Combination of DNA prime--adenovirus boost immunization with entecavir elicits sustained control of chronic hepatitis B in the woodchuck model

PLoS Pathog. 2013;9(6):e1003391. doi: 10.1371/journal.ppat.1003391. Epub 2013 Jun 13.

Abstract

A potent therapeutic T-cell vaccine may be an alternative treatment of chronic hepatitis B virus (HBV) infection. Previously, we developed a DNA prime-adenovirus (AdV) boost vaccination protocol that could elicit strong and specific CD8+ T-cell responses to woodchuck hepatitis virus (WHV) core antigen (WHcAg) in mice. In the present study, we first examined whether this new prime-boost immunization could induce WHcAg-specific T-cell responses and effectively control WHV replication in the WHV-transgenic mouse model. Secondly, we evaluated the therapeutic effect of this new vaccination strategy in chronically WHV-infected woodchucks in combination with a potent antiviral treatment. Immunization of WHV-transgenic mice by DNA prime-AdV boost regimen elicited potent and functional WHcAg-specific CD8+ T-cell response that consequently resulted in the reduction of the WHV load below the detection limit in more than 70% of animals. The combination therapy of entecavir (ETV) treatment and DNA prime-AdV boost immunization in chronic WHV carriers resulted in WHsAg- and WHcAg-specific CD4+ and CD8+ T-cell responses, which were not detectable in ETV-only treated controls. Woodchucks receiving the combination therapy showed a prolonged suppression of WHV replication and lower WHsAg levels compared to controls. Moreover, two of four immunized carriers remained WHV negative after the end of ETV treatment and developed anti-WHs antibodies. These results demonstrate that the combined antiviral and vaccination approach efficiently elicited sustained immunological control of chronic hepadnaviral infection in woodchucks and may be a new promising therapeutic strategy in patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenoviridae*
  • Animals
  • CD4-Positive T-Lymphocytes / immunology
  • CD8-Positive T-Lymphocytes / immunology
  • Cells, Cultured
  • Disease Models, Animal
  • Hepatitis B Vaccines / genetics
  • Hepatitis B Vaccines / immunology
  • Hepatitis B Vaccines / pharmacology*
  • Hepatitis B, Chronic / genetics
  • Hepatitis B, Chronic / immunology
  • Hepatitis B, Chronic / prevention & control*
  • Humans
  • Immunity, Cellular / drug effects*
  • Immunity, Cellular / genetics
  • Immunity, Cellular / immunology
  • Immunization, Secondary*
  • Marmota
  • Mice
  • Mice, Transgenic
  • Vaccines, DNA / genetics
  • Vaccines, DNA / microbiology*

Substances

  • Hepatitis B Vaccines
  • Vaccines, DNA

Grants and funding

This work was supported by the Deutsche Forschungsgemeinschaft (GK 1045/2 and TRR60), Wilhelm-Sander Stiftung and a grant from the Robert Koch Institute (to DG). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.