Trends in Immunotherapy

Review

A critical review of the prospects and challenges of Hepatitis B therapeutic vaccines

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Abdullahi Hudu, S., Osman, A., Jebreel Ibrahim Abu-Shoura, E., & Olayiwola Jimoh, A. (2024). A critical review of the prospects and challenges of Hepatitis B therapeutic vaccines. Trends in Immunotherapy, 8(1). https://doi.org/10.24294/ti.v8.i1.5644

Authors

  • Shuaibu Abdullahi Hudu
    Department of Basic Medical and Dental Sciences, Faculty of Dentistry, Zarqa University, Zarqa 13110, Jordan; Department of Microbiology and Parasitology, Faculty of Basic Clinical Sciences, College of Health Sciences, Usmanu Danfodiyo University, Sokoto 840232, Nigeria
  • Amira Osman Department of Basic Medical and Dental Sciences, Faculty of Dentistry, Zarqa University, Zarqa 13110, Jordan; Department of Histology and Cell Biology, Faculty of Medicine, Kafrelsheikh University, Kafr El Sheikh 6860404, Egypt
  • Esra’a Jebreel Ibrahim Abu-Shoura Department of Basic Medical and Dental Sciences, Faculty of Dentistry, Zarqa University, Zarqa 13110, Jordan
  • Abdulgafar Olayiwola Jimoh Department of Pharmacology and Therapeutics, Faculty of Basic Clinical Sciences, College of Health Sciences, Usmanu Danfodiyo University, Sokoto 840232, Nigeria

Hepatitis B therapeutic vaccines hold great promise in the treatment of chronic Hepatitis B virus (HBV) infection. However, like any medical intervention, they also face certain prospects and challenges which forms the aim of this critical review. Therapeutic vaccines offer a targeted approach to manage chronic Hepatitis B infections, aiming to stimulate the immune system to recognise and eliminate infected cells. The potential to halt disease progression holds promise for preventing severe liver diseases associated with chronic Hepatitis B, such as cirrhosis and hepatocellular carcinoma. Therapeutic vaccines, if effective, could contribute to a more equitable distribution of treatment options globally, especially in resource-limited settings. Hepatitis B therapeutic vaccines may play a crucial role in preventing vertical transmission, reducing the global incidence of perinatal HBV infections and improving maternal-child health outcomes. Diverse vaccine platforms and combination strategies, including immunomodulation and checkpoint inhibitors, are advancing, optimising immunogenicity, and eliciting strong immune responses. Tailoring therapeutic vaccines to individual patients based on genetic considerations may enhance efficacy, recognizing the genetic diversity of Hepatitis B. Therapeutic vaccines need to align with global health goals related to infectious disease elimination, contributing to broader efforts to reduce the burden of Hepatitis B worldwide. While Hepatitis B therapeutic vaccines hold significant promise in transforming the management of chronic infections, addressing challenges related to access, viral variability, and long-term monitoring is crucial for their successful integration into global healthcare strategies.

Keywords:

