A Global View to HBV Chronic Infection: Evolving Strategies for Diagnosis, Treatment and Prevention in Immunocompetent Individuals

Nicolini, Laura Ambra; Orsi, Andrea; Tatarelli, Paola; Viscoli, Claudio; Icardi, Giancarlo; Sticchi, Laura

doi:10.3390/ijerph16183307

Cited by 32 publications

(28 citation statements)

References 116 publications

(152 reference statements)

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“…Hepatitis B virus (HBV) infection remains a public health problem all over the world. Around 250 million people live with chronic HBV infection [ 1 , 2 ] and roughly 30% of the world’s population would show serological evidence of current or past infection [ 3 ]. Most acute infections are asymptomatic.…”

Section: Introductionmentioning

confidence: 99%

Persistence of Anti-Hbs after up to 30 Years in Health Care Workers Vaccinated against Hepatitis B Virus

et al. 2021

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The burden of hepatitis B virus (HBV) infection is a serious public health problem all over the world. Vaccination remains the most effective prevention measure, and safe and effective HBV vaccines have been available since 1982. Health care workers (HCWs) vaccinated against HBV and prospectively followed up for at least 14 years were classified by their antibody titers after primary vaccination as: poor responders (10–99 mIU/mL); moderate responders (100–999 mIU/mL); and good responders (≥1000 mIU/mL). The incidence of antibody loss was calculated for 1000 person-years and the anti-HBs persistence was calculated. The analysis concerned 539 HCWs: 494 good responders (91.7%); 37 moderate responders (6.9%); and eight poor responders (1.5%). The incidence of anti-HBs loss was 52.1 per 1000 person-years for the poor responders, 11.3 per 1000 person-years for the moderate responders, and 1.4 per 1000 person-years for the good responders. The mean persistence of anti-HBs differed significantly between the three groups, being: 19.2 years (95% CI: 15.6–22.8), 25.4 years (95% CI: 23.0–27.9), and 31.0 years (95% CI: 30.5–31.5) for the poor, moderate and good responders, respectively. In conclusion, our findings demonstrate a good persistence of protective anti-HBs titers in HCWs exposed to occupational risk for up to 30 years after a primary vaccination cycle (even without a booster dose) if their titer was initially higher than 100 mIU/mL.

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Section: Introductionmentioning

confidence: 99%

Persistence of Anti-Hbs after up to 30 Years in Health Care Workers Vaccinated against Hepatitis B Virus

et al. 2021

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“…Current antiviral therapy for chronic HBV infection remains limited to immunomodulatory treatments, such as interferon, or NUCs such as entecavir (ETV), tenofovir (TDF) and tenofovir alafenamide fumarate (TAF) [21]. However, these two antiviral drugs are unable to cure HBV even after prolonged treatment due to their inability to eliminate cccDNA, primary matrix of HBV persistence.…”

Section: Discussionmentioning

confidence: 99%

Dicoumarol, an NQO1 inhibitor, blocks cccDNA transcription by promoting degradation of HBx

Cheng

Ren

et al. 2021

Journal of Hepatology

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…Also, the immune response has to be meticulously analyzed, followed by evaluation of possible CHB therapeutic effects in transgenic mice. Assuming efficacy of the injection-oral vaccination, a plant-derived CHB therapeutic vaccine could be subsequently tested in clinical trials and then used for human immunization, although similarly to other tested CHB vaccines, probably not until the next decade [2]. Nevertheless, a potential plant-derived CHB vaccine would substantially improve public health, especially in developing countries.…”

Section: Discussionmentioning

confidence: 99%

Parenteral–Oral Immunization with Plant-Derived HBcAg as a Potential Therapeutic Vaccine against Chronic Hepatitis B

et al. 2019

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Chronic hepatitis B (CHB) is the cause of severe liver damage, cirrhosis, and hepatocellular carcinoma for over 240 million people worldwide. Nowadays, several types of treatment are being investigated, including immunotherapy using hepatitis B core antigen (HBcAg) assembled into highly immunogenic capsid-like particles (CLPs). Immunogenicity of plant-produced and purified HBcAg, administered parenterally or intranasally, was previously reported. In this study, a novel parenteral–oral vaccination scheme is proposed using plant-derived HBcAg preparations. The antigen for injection was obtained via transient expression in Nicotiana benthamiana. HBcAg-producing transgenic lettuce was lyophilized and used as an orally delivered booster. The intracellular location of plant-produced HBcAg CLPs implies additional protection in the digestive tract during oral immunization. BALB/c mice were intramuscularly primed with 10 µg of the purified antigen and orally boosted twice with 5 or 200 ng of HBcAg. A long-lasting and significant systemic response after boosting with 200 ng HBcAg was induced, with anti-HBc titer of 25,000. Concomitantly, an insignificant mucosal response was observed, with an S-IgA titer of only 500. The profile of IgG isotypes indicates a predominant Th1 type of immune response, supplemented by Th2, after injection–oral vaccination. The results demonstrate that a low dose of parenteral–oral immunization with plant-derived HBcAg can elicit a specific and efficient response. This study presents a potential new pathway of CHB treatment.

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A Global View to HBV Chronic Infection: Evolving Strategies for Diagnosis, Treatment and Prevention in Immunocompetent Individuals

Cited by 32 publications

References 116 publications

Persistence of Anti-Hbs after up to 30 Years in Health Care Workers Vaccinated against Hepatitis B Virus

Persistence of Anti-Hbs after up to 30 Years in Health Care Workers Vaccinated against Hepatitis B Virus

Dicoumarol, an NQO1 inhibitor, blocks cccDNA transcription by promoting degradation of HBx

Parenteral–Oral Immunization with Plant-Derived HBcAg as a Potential Therapeutic Vaccine against Chronic Hepatitis B

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