Biography:

Paul has run the Hepatitis B Trust National Charity and helpline since 2010, some 10,000 HBV and HCV patients have been advised.  The Hepatitis B Trust produces guidance for 14 Industries, the Medical Profession and patients.  Paul has talked to hundreds of organisations about hepatitis B and C and advised on 500,000 hbv vaccinations, his online forum has reached 500,000 users.  Policy packs for Unions, Schools and Politicians are also produced.  Some 40 posters and videos have also been used tailored to different venues.

Abstract:

Campaigners for the Hepatitis B Trust today condemned 20 years of government failure to address our tripling Hepatitis B infections and accused the Department of Health of hiding them, especially among UK children, migrants and valuable key workers.

Trust Director of Communications, Paul Desmond said, “The UK is still continuing to under publicise the prevalence of this booming epidemic even in 2017, forty years after the test became available. We have received the last audit of 100,000 HPA hospital tests done to keep an eye on HBV from 2008 to 2015, and now it is published, the results are far worse than anyone dreamt possible.”

“The fact is our hospitals are reporting 1 in 64 adults and even more concerning 1 in 140 children in the UK are already incurably infected with HBV when tested.  This means our children are now testing 30 times more infected than their US counterparts, who are testing 1 in 5000 positive in their surveillance programs.  Our inner cities and their schools have suffered a massive boom in infections and we are still not being warned or using the vaccine effectively.  We are not being allowed to test enough to find out what help is needed among children, professions and migrants when there are onward infections and school and healthcare/high street outbreaks.”

Paul explains, “The reason why people need to know about HBV is we have 12 million adults and children at risk of infection and we estimate a fast growing 440,000 HBV positive people out there, mainly undiagnosed at risk of cancer.  People especially need to learn HBV is not rare like HIV with 90,000 UK infections; HBV is common with 2,000,000 UK infections and 500,000 unable to clear the virus.  Further HBV is not mild like Swine Flu, killing in the hundreds; it kills up to a third of the long term infected, potentially 166,000 lives in the UK.  And our non alcoholic liver deaths are booming fastest in the EU. 

People need to ask themselves why on earth they know about rare bugs and mild bugs and yet with a vast deadly threat like HBV we have 12 million citizens who have not been told they are at risk of infection and indicated for testing on the WHO Atlas for 20 years. Over the years the National HBV Helpline has received calls from thousands of patients, public and even health secretaries and doctors, all needing basic facts about HBV, all struggling to understand HBV and its risk.“

Paul continued “Citizens have a right to know how you catch HBV, how hundreds of millions of children catch it, how their schools are infectious, how their occupations may often be infectious or if the World Health Organisation has audited their nationality as being a more than 1 in 50 risk like Spain and the 100 other nationals we recommend for prompt safety testing and vaccination.“

 “Mothers have a right to know children cannot enter schools without HBV vaccination certificates in the rest of the world, that only zero migration Scandinavia and ourselves do not protect children from HBV. How anybody, never mind the Minister for Public Health can imagine we have the HBV  prevalence of Finland while gazing from the Commons at 3.8 million migrants from endemic areas in London alone is simply beyond any logic. Especially with the Department of Health refusing to test and guessing there are only 180,000 cases in the UK since 1993, while so many independent experts both here and overseas are seeing 500,000 or much nearer the EU average due to migration.”

In 2017 can our new UK Government finally enact the 1999 WHO Hepatitis Guidelines for testing?

Biography:

Mr. Kuranz is an epidemiologist at DRG specializing in the epidemiology of metabolic, renal and psychiatric disorders. He holds an MPH from Boston University.  Prior to joining DRG, he served as the coordinator of an international research project focusing on early adult development and substance abuse dependence. 

Abstract:

Introduction: Hepatitis C virus (HCV) contributes substantially to the burden of disease worldwide. Modes of transmission and risk of HCV differ by geographic regions (WHO, 2016). The impact of HCV treatment on the future prevalence and incidence of HCV will vary based on rates of diagnosis and compliance.