clinical trial Hepatitis B hepatocellular therapeutics vaccine

References

  1. Hsu YC, Huang DQ, Nguyen MH. Global burden of hepatitis B virus: current status, missed opportunities and a call for action. Nature Reviews Gastroenterology & Hepatology. 2023; 20(8): 524-537. doi: 10.1038/s41575-023-00760-9
  2. Cao G, Jing W, Liu J, et al. The global trends and regional differences in incidence and mortality of hepatitis A from 1990 to 2019 and implications for its prevention. Hepatology International. 2021; 15(5): 1068-1082. doi: 10.1007/s12072-021-10232-4
  3. Patel A, Dossaji Z, Gupta K, et al. The Epidemiology, Transmission, Genotypes, Replication, Serologic and Nucleic Acid Testing, Immunotolerance, and Reactivation of Hepatitis B Virus. Gastro Hep Advances. 2024; 3(2): 139-150. doi: 10.1016/j.gastha.2023.10.008
  4. Alberts C, Clifford G, Georges D, et al. Worldwide prevalence of hepatitis B virus and hepatitis C virus among patients with cirrhosis at country, region, and global levels: a systematic review. The Lancet Gastroenterology & Hepatology. 2022. doi: 10.1016/S2468-1253(22)00050-4
  5. Duberg A, Lybeck C, Fält A, et al. Chronic hepatitis B virus infection and the risk of hepatocellular carcinoma by age and country of origin in people living in Sweden: A national register study. Hepatology Communications. 2022; 6(9): 2418-2430. doi: 10.1002/hep4.1974
  6. Bollerup S, Hallager S, Engsig F, et al. Mortality and cause of death in persons with chronic hepatitis B virus infection versus healthy persons from the general population in Denmark. Journal of Viral Hepatitis. 2022; 29(9): 727-736. doi: 10.1111/jvh.13713
  7. Hudu AS, Malik Y, Taib N, et al. Antibody and immune memory persistence post infant hepatitis B vaccination. Patient Preference and Adherence. 2013. doi: 10.2147/ppa.s49776
  8. Su J, Brunner L, Ates Oz E, et al. Activation of CD4 T cells during prime immunization determines the success of a therapeutic hepatitis B vaccine in HBV-carrier mouse models. Journal of Hepatology. 2023; 78(4): 717-730. doi: 10.1016/j.jhep.2022.12.013
  9. de Morais Pinto R, de Medeiros Valentim RA, Fernandes da Silva L, et al. Analyzing the reach of public health campaigns based on multidimensional aspects: the case of the syphilis epidemic in Brazil. BMC Public Health. 2021; 21(1). doi: 10.1186/s12889-021-11588-w
  10. Smith-Palmer J, Cerri K, Sbarigia U, et al. Impact of Stigma on People Living with Chronic Hepatitis B. Patient Related Outcome Measures. 2020; 11: 95-107. doi: 10.2147/prom.s226936
  11. Martyn E, Eisen S, Longley N, et al. The forgotten people: Hepatitis B virus (HBV) infection as a priority for the inclusion health agenda. eLife. 2023; 12. doi: 10.7554/elife.81070
  12. Hudu S, Jimoh A, Ibrahim K, et al. Hepatitis B Therapeutic Vaccine: A Patent Review. Pharmaceuticals. 2022; 15(12): 1542. doi: 10.3390/ph15121542
  13. Phillips S, Jagatia R, Chokshi S. Novel therapeutic strategies for chronic hepatitis B. Virulence. 2022; 13(1): 1111-1132. doi: 10.1080/21505594.2022.2093444
  14. Jiang N, Malone M, Chizari S. Antigen‐specific and cross‐reactive T cells in protection and disease. Immunological Reviews. 2023; 316(1): 120-135. doi: 10.1111/imr.13217
  15. Takahama S, Yoshio S, Masuta Y, et al. Hepatitis B surface antigen reduction is associated with hepatitis B core-specific CD8+ T cell quality. Frontiers in Immunology. 2023; 14. doi: 10.3389/fimmu.2023.1257113
  16. Hudu SA. Cell Culture, Technology: Enhancing the Culture of Diagnosing Human Diseases. Journal of Clinical and Diagnostic Research. 2016. doi: 10.7860/jcdr/2016/15837.7460
  17. Hudu SA, Shinkafi SH, Umar S, et al. Reverse Vaccinology Approach for a Potential Rhinovirus Vaccine. Avicenna Journal of Clinical Microbiology and Infection. 2021; 8(2): 66-73. doi: 10.34172/ajcmi.2021.12
