Table 2. Host factors.
| Factors | Targets | Results | Ref. |
|---|---|---|---|
| Innate immunity | |||
|
| |||
| PRRs (TLRs) | TLR-7 agonist: GS-9620 | Suppression of HBV DNA in both serum and liver of HBV-infected chimpanzees; induction of IFN-α and cytokines Phase I trials in CHB patients |
Animal study: [124] Phase I study in healthy volunteers: [125] Phase I trials in CHB (completed) [126,127] |
|
| |||
| Cytokines | IL-7 Recombinant human IL-7 (rhIL-7)-CYT 107 IL-21 Recombinant IL-21 |
Preclinical data: Immunorestorative and vaccine adjuvant effect Phase I-II clinical trial on CHB patients ongoing Possible immunorestorative effect when used in combination with antivirals |
Small animal study (LCMV mice): [128,129] Small animal study (LCMV mice): [134–135,137] |
|
| |||
| Adaptive immunity | |||
|
| |||
| Inhibitory T lymphocytes |
PD-1/PD-L1 | Blockade of PD-1/PD-L1 interaction leading to restoration of T-cell function |
Small animal study (LCMV mice): [146] Wood chucks (WHV infected): [153,154] |
|
| |||
| Humoral & adaptive immunity | |||
|
| |||
| Therapeutic vaccination |
Immunogenic complexes: HBsAg with anti-HBs immunoglobulin) |
Priming of HBV-specific CD8+ CTL responses | Clinical trial: [165] Phase 11 b clinical trial: [164] Phase III clinical trial: [166] |
| HBsAg and HBcAg Combination: NASVAC |
Recombinant HBcAg act as potent Th1 adjuvant to HBsAg and strong immunogen Phase I clinical trial in HVs demonstrated safety and immunologic efficacy Phase III clinical trial is on going in CHB patients |
Phase I clinical trial: [169] Phase III clinical trial: [170] |
|
| Whole recombinant yeast- based therapeutic vaccine: tarmogens: GS-4774 (formerly GI-13020) |
Antigen-specific T-cell responses; tarmogens elicited HBV-specific T-cell responses ex vivo in samples collected from HVs and donors with CHB; induce both CD4+ and CD8+ T-cell responses in ex vivo model; induce HBV-specific T-cell response |
[172,183] Phase I trial in HV completed: [184] Phase II trial in CHB patients: [185] |
|
| Adenovirus-based therapeutic vaccination TG1050 |
Stimulate polyfunctional, multispecific, robust and long-lasting T cells targeting multiple epitopes from three major viral proteins, expected to control the HBV replication and to elicit viral clearance |
[173] | |
| DNA vaccines | Activate not only the T-cell responses specific to HBV but also natural killer cells |
Phase I clinical trial: [175] Proof-of-concept study/CHB carriers: [176] |
|
| T-cell peptide epitope vaccine |
String of 30 HBV-derived CTL epitopes linked to 16 Th epitopes presented to T cells by a large number of HLA molecules |
Mouse model: [177] | |
AASLD: American Association for the Study of Liver Diseases; anti-HBs: Hepatitis B surface antibody; CHB: Chronic hepatitis B; CTL: Cytotoxic T lymphocyte; HBcAg: Hepatitis B core antigen; HBsAg: Hepatitis B surface antigen; HV: Healthy volunteer; LCMV:lymphocytic choriomeningitis virus; NASVAC: Nasal HBV vaccine candidate; PD1/PD-L1: Programmed death-1/Programmed death-ligand 1; PRR: Pattern recognition receptor; Th: T helper; TLR: Toll-like receptor.