Methods: To estimate the incidence and prevalence of HCV, we systematically reviewed the literature (DRG, 2017) and analyzed NHANES cycles 2007-2014 (CDC, 2016). We defined prevalent anti-body positive cases of HCV as individuals who received a positive result on an ELISA or equivalent test and, where possible, in combination with a RIBA. We defined HCV viremia as the presence of HCV RNA in the serum. We incorporated diagnosis and drug-treatment assumptions into out trend and these were applied to region-specific HCV genotype (Gower E, 2014) and cirrhotic distributions. The 10-year forecast incorporated demographic changes related to aging and population growth. When country-specific data were unavailable we extrapolated based on data from comparable countries. To estimate the number cases in each country, we multiplied the age- and gender-specific estimates presented in these studies by the UN population estimates for each forecast year (United Nations, 2016).

Results: Over the 10-year forecast, incident cases, prevalent anti-body positive cases, and viremic prevalent cases decreased substantially due to reduced risk in the population and improved treatment.  If rates of treatment and treatment efficacy were to remain constant over the forecast period, viremic HCV decreases by over 20% between 2017 and 2027. Assuming treatment becomes more readily available during the forecast period across all regions and that compliance remains relatively high, HCV will decrease to an even greater magnitude by 2027.

Conclusion: Viremic prevalence will decrease substantially in both higher-income and lower-income countries with the later experiencing the largest decrease in prevalence over the forecast period.

Biography:

Dr André-Jean REMY, is Head of Hepatology and Gastroenterology Unit & Social Medicine Unit of Perpignan Hospital, and he is one of 41 viral hepatitis experts unit in France. Social medicine include jailhouse medical unit, retention center medical and primary care access unit. He is also Medical coordinator of Mobile Hepatitis Team, a new concept of HCV/HBV patients care from diagnosis to treatment. He is a Member of French hepatitis B and C guidelines follow-up national staff,  General Secretary of ANGH, Administrator of AFEF (French Liver Diseases Association) and a specialist of viral hepatitis in drug users, inmates and precarious populations. He has published more than 150 scientific articles; 50 articles in 2012 to 2016.

Abstract:

In hepatitis C, Drug users and inmates are a hard to screen population as well as to take over and treat. There is a common understanding that these patients have a delayed access to antiviral C treatment. French rulings published on June 10, 2016 could provide treatment by direct acting antivirals (DAA) to all these patients regardless of fibrosis stage. Since it’s creation in July 2013, the hepatitis mobile teams offers to all partner entities all or part of the following 15 services: 1. Training of socio-medical institutions staff with trimestral  days of exchange or on-demand and on-premises. 2. Prevention information sessions toward drug users in day-care or housing structures. 3. On-site HVC HVB HIV POCT screening. 4. BOUSSOLE 5 days a week Reception Information & Accompaniment. 5. On-premises mobile Fibroscan®. 6. Social evaluation & diagnosis by EPICES score. 7. Free biological check-up at the PASS (in case of absence of health care rights). 8. On-site specialised consultations. 9. LE FIL VERT: POCT & Fibroscan® in outdoor sites. 10. Rapid access to a close expert service called “RCP” (multidisciplinary meeting), obligatory in France before treatment acesss. 11. Mobile phone lending for patients. 12. Individual sessions of therapeutic education inside an ARS (Regional Health Agency) authorized program. 13. Therapeutic support groups (nurse, psychologist, sophrologist, nutritionist). 14.  Dedicated day hospital. 15. Expert patient support.

 

Patients and methods: The aim is to compare the average delay of access to DAA treatment in 2016 of all the patients of our centre (group 1) to the drug user patients (group 2) followed by specialised medico-social institutions (CSAPA/CAARUD), to excluded patients newly outdoor screened (group 3) with an EPICES score over 45 and inmates (group 4). The date of first contact was when the patient met the hepatitis mobile team nurse in CSAPA/CAARUD, screening date for the outdoor patients and date of detention for inmates. Was also calculated the average delay of access to RCP and the one between RCP and treatment day 0. Groups 3 and 4 patients were totally taken over by the hepatitis mobile team.

