Studies of Immune Responses in Patients With Chronic Hepatitis B

December 1, 2008 updated by: National Taiwan University Hospital

Analysis of HBV-Specific T Cell Responses and Regulatory T Cells in Patients With Chronic Hepatitis B Virus Infection

Taiwan is a hyperendemic area of hepatitis B virus (HBV) infection. Previous studies demonstrated vigorous T cell responses to HBV-encoded antigens developed in patients with self-limited acute hepatitis B. In contrast, weak or no T cell responses could be detected in chronic hepatitis B (CH-B) patients. However, these immune responses are still not well known in patients with acute exacerbation (AE) of CH-B and in patients with advanced liver diseases, such as liver cirrhosis (LC) and hepatocellular carcinoma (HCC). The CD4+CD25+ regulatory T cells might suppress immune responses against foreign antigens and pathogens. The roles of CD4+CD25+ regulatory T cells in patients chronically infected with HBV remain to be clarified. The high percentage of HBV carriers in Taiwan are related to the vertical transmissions. High maternal HBV viral load may make the newborns tolerant to the HBV. However, the HBV-specific CD8+ T cells responses in the cord bloods of newborns are still unknown. Thus, we want to resolve these issues in this study. We will enroll the HBsAg (+) patients from NTUH. Blood samples will be collected. We will then analyze the HBV-specific CD8+ T cell responses and the clarify the roles of regulatory T cells.

Study Overview

Status

Completed

Conditions

Detailed Description

The HBsAg (+) patients from National Taiwan University Hospital will be included. Screening for HLA haplotype will be performed by amplification refractory mutation system / PCR method. The HLA-A2 or HLA-A11 will be enrolled to the study group because these two haplotypes are the most ones in Taiwan. The other HLA haplotype HBV carriers will be enrolled as HLA-mismatch control. The disease spectra include inactive HBV carrier, CH-B, CH-B with AE (defined as ALT >= 5 X UNL), HBV-related LC, HBV-related HCCs.

HBsAg, anti-HBs, IgM anti-HBc, HBeAg, anti-HBe, anti-HCV, anti-HDV, anti-HIV will be determined by commercial enzyme immunoassay kits. The serum levels of HBV DNA and genotypes will be done by quantitative real-time PCR. Patients who are also infected with HDV or HCV or HIV will be excluded.

PBMCs will be isolated from heparinized blood samples by density gradient centrifugation on Ficoll-Hypaque. The PBMC will be washed with phosphate-buffered saline (PBS) and resuspended in T cell medium.

Analysis of HBV-specific CD8+ T cell responses will be done by flow cytometry using pentamer staining.

To analyze HBV-specific CD8+ T cells responses in patients with chronic HBV infection (prospective study). This part of the study is to clarify the role of HBV-specific T cell responses during the course of acute exacerbation of CH-B. Blood will be collected at four important time points.

Study Type

Observational

Enrollment (Anticipated)

100

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • Taipei, Taiwan, 100
        • National Taiwan University Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • patients chronically infected with hepatitis B virus

Exclusion Criteria:

  • coinfected with HCV or HIV

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

May 1, 2005

Primary Completion (Actual)

April 1, 2008

Study Registration Dates

First Submitted

September 9, 2005

First Submitted That Met QC Criteria

September 9, 2005

First Posted (Estimate)

September 12, 2005

Study Record Updates

Last Update Posted (Estimate)

December 2, 2008

Last Update Submitted That Met QC Criteria

December 1, 2008

Last Verified

November 1, 2008

More Information

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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