  18. Farhad T, Neves K, Arbuthnot P, et al. Adenoviral Vectors: Potential as Anti-HBV Vaccines and Therapeutics. Genes. 2022; 13(11): 1941. doi: 10.3390/genes13111941
  19. Mohsen MO, Bachmann MF. Virus-like particle vaccinology, from bench to bedside. Cellular & Molecular Immunology. 2022; 19(9): 993-1011. doi: 10.1038/s41423-022-00897-8
  20. Taverniti V, Ligat G, Debing Y, et al. Capsid Assembly Modulators as Antiviral Agents against HBV: Molecular Mechanisms and Clinical Perspectives. Journal of Clinical Medicine. 2022; 11(5): 1349. doi: 10.3390/jcm11051349
  21. Salama II, Sami SM, Salama SI, et al. Current and novel modalities for management of chronic hepatitis B infection. World Journal of Hepatology. 2023; 15(5): 585-608. doi: 10.4254/wjh.v15.i5.585
  22. Iannacone M, Guidotti LG. Immunobiology and pathogenesis of hepatitis B virus infection. Nature Reviews Immunology. 2021; 22(1): 19-32. doi: 10.1038/s41577-021-00549-4
  23. Hudu S, Niazlin M, Nordin S, et al. Expression of Human Cytokine Genes Associated with Chronic Hepatitis B Disease Progression. Iranian Journal of Immunology. 2017; 14(4): 281-292.
  24. Akbar SMF, Yoshida O, Hiasa Y. Immune therapies against chronic hepatitis B. Journal of Gastroenterology. 2022; 57(8): 517-528. doi: 10.1007/s00535-022-01890-8
  25. Aguilar J, Aguiar J, Akbar S. Action Mechanisms and Scientific Rationale of Using Nasal Vaccine (HeberNasvac) for the Treatment of Chronic Hepatitis B. Vaccines. 2022; 10(12): 2087. doi: 10.3390/vaccines10122087
  26. Vanwolleghem T, Adomati T, Van Hees S, et al. Humoral immunity in hepatitis B virus infection: Rehabilitating the B in HBV. JHEP Reports. 2022; 4(2): 100398. doi: 10.1016/j.jhepr.2021.100398
  27. Beretta M, Mouquet H. Advances in human monoclonal antibody therapy for HBV infection. Current Opinion in Virology. 2022; 53: 101205. doi: 10.1016/j.coviro.2022.101205
  28. Boudewijns R, Ma J, Neyts J, et al. A novel therapeutic HBV vaccine candidate induces strong polyfunctional cytotoxic T cell responses in mice. JHEP Reports. 2021; 3(4): 100295. doi: 10.1016/j.jhepr.2021.100295
  29. Wang L, Zeng X, Wang Z, et al. Recent advances in understanding T cell activation and exhaustion during HBV infection. Virologica Sinica. 2023; 38(6): 851-859. doi: 10.1016/j.virs.2023.10.007
  30. Konopleva MV, Borisova VN, Sokolova MV, et al. Recombinant HBsAg of the Wild-Type and the G145R Escape Mutant, included in the New Multivalent Vaccine against Hepatitis B Virus, Dramatically Differ in their Effects on Leukocytes from Healthy Donors In Vitro. Vaccines. 2022; 10(2): 235. doi: 10.3390/vaccines10020235
  31. Lei X, Cai X, Yang Y. Genetic engineering strategies for construction of multivalent chimeric VLPs vaccines. Expert Review of Vaccines. 2020; 19(3): 235-246. doi: 10.1080/14760584.2020.1738227
  32. Zheng P, Dou Y, Wang Q. Immune response and treatment targets of chronic hepatitis B virus infection: innate and adaptive immunity. Frontiers in Cellular and Infection Microbiology. 2023; 13. doi: 10.3389/fcimb.2023.1206720
  33. Tian Y, Hu D, Li Y, et al. Development of therapeutic vaccines for the treatment of diseases. Molecular Biomedicine. 2022; 3(1). doi: 10.1186/s43556-022-00098-9
  34. Yoshida O, Akbar SMF, Imai Y, et al. Intranasal therapeutic vaccine containing HBsAg and HBcAg for patients with chronic hepatitis B; 18 months follow‐up results of phase IIa clinical study. Hepatology Research. 2022; 53(3): 196-207. doi: 10.1111/hepr.13851
  35. Su J, Brunner L, Ates Oz E, et al. Activation of CD4 T cells during prime immunization determines the success of a therapeutic hepatitis B vaccine in HBV-carrier mouse models. Journal of Hepatology. 2023; 78(4): 717-730. doi: 10.1016/j.jhep.2022.12.013
