Amr Shaaban Hanafy1. 1. Internal Medicine Department - Hepatology Division, Zagazig University, Egypt. Electronic address: Dr_amr_hanafy@yahoo.com.
Abstract
BACKGROUND AND AIMS: Persistent HBs antigenemia >1000IU/ml has a possibility of viral reactivation and HCC in 8%, so we investigated the effect of HBV vaccine on HBsAg, IP-10, and recurrence of viremia. METHODS: Group I: inactive carriers(n=100). Group II: CHB exposed to nucleos(t)ides (n=120) till 1year after HBe seroconversion and HBV DNA disappearance in HBeAg positive (n=60) or3years after DNA disappearance in HBeAg negativepatients (n=60). All showed persistent HBs antigenemia. A control group (n=100) did not receive HBV vaccine. 30µg of HBV vaccine initiated at the determined points of time. 3months after the last vaccine dose; IP-10, HBsAb, HOMA-IR and liver stiffness by fibroscanwere evaluated. HBV DNA and HBsAg were detected every 6months for 3years post vaccination. RESULTS: 46 patients (20.9%) were vaccine nonresponders. 174 patients were responders (79.1%). 62 patients (28.2%)cleared HBsAg, 143 patients showed marked reduction of HBsAg (65%). Recurrence of viremia occurred in 4 vaccinated patients (7.8%) vs. 30 patients in the control group (30%,p=0.000). The vaccine enhanced IP-10 which at a cutoff 350pg/ml helped in HBsAg reduction to a favorable level. The vaccine had no significant effect on HOMA-IR nor fibroscan value. CONCLUSIONS: HBV vaccine was efficient in enhancing IP-10 level with HBsAg clearance, or reduction to a favorable level. ClinicalTrials.gov Identifier: NCT03193775.
BACKGROUND AND AIMS: Persistent HBs antigenemia >1000IU/ml has a possibility of viral reactivation and HCC in 8%, so we investigated the effect of HBV vaccine on HBsAg, IP-10, and recurrence of viremia. METHODS: Group I: inactive carriers(n=100). Group II: CHB exposed to nucleos(t)ides (n=120) till 1year after HBe seroconversion and HBV DNA disappearance in HBeAg positive (n=60) or3years after DNA disappearance in HBeAg negativepatients (n=60). All showed persistent HBs antigenemia. A control group (n=100) did not receive HBV vaccine. 30µg of HBV vaccine initiated at the determined points of time. 3months after the last vaccine dose; IP-10, HBsAb, HOMA-IR and liver stiffness by fibroscanwere evaluated. HBV DNA and HBsAg were detected every 6months for 3years post vaccination. RESULTS: 46 patients (20.9%) were vaccine nonresponders. 174 patients were responders (79.1%). 62 patients (28.2%)cleared HBsAg, 143 patients showed marked reduction of HBsAg (65%). Recurrence of viremia occurred in 4 vaccinated patients (7.8%) vs. 30 patients in the control group (30%,p=0.000). The vaccine enhanced IP-10 which at a cutoff 350pg/ml helped in HBsAg reduction to a favorable level. The vaccine had no significant effect on HOMA-IR nor fibroscan value. CONCLUSIONS: HBV vaccine was efficient in enhancing IP-10 level with HBsAg clearance, or reduction to a favorable level. ClinicalTrials.gov Identifier: NCT03193775.