276:immunology* / Q000627:therapeutic use*; D017325:Hepatitis B Vaccines / Q000009:adverse effects / Q000627:therapeutic use*; D019694:Hepatitis B, Chronic / Q000188:drug therapy / Q000628:therapy* / Q000821:virology; D006801:Humans; D007111:Immunity, Cellular / Q000276:immunology; D007167:Immunotherapy; D019259:Lamivudine / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome
D000276:Adjuvants, Immunologic; D000914:Antibodies, Viral; D000998:Antiviral Agents; D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine