Tracking B cell immunity during perturbation of hepatitis B infection induced by treatment withdrawal

08 Jul 20264 min read0 viewsJournal Feed

GIST (Key Takeaways)

Background Withdrawal of prolonged nucleos(t)ide analogue (NA) treatment results in hepatitis B surface antigen (HBsAg) loss in some subjects with chronic hepatitis B (CHB), potentially revealing immune correlates of functional cure. Objective We investigated whether baseline or longitudinal changes in humoral immunity correlated with outcome of discontinuing prolonged NA treatment.
Design Global memory B cells (MBC) and T follicular helper cells (Tfh) were analysed by flow cytometry. HBs (small surface)/HBc (core)-MBC were quantified by ex-vivo bait staining and function assessed by cultured ELISpots (enzyme-linked immunosorbent spots).
Immune parameters assessed at end-of-treatment (EOT), 12 and 48 weeks after treatment withdrawal (and at 4 - 8 years in a subset) were correlated with intrahepatic and longitudinal serum viral markers and alanine transaminase (ALT). Results Individuals on prolonged NA had comparable frequencies of HBc-MBC and HBs-MBC, although the latter were PD-1 hi and functionally defective.
Following treatment withdrawal, increases in class-switched HBc-MBC were frequently temporally linked with hepatic flares.