Results: 113 patients were included in this study on September 15, 2016. Average delay between first contact and treatment day 0 was of 10 weeks with differences among groups detailed in Table 1. Average access delay to treatment was of 98 days for group 2, 70 for group 3 and 57 for group 4. Average delay between first contact and RCP was respectively of 56/77/55 and 49 for groups 1 to 4. The difference would be due to average delay between RCP and treatment day 0. The delay difference was significant (p<0,05) between group 2 and 1. No significant difference was stated in groups 3 and 4 against group 1.

Conclusion: Drug users who are followed in a medico-social institution have by our experience a longer access to antiviral C treatment than inmates or excluded patients. This is explained by a shorter care pathway (screening-blood test-RCP-treatment) and calls for an organisation of “all-in-one” centres, set-up around a multidisciplinary team to the benefits of patients with chronic hepatitis C viral infection.

Time (days)	Total of patients	PWID in drug centers	Precarious outdoor screening people	Inmates
First contact to treatment	70	98	70	58
First contact to RCP	56	77	55	49
RCP to treatment	14	19	15	9

Publications:

1. AJ REMY, H WENGER, H BOUCHKIRA. Traiter l’hépatite C  chez des patients usagers de drogue et/ou précaires : utile, efficace et éthique. Presse Médicale 2014, 1314-1316
2. REMY AJ, WENGER AJ, BOUCHKIRA H. Treatment of chronic hepatitis C in drug users : ethic, successful and useful. EUROPAD FORUM during AATOD Conference, Atlanta,28 mars-1^er avril 2015..
3. BOUCHKIRA H. Treatment of chronic hepatitis C in drug users : ethic, successful and useful. Viral Hepatitis Congress, Orlando 19-22 juillet 2015.
4. REMY AJ. News Tools of screening viral hepatitis in real life: the french model of care. Viral Hepatitis Congress, Orlando 19-22 juillet 2015.
5. REMY AJ. Incidence of the hepatitis C in prison in france: results of a study by POCT. Viral Hepatitis Congress, Chicago 9-11 mai 2016.
6. REMY AJ. BOUCHKIRA H, MONTABONE S. Dépistage hors les murs de l'hépatite C par TROD: résultats de 3 années de pratiques. Communication orale AFEF Bordeaux 2016.
7. REMY AJ, BOUCHKIRA H, MONTABONE S. Decrease of specific social score EPICES before and after direct antiviral agent  treatment in HCV patients in France: 2 years experience. Third Hepatitis World Congress, Dubaï, 9-11 octobre 2016.
8. REMY AJ, BOULOGNE G. COMPASS project, inside and outside link for prisoners and PWID with hepatitis C in France. EUROPAD FORUM during AATOD Conference,  Baltimore, 29 octobre – 2 novembre 2016..
9. REMY AJ, BOUCHKIRA H, MONTABONE S. Hepatitis Mobile Team: a new concept for benefit toward drugs users and precarious people with hepatitis C in France. AASLD Boston 2016

 

Biography:

Bevin Gangadharan is a Research Associate in the Oxford Antiviral Drug Discovery Unit, University of Oxford headed by Professor Nicole Zitzmann. The main focus of his current research is to use proteomics to identify and validate novel serum biomarker candidates for NAFLD. He carried out his DPhil with Professor Nicole Zitzmann where he identified serum biomarker candidates for liver fibrosis in hepatitis C patients.

Abstract:

Background & Aim: Liver biopsy is the reference standard for NAFLD diagnosis and staging. NAFLD can be assessed less invasively using immunoassays to detect serum biomarkers. However, biomarkers can degrade due to sample storage conditions and therefore may not be detected using these antibody-based assays. Detection of biomarkers by mass spectrometry (MS) overcomes this disadvantage.

Methods: MS and two dimensional gel electrophoresis (2DE) were used to find differences in the abundance of proteins among serum samples from patients with varying NAFLD and fibrosis stages (NAFL, NASH F0, NASH F1, NASH F3 and healthy individuals). The identified proteins are potential NAFLD biomarkers. Mass spectrometry was used to assay for biomarkers by detecting their tryptic peptides and fragments. We are the first and only lab to use a novel quantitation method with clinical samples. Unlike current liver disease biomarker tests, our approach is the only biomarker assay using a universal calibration mix.

