3 years ago

Unconventional T-cells in Chronic Hepatitis B Patients on Long-Term Suppressive Therapy with Tenofovir followed by a Peg-IFN Add-On Strategy: a randomized study

Camilla Tincati, Laura Milazzo, Elvira Stefania Cannizzo, Giulia Marchetti, Francesca Binda, Federico Angelo Cazzaniga, Antonella d'Arminio Monforte, Paola Ronzi, Spinello Antinori
HBV eradication in Chronic Hepatitis B (CHB) subjects is rarely achieved with either nucleos(t)ide analogues (NA) or pegylated interferon (Peg-IFN), which both have a limited effect in restoring immune responses. 30 CHB subjects on long-term treatment with tenofovir (TDF) and HBV suppression were enrolled and randomized 1:2 to either receive Peg-IFN-α-2a add-on therapy or continue TDF alone. We studied γδT and iNKT frequency and function (by flow cytometry) at baseline, at 12 weeks and 12 weeks after the end of treatment. A higher reduction of qHBsAg occurred in the Add-On compared with the NA group at W12 (p=0.016) and at W24 (p=0.012). A decline of qHBsAg > 0.5 log10 at week 24 occurred in 4/10 patients in the Add-On and 1/20 in the NA arm, respectively (p=0.03). HBsAg loss was seen in 20% of subjects in the Add-On and in none of the NA group. Compared to HBV negative, CHB on TDF showed lower frequency of iNKT (p=0.03) and γδT cells (p=0.03) as well as fewer γδT cells expressing Vδ2 T cell receptors (p=0.005). No changes in unconventional T cell frequency and function were shown in both Add-On and NA patients nor were differences detected between the two treatment groups. We report persistent impairment of unconventional T cells in CHB. Despite a greater qHBsAg decline in Add-On patients, our data failed to detect any effect of Peg-IFN treatment on unconventional T cells. This article is protected by copyright. All rights reserved.

Publisher URL: http://onlinelibrary.wiley.com/resolve/doi

DOI: 10.1111/jvh.12820

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