The aim of the prospective study is to determine whether combination/ sequential therapy with Entecavir, Peginterferon alfa-2b and immunomodulators Granulocyte Macrophage Colony Stimulating Factor (GMCSF)+vaccine could induce HBsAg loss in chronic hepatitis B patients with maintained Hepatitis B Virus (HBV) DNA suppression on long-term nucleoside or nucleotide analogue (NA).
Patents who were treated with NA at least one year and achieved HBV DNA suppression are enrolled in this study, they will receive Entecavir (ETV) for 60 weeks, HBV vaccine (60ug/month, every four weeks) for 24 weeks, GMCSF (75 μg/day, first 5 days each month, subcutaneous) from baseline to week 16 and from week 60 to week 84, and Y peginterferon alfa-2b (180 μg/week, subcutaneous) from week 16 to week 108.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
15
Entecavir is used for 96 weeks
Granulocyte-macrophage colony stimulating factor is used intermittently from baseline to week 16 and from 60 to week 84
Y peginterferon alfa-2b is used for 96 weeks
HBsAg loss rate
Percentages of patients who achieve HBsAg loss at the end of treatment
Time frame: at week 108
HBsAg level
Dynamic change in HBsAg level from baseline to the end of treatment
Time frame: at week 60
HBsAg level
Dynamic change in HBsAg level from baseline to the end of treatment
Time frame: at week 108
decline in HBsAg level
Decline in HBsAg level from baseline to the end of treatment
Time frame: at week 60
decline in HBsAg level
Decline in HBsAg level from baseline to the end of treatment
Time frame: at week 108
HBsAb appearance rate
Percentages of HBsAb appearance at the end of treatment
Time frame: at week 108
HBsAb seroconversion rate
Percentages of HBsAb seroconversion at the end of treatment
Time frame: at week 108
HBeAg loss rate
Percentages of HBeAg loss in the HBeAg-positive patients at the end of treatment
Time frame: at week 108
HBeAg seroconversion rate
Percentages of HBeAg seroconversion in the HBeAb-negative patients at the end of treatment
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60ug HBV vaccine is used every four week for 24 weeks
Time frame: at week 108
Rate of HBV DNA level <1000 copies/mL
Percentages of HBV DNA level \<1000 copies/mL at the end of treatment
Time frame: at week 108
Rate of alanine aminotransferase (ALT) normalisation
Percentages of ALT normalisation at the end of treatment
Time frame: at week 108
Sustained HBsAg loss rate
Percentages of sustained HBsAg loss at the end of follow-up
Time frame: at week 156
The rate of progression to cirrhosis
The rate of progression to cirrhosis at the end of follow-up
Time frame: at week 156
The incidence rate of hepatocarcinoma
The incidence rate of hepatocarcinoma at the end of follow-up
Time frame: at week 156