Results: Using MS and 2DE, we identified several potential biomarkers for NAFLD which were checked by both targeted MS and Western blotting using serum from patients with varying stages of NAFLD. Our novel biomarkers look promising when compared to cytokeratin-18 and the protein markers used in NashTest. A mass spectrometry assay was developed for the most promising novel liver fibrosis biomarkers.

Conclusion: We are working towards the first ever antibody-free biomarker assay for NAFLD. Our assay is nine times faster than conventional quantitation by MS making our approach for absolute biomarker quantitation applicable for clinical use. In all current liver disease biomarker assays, different calibrations curves are required for each biomarker with each point on the curves being read separately and samples could be analyzed several hours after establishing a calibration curve by which time there is the possibility of instrument drift. Our assay overcomes these disadvantages since it is the only assay which can analyze all points of the calibration curve and determine the absolute concentration of the NAFLD biomarker in a single acquisition. Our assay may help reduce the need for invasive liver biopsies in NAFLD patients.

Biography:

Dr. Aljumah is a consultant hepatologist and gastroenterologist at King Abdulaziz Medical City and Associate Professor, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia. He was graduated from Faculty of Medicine, Cairo University, Egypt. Then had obtained a diploma in internal medicine from the Royal Postgraduate Medical School, University of London, United Kingdom. This was followed by the Membership of The Royal College of Physicians of Ireland (MRCP), Dublin, Ireland and the Arab Board in Internal Medicine (ABIM), Arab Board Medical Specialization, Riyadh, Saudi Arabia. After that he completed 2 years Clinical Fellowship training program in (Gastroenterology, Hepatology & Liver Transplantation) from the Toronto Hospital, University of Toronto, Toronto, Canada. He was awarded the Fellowship of the Royal College of Physicians of Ireland (FRCP) Dublin, Ireland. Finally he was awarded a Master degree of Public Health in Epidemiology and Biostatistics (MPH), College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia and Liverpool School of Tropical Medicine, UK.  Dr. Aljumah was the Associate Editor of the Saudi Journal of Gastroenterology and currently a member of the editorial board in; Journal of Gastroenterology and Hepatology Research, World Journal of Hepatology, SM Journal of Hepatitis Research and Treatment, and Journal of Archives of Clinical Gastroenterology. Additionally he is a reviewer for several international journals. He has published about 60 publications in different peer-reviewed journals and has been a speaker in multiple conferences.

Abstract:

The Middle East is a geographical region that includes areas in Southwest Asia and parts of North Africa. Hepatitis C virus (HCV) infection is a major cause of chronic hepatitis, liver cirrhosis and hepatocellular carcinoma and is the leading indication for liver transplantation. It was estimated that 170 million people are infected with HCV, with a worldwide prevalence of 3%. HCV is one of the main causes of mortality and morbidity globally. In the Middle East, HCV is a significant health concern, with some areas in the region categorized as having a high prevalence of HCV infection (1-3.5%). Egypt has the highest prevalence of HCV in the world (>15%).  It was estimated that currently there are at least 23 million people live with HCV infection in the countries of the Eastern Mediterranean Region. This is almost similar to the number of total HCV cases in the Americas and Europe together. The most prevalent HCV genotype in the Middle East region is genotype 4. However, genotype 1 is also common and the most prevalent among non-Arab countries in the region including Turkey, Iran and Cyprus. With the recent discovery of the new direct antiviral therapies, there have been significant developments in treatment strategies that have provided an opportunity to eliminate HCV infection in the near future. However, there are some major issues concerning HCV that still need to be tackled in the Middle East, particularly, the cost of new drugs and the difficulty of identifying patients with HCV infection. HCV remains however a substantial challenge in the Middle East. Important health and financial burden namely; the cost of new drugs and the difficulty of identifying patients with HCV infection are issues that need hard work. To establish public health strategies, more efforts are required for prevention and treatment programs.

