Study of Therapeutic Vaccination With Intensified Schedule Plus Pegasys Dual Therapy on Chronic Hepatitis B Infection (E+VIP)
Hepatitis B, Chronic
About this trial
This is an interventional treatment trial for Hepatitis B, Chronic focused on measuring chronic hepatitis B, Pegasys, Euvax B, Baracrude
Eligibility Criteria
Inclusion Criteria:
- Age between 20 and 75 year-old
- HBsAg-positive for > 6 months apart (medical history can be alternative)
- Currently being treated with entecavir 0.5 mg/day for more than 18 months
- Undetectable HBV DNA in serum (<20IU/mL) and HBeAg-negative or positive for > 1year
- HBsAg titer < 3,000 IU/mL
- ALT<300 IU/L
- Signed written informed consent after being instructed about the objective and procedure of the clinical study
Exclusion Criteria:
Patients with decompensated liver cirrhosis, any one of the following ① Serum bilirubin > 3 mg/dL
② Prothrombin time > 6 seconds prolonged or INR >2.3
③ Serum albumin < 2.8 g/dL
④ History of ascites, variceal hemorrhage, or hepatic encephalopathy
⑤ Child-Pugh score ≥7 (Child-Pugh class B or C)
- Patients who have evidence of renal insufficiency defined as serum creatinine>1.5 mg/dL
- Patients with psychological problem including depression
- Patients who have previous/current significant co-morbidities including congestive heart failure, chronic kidney disease, hematologic disease and malignancy including hepatocellular carcinoma(patients with malignancy cured 5 years before screening can be enrolled)
- Patients with seropositivity for anti-HCV, anti-HDV or anti-HIV
- Patients who have excessive alcohol consumption (> 30 g/day)
- Patients who have evidence of autoimmune hepatitis, hemochromatosis or Wilson's disease
- Pregnant or breast feeding females or plan for pregnancy or no contraception
- Patients with disease may deteriorate with interferon therapy(eg, autoimmune thyroiditis)
- Patients who have an psoriasis
- Patients who have history of antiviral-resistant HBV after previous treatment with oral antiviral agents
- Previous diagnosis with immunodeficiency or concomitant treatment of immune suppressive agent or previous organ transplantation Recipients
- Patients who have a history of hypersensitivity to study drug
- Uncontrollable seizure, convulsion and/or central nervous system disorders
- Patients with severe bone marrow disorder or with history of hypersensitivity to biologic agent such as vaccine.
- Neutrophil count < 1,500/mm3 or platelet count < 75,000/mm3 or hemoglobin < 10 g/dl
- Patients with Pulmonary disease (in case of history of pulmonary disease with complete recovery, enrollment is on investigator's discretion)
- Patients who have a fever ≥ 38 °C at the baseline
- Patients who have a risk of febrile response or systemic reaction
- Patients who the investigator deems inappropriate to participate in this study
Sites / Locations
- Seoul National University
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Experimental
Active Comparator
Concomitant:Pegasys, Euvax B, Baracrude
Sequential:Pegasys, Euvax B, Baracrude
Control Group
Peginterferon alfa-2a: once weekly 180 μg subcutaneous injection for 48 weeks HBV vaccination (Euvax B Inj): 1.0 mL (20 μg) intramuscular injection at 4, 8, 12 and 28 weeks Continue Entecavir(0.5mg) for 100 weeks(once daily)
Peginterferon alfa-2a: once weekly 180 μg or weight base dose subcutaneous injection for 48 weeks HBV vaccination (Euvax B Inj): 1.0 mL (20 μg) intramuscular injection at 52, 56, 60 and 76 weeks Continue Entecavir(0.5mg) for 100 weeks(once daily)
Continue Entecavir(0.5mg) for 100 weeks(once daily) After EOS(100W), injection(once weekly) a Peginterferon alfa-2a for 48 weeks