  36. Aguiar Santiago JA, Marrero Miragaya MA, Figueroa Oliva DA, et al. Preparing for the Next Pandemic: Increased Expression of Interferon-Stimulated Genes After Local Administration of Nasalferon or HeberNasvac. DNA and Cell Biology. 2024; 43(2): 95-102. doi: 10.1089/dna.2023.0283
  37. Shiraishi K, Yoshida O, Imai Y, et al. Intranasal HBsAg/HBcAg-Containing Vaccine Induces Neutralizing Anti-HBs Production in Hepatitis B Vaccine Non-Responders. Vaccines. 2023; 11(9): 1479. doi: 10.3390/vaccines11091479
  38. Zhang S, Yan C, Millar DG, et al. Antibody-Peptide Epitope Conjugates for Personalized Cancer Therapy. Cancer Research. 2021; 82(5): 773-784. doi: 10.1158/0008-5472.can-21-2200
  39. Srivastava M, Copin R, Choy A, et al. Proteogenomic identification of Hepatitis B virus (HBV) genotype-specific HLA-I restricted peptides from HBV-positive patient liver tissues. Frontiers in Immunology. 2022; 13. doi: 10.3389/fimmu.2022.1032716
  40. Yamamoto Y, Kanayama N, Nakayama Y, et al. Current Status, Issues and Future Prospects of Personalized Medicine for Each Disease. Journal of Personalized Medicine. 2022; 12(3): 444. doi: 10.3390/jpm12030444
  41. Salmon DA, Dudley MZ, Brewer J, et al. LetsTalkShots: personalized vaccine risk communication. Frontiers in Public Health. 2023; 11. doi: 10.3389/fpubh.2023.1195751
  42. Jain KK. Personalized therapy of Infectious Diseases. In: Textbook of Personalized Medicine. Springer International Publishing; 2021. doi: 10.1007/978-3-030-62080-6
  43. Poria R, Kala D, Nagraik R, et al. Vaccine development: Current trends and technologies. Life Sciences. 2024; 336: 122331. doi: 10.1016/j.lfs.2023.122331
  44. Zhang Y, Bourgine M, Wan Y, et al. Therapeutic vaccination with lentiviral vector in HBV-persistent mice and two inactive HBsAg carriers. Journal of Hepatology. 2024; 80(1): 31-40. doi: 10.1016/j.jhep.2023.09.019
  45. Sacherl J, Kosinska AD, Kemter K, et al. Efficient stabilization of therapeutic hepatitis B vaccine components by amino-acid formulation maintains its potential to break immune tolerance. JHEP Reports. 2023; 5(2): 100603. doi: 10.1016/j.jhepr.2022.100603
  46. Chang ML, Liaw YF. Emerging Therapies for Chronic Hepatitis B and the Potential for a Functional Cure. Drugs. 2023; 83(5): 367-388. doi: 10.1007/s40265-023-01843-2
  47. Yardeni D, Chang KM, Ghany MG. Current Best Practice in Hepatitis B Management and Understanding Long-term Prospects for Cure. Gastroenterology. 2023; 164(1): 42-60.e6. doi: 10.1053/j.gastro.2022.10.008
  48. Poria R, Kala D, Nagraik R, et al. Vaccine development: Current trends and technologies. Life Sciences. 2024; 336: 122331. doi: 10.1016/j.lfs.2023.122331
  49. Campos-Valdez M, Monroy-Ramírez HC, Armendáriz-Borunda J, et al. Molecular Mechanisms during Hepatitis B Infection and the Effects of the Virus Variability. Viruses. 2021; 13(6): 1167. doi: 10.3390/v13061167
  50. Zaki MYW, Fathi AM, Samir S, et al. Innate and Adaptive Immunopathogeneses in Viral Hepatitis; Crucial Determinants of Hepatocellular Carcinoma. Cancers. 2022; 14(5): 1255. doi: 10.3390/cancers14051255
  51. Liu Y, Park D, Cafiero T, et al. Molecular clones of genetically distinct hepatitis B virus genotypes reveal distinct host and drug treatment responses. Innovation in Hepatology. 2022; 4(9): 100535. doi: 10.1016/j.jhepr.2022.100535
  52. Said Z, El-Sayed M. Challenge of managing hepatitis B virus and hepatitis C virus infections in resource-limited settings. World Journal of Hepatology. 2022; 14(7): 1333-1343. doi: 10.4254/wjh.v14.i7.1333
  53. Lok AS, Pan CQ, Han S-HB, et al. Randomized phase II study of GS-4774 as a therapeutic vaccine in virally suppressed patients with chronic hepatitis B. Journal of Hepatology. 2016; 65(3): 509-516. doi: 10.1016/j.jhep.2016.05.016
