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| Name | Class |
|---|---|
| The Affiliated Hospital Of Southwest Medical University | OTHER |
| Guizhou Provincial People's Hospital | OTHER |
| Chongqing Three Gorges Central Hospital | OTHER |
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Hepatitis B virus (HBV) infection is a major public health threat in China. At present, a functional cure, also known as clinical cure or sustained Hepatitis B surface antigen (HBsAg) loss, is recommended as the ideal endpoint of HBV treatment. However, HBsAg loss can be achieved in less than 10% of chronic hepatitis B (CHB) patients treated with current available antiviral drug interferon (IFNα) or nucleos(t)ide analogues (NAs) monotherapy. With the support of the national major special funding for infectious diseases from "11th Five-Year Plan" to "13th Five-Year Plan", we have implemented a pioneer clinical study of sequential combination of IFNα therapy on NAs to treat NAs-treated CHB patients (ie. New Switch Study). This is the world's first clinical trial aiming to functional cure, which increased the rate of HBsAg loss to 15% in the overall population in our study, and to 30-50% among those with lower baseline HBsAg levels. How to further improve the HBsAg loss rate is an urgent issue for us. The key point of achieving functional cure is to reverse the HBV-specific T cell exhaustion and establish the long-term immune control against HBV infection. Programmed death-1 (PD-1)/ programmed death-ligand 1 (PD-L1) axis blockade has been demonstrated to reinvigorate exhausted CD8+ T cells, and would be a potential strategy to treat chronic HBV infection. In this study, a large multicenter prospective study will be performed to explore the safety and efficacy of a novel combination strategy involving immune checkpoint inhibitor (anti-PD-1 antibody) in CHB patients, observe the HBsAg loss rate in NA-treated CHB patients receiving this combination strategy, evaluate the potential of breaking immune tolerance by this strategy, and further assess its efficacy to further improve the clinical cure rate on the basis of New Switch Study. Based on New Switch Study, this study further attempts to reverse T cell exhaustion in CHB patients, explore a novel platform of combination therapy development for clinical cure, and ultimately increase the HBsAg loss rate to higher than 50% in overall patients. The implementation of the project is expected to reduce the burden of HBV infection in China and contribute to the goal of global elimination of hepatitis B and C by 2030 (WHO 2030).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group 1 | Experimental | NAs combined with anti-PD-1 antibody, followed by NAs monotherapy |
|
| Group 2 | Active Comparator | NAs |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Anti-PD-1 antibody | Drug | Once/two or three weeks, dose lower than the dose used in cancer patients, subcutaneous/intravenous injection |
|
| Measure | Description | Time Frame |
|---|---|---|
| Serum HBsAg | Serum HBsAg level | Baseline |
| Serum HBsAg | Serum HBsAg level | 24 weeks after the treatment |
| Serum HBsAg | Serum HBsAg level | 48 weeks after the treatment |
| Serum HBsAg | Serum HBsAg level | 24 weeks after the end of treatment |
| Serum HBV DNA | Serum HBV DNA level | Baseline |
| Serum HBV DNA | Serum HBV DNA level | 24 weeks after the treatment |
| Serum HBV DNA | Serum HBV DNA level | 48 weeks after the treatment |
| Serum HBV DNA | Serum HBV DNA level | 24 weeks after the end of treatment |
| Serum alanine aminotransferase (ALT) | Serum ALT level | Baseline |
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| Measure | Description | Time Frame |
|---|---|---|
| Other HBV markers | Levels of other HBV markers | Baseline |
| Other HBV markers | Levels of other HBV markers | 24 weeks after the treatment |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Dachuan Cai, MD | Contact | +86 18323409779 | cqmucdc@cqmu.edu.cn | |
| Min Chen, PhD | Contact | +86 17338600343 | mchen@hospital.cqmu.edu.cn |
| Name | Affiliation | Role |
|---|---|---|
| Hong Ren, MM | The Second Affiliated Hospital of Chongqing Medical University | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The 2nd affiliated Hospital of Chongqing Medical University | Recruiting | Chongqing | Chongqing Municipality | 400010 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41443982 | Derived | He T, Chen M, Liu M, Zhang L, Sun H, Zhang L, Li A, Zeng W, Ling N, Shi X, He H, Peng M, Cai D, Hu P, Zhang D, Lan Y, Ren H. Twenty-four-week anti-PD-1 antibody regimen promoted HBsAg reduction and concurrently enhanced HBV-specific T cell responses in patients with chronic hepatitis B. Gut. 2025 Dec 24:gutjnl-2025-336655. doi: 10.1136/gutjnl-2025-336655. Online ahead of print. |
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| First Affiliated Hospital of Chongqing Medical University |
| OTHER |
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| NAs | Drug | Once/day, 1 capsule/time, oral |
|
|
| Serum alanine aminotransferase (ALT) |
Serum ALT level |
| 24 weeks after the treatment |
| Serum alanine aminotransferase (ALT) | Serum ALT level | 48 weeks after the treatment |
| Serum alanine aminotransferase (ALT) | Serum ALT level | 24 weeks after the end of treatment |
| Other HBV markers | Levels of other HBV markers | 48 weeks after the treatment |
| Other HBV markers | Levels of other HBV markers | 24 weeks after the end of treatment |
| Immune response of T and B cells | Frequencies and functions of T and B cells (tested by flowcytometry/FluoroSpot/ELISPOT) | Baseline |
| Immune response of T and B cells | Frequencies and functions of T and B cells (tested by flowcytometry/FluoroSpot/ELISPOT) | 24 weeks after the treatment |
| Immune response of T and B cells | Frequencies and functions of T and B cells (tested by flowcytometry/FluoroSpot/ELISPOT) | 48 weeks after the treatment |
| Immune response of T and B cells | Frequencies and functions of T and B cells (tested by flowcytometry/FluoroSpot/ELISPOT) | 24 weeks after the end of treatment |
| Virus and host genome | Detect virus and host genome (focusing on HBV genotype, resistant mutation) using peripheral blood by sequencing | Baseline |
| ID | Term |
|---|---|
| D019694 | Hepatitis B, Chronic |
| ID | Term |
|---|---|
| D006509 | Hepatitis B |
| D000086982 | Blood-Borne Infections |
| D003141 | Communicable Diseases |
| D007239 | Infections |
| D018347 | Hepadnaviridae Infections |
| D004266 | DNA Virus Infections |
| D014777 | Virus Diseases |
| D006525 | Hepatitis, Viral, Human |
| D006521 | Hepatitis, Chronic |
| D006505 | Hepatitis |
| D008107 | Liver Diseases |
| D004066 | Digestive System Diseases |
| D002908 | Chronic Disease |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| C000711728 | spartalizumab |
| C015378 | nas |
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