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A clinical study on anti-HBV-DC-MTL combined with telbivudine in the HBeAg positive chronic hepatitis B virus infection
发布时间: 2013-05-08    人气指数:1156

ILC 2013 ---48th annual meeting of the European Association for the Study of the Liver

Poster 780

Journal of Hepatology. 2013, 58 (suppl No.1):s317-s318.


B.-F. Wu1,2*, J.-Y. Yang2, Y. Liu1, X.-Q. Wang1, X.-H. Huang1, Z.-S. Xiao1, X.-S. Li1, M. Yang1, Y. Zhou2, J. Yang2, F.-Q. Li1, H. Huang1, Q.-M. Qiu1


1Gastroenterology and Hepatology Center, Southern Medical University Renkang Hospital, Dongguan, 2Guangzhou Pubang Bio-Immunological Tech Research Institute, Guangzhou, China. *bangfu.wu@163.com


Background and aims: To observe the clinical efficacy of anti-HBV-DC and anti-HBV-MTL (anti-HBV-DC-MTL), the dendritic cells(DC) and mixed T lymphocyte(MTL) originating from peripheral blood mononuclear cells(PBMC) sensitized by HBsAg, in combination with telbivudine, in HBeAg positive chronic hepatitis B virus(HBV) infection.


Methods: 46 HBeAg positive chronic HBV infection including 34 males and 12 females aged 17-50 years were recruited in the study including 15 chronic HBV carriers, 16 chronic hepatitis B(CHB) patients with ALT≤2ULN and 15 CHB patients with ALT>2ULN.
PBMCs were obtained from 50ml of heparinized peripheral blood through density gradient centrifuge. Anti-HBV-DC was proliferated from adherence PBMCs under the induction by GM-CSF and IL-4, and sensitized with hepatitis B vaccine containing 50µg HBsAg. Anti-HBV-MTL was proliferated from no-adherence PBMCs under the induction by IL-2, IL-12 and anti-HBV-DC. Anti-HBV-DC was harvested on day 7 and injected, half hypodermically and half intravenously, to the patient once every two weeks for 12 times totally. Anti-HBV-MTL was harvested on day 14 and injected intravenously to the patient once every two weeks for 12 times totally. Telbivudine was taken 600mg daily. Quantitative HBVM(TRFIA) and HBVDNA and hepatic functions were evaluated at week 0, 4, 12, and 24.
Results: Mean of HBsAg, HBeAg and HBVDNA decreased significantly, while mean of HBeAb increased obviously at week 4, 12 and 24, HBeAg negative conversion rate were 38.13%(18/46), 43.47(20/46) and 50.00%(23/46) respectively, HBeAb positive conversion rate were 28.26%(13/46), 39.13%(18/46) and 45.65%(21/46), HBeAg seroconversion rate were 26.09%(12/46), 36.96%(17/46) and 45.65%(21/46), HBVDNA negative conversion rate were 36.96%(17/46), 43.48%(20/46) and 69.57%(32/46), ALT normalization rate were 22.58%(7/31), 61.29%(19/31) and 80.65%(25/31), and HBeAg seroconversion rate was 13.33%(2/15), 20.00%(3/15) and 26.67%(4/15) in chronic HBV carriers, 25.00%(4/16), 37.50%(6/16) and 43.75%(7/16) in patients with ALT≤2ULN, and 40.00%(6/15), 53.33%(8/15) and 66.67%(10/15) in patients with ALT>2ULN.
The rate of adverse effect was 2.98% observed in re-infusion of anti-HBV-DC and anti-HBV-MTL.
Conclusions: Anti-HBV-DC and anti-HBV-MTL (anti-HBV-DC-MTL) in combination with telbivudine can be considered as a safe and efficient approach for HBeAg positive chronic HBV infection, which may effectively inhibit the viral replication, lower rapidly HBsAg, HBeAg and HBVDNA, improve the production of HBeAb, and increase the HBeAg seroconversion rate.



Author Keywords: Dendritic cells (DC); Mixed T lymphocyte (MTL); Hepatitis B virus (HBV); Chronic hepatitis B (CHB); Hepatitis B virus carriers; Telbivudine