  54. Lobaina Y, Aguilar JC, Guillen G. ABX203, a novel therapeutic vaccine for chronic hepatitis B patients. Almanac of Clinical Medicine. 2016; 44(6): 713–718. doi: 10.18786/2072-0505-2016-44-6-713-718
  55. Wei L, Zhao T, Zhang J, et al. Efficacy and safety of a nanoparticle therapeutic vaccine in patients with chronic hepatitis B: A randomized clinical trial. Hepatology. 2021; 75(1): 182-195. doi: 10.1002/hep.32109
  56. Li T, Qian C, Gu Y, et al. Current progress in the development of prophylactic and therapeutic vaccines. Science China Life Sciences. 2023; 66(4): 679-710. doi: 10.1007/s11427-022-2230-4
  57. Lim SG, Baumert TF, Boni C, et al. The scientific basis of combination therapy for chronic hepatitis B functional cure. Nature Reviews Gastroenterology & Hepatology. 2023; 20(4): 238-253. doi: 10.1038/s41575-022-00724-5
  58. Hudu SA, Shinkafi SH, Umar S. An overview of recombinant vaccine technology, adjuvants and vaccine delivery methods. International Journal of Pharmacy and Pharmaceutical Sciences. 2016; 8(11): 19-24. doi: 10.22159/ijpps.2016v8i11.14311
  59. Khan N, Almajed MR, Fitzmaurice MG, et al. Developments in pharmacotherapeutic agents for hepatitis B–how close are we to a functional cure? Expert opinion on pharmacotherapy. 2023; 24(9): 1001-1011. doi: 10.1080/14656566.2023.2211259
  60. Devarbhavi H, Asrani SK, Arab JP, et al. Global burden of liver disease: 2023 update. Journal of Hepatology. 2023; 79(2): 516-537. doi: 10.1016/j.jhep.2023.03.017
  61. Laupèze B, Vassilev V, Badur S. A role for immune modulation in achieving a functional cure for chronic hepatitis B among current changes in the landscape of new treatments. Expert Review of Gastroenterology & Hepatology. 2023; 17(11): 1135-1147. doi: 10.1080/17474124.2023.2268503
  62. Uwishema O, Nchasi G, Nnko GG, et al. The insight through the current immunotherapeutic guidelines for infectious diseases. International Journal of Surgery. 2023; 109(1): 71-72. doi: 10.1097/JS9.0000000000000152
  63. Adugna A. Antigen Recognition and Immune Response to Acute and Chronic Hepatitis B Virus Infection. Journal of Inflammation Research. 2023; 2159-2166. doi: 10.2147/JIR.S411492
  64. Tapper EB, Parikh ND. Diagnosis and Management of Cirrhosis and Its Complications: A Review. Jama. 2023; 329(18): 1589-1602. doi: 10.1001/jama.2023.5997
  65. Farlow A, Torreele E, Gray G, et al. The Future of Epidemic and Pandemic Vaccines to Serve Global Public Health Needs. Vaccines. 2023; 11(3): 690. doi: 10.3390/vaccines11030690
  66. Lu H, Cao W, Zhang L, et al. Effects of hepatitis B virus infection and strategies for preventing mother-to-child transmission on maternal and fetal T-cell immunity. Frontiers in Immunology. 2023; 14: 1122048. doi: 10.3389/fimmu.2023.1122048
  67. Maqsood Q, Sumrin A, Iqbal M, et al. Hepatitis C virus/Hepatitis B virus coinfection: Current prospectives. Antiviral Therapy. 2023; 28(4): 13596535231189643. doi: 10.1177/13596535231189643
  68. Umemura T, Wattanakamolkul K, Nakayama Y, et al. Real-World Epidemiology, Clinical and Economic Burden of Chronic Hepatitis B in Japan: A Retrospective Study Using JMDC Claims Database. Infectious Diseases and Therapy. 2023; 12(5): 1337-1349. doi: 10.1007/s40121-023-00795-0
  69. Feld J, Lok A, Zoulim F. New perspectives on the development of curative strategies for chronic hepatitis B. Clinical Gastroenterology and Hepatology. 2023; S1542-3565. doi: 10.1016/j.cgh.2023.02.032
  70. Haddad-Boubaker S, Mbarek H, Yassine H. Personalized medicine and infectious disease management. Frontiers in Medicine. 2023; 10: 1191147. doi: 10.3389/fmed.2023.1191147
  71. Kumar M, Pahuja S, Khare P, et al. Current Challenges and Future Perspectives of Diagnosis of Hepatitis B Virus. Diagnostics. 2023; 13(3): 368-368. doi: 10.3390/diagnostics13030368