Publications:

1. Liakina V, et al. Historical epidemiology of hepatitis C virus (HCV) in select countries. J Viral Hepat. 2015; 22 Suppl 4:4-20.

 

2. Sibley A, et al. The present and future disease burden of hepatitis C virus infections with today's treatment paradigm. J Viral Hepat. 2015; 22 Suppl 4:21-41.

 

3. Alfaleh FZ, et al. Strategies to manage hepatitis C virus infection disease burden. J Viral Hepat. 2015; 22 Suppl 4:42-65.

 

4. Aljumah AA, et al. Epidemiology, disease burden, and treatment strategies of chronic hepatitis C virus infections in Saudi Arabia in the new treatment paradigm shift. Saudi J Gastroenterol. 2016; 22(4): 269-81.

 

5. Aljumah AA, et al. Clinical Presentation, Risk Factors, and Treatment Modalities of Hepatocellular Carcinoma: A Single Tertiary Care Center Experience. Gastroenterol Res Pract. 2016; 2016:1989045.

 

6. Aljumah AA, et al. Clinical Presentation, Treatment Outcome and Predictors of Severity in Autoimmune Hepatitis: A Retrospective, Multicenter Experience. Journal of Gastroenterology and Hepatology Research 2016; 5(4): 2047-2051.

 

7. Balkhy HH, et al. Magnitude and causes of loss to follow-up among patients with viral hepatitis at a tertiary care hospital in Saudi Arabia. J Infect Public Health. 2016 Oct 6. pii: S1876-0341(16)30101-0.

 

8. Blach S, et al.  Global prevalence and genotype distribution of hepatitis C virus infection in 2015: a modelling study. Lancet Gastroenterol Hepatol. 2017 Mar;2(3):161-176.

 

9. Khan A, et al. Tracing the epidemic history of hepatitis C virus genotypes in Saudi Arabia. Infect Genet Evol. 2017 Apr 27;52:82-88.

 

10. Aljumah AA, et al. Policy of screening for colorectal cancer in Saudi Arabia: A prospective analysis. Saudi J Gastroenterol. 2017;23(3):161-168.

  

Biography:

Terence T Lao is a specialist in Obstetrics, Gynaecology and Maternal-Fetal Medicine. He has received training in Hong Kong; London, UK; and Canada.  He is currently a Professor in the Department of Obstetrics and Gynaecology, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong. His clinical and research interests are oriented around maternal medicine, especially endocrine and hepatic problems, hypertension, and hepatitis, as well as the management of high risk pregnancy. He is a reviewer of many international journals, and serves on the Editorial Board of three. He has 442 publications, including abstracts, listed under Google Scholar.

Abstract:

Publications:

TT Lao, JSM Mak, TC Li. Hepatitis B virus infection status and infertility causes in couples seeking fertility treatment—Indicator of impaired immune response? American Journal of Reproductive Immunology 2017 (in press).

TT Lao. Immune persistence after hepatitis B vaccination in infancy–Fact or fancy? Human Vaccines & Immunotherapeutics 2016;12 (5), 1172-1176.

TT Lao, MK Chung, TKW Cheung, LW Law. Antenatal hepatitis B and increased risk of gestational diabetes mellitus–Implications for obstetric care. Journal of Infection 2016;72 (5), 625-626.

TT Lao, KL Cheung, V Wong. Hepatitis B vaccine response among infants born to hepatitis B surface antigen-positive women.Vaccine 2015;33 (1), 15-16.

TT Lao, DS Sahota, LW Law, YKY Cheng, TY Leung. Age-specific prevalence of hepatitis B virus infection in young pregnant women, Hong Kong Special Administrative Region of China. Bulletin of the World Health Organization 2014;92 (11), 782-789.

TT Lao, DS Sahota, MK Chung, TKW Cheung, YKY Cheng, TY Leung. Maternal ABO and rhesus blood group phenotypes and hepatitis B surface antigen carriage. Journal of Viral Hepatitis 2014;21 (11), 818-823.

PKS Chan, KLK Ngai, TT Lao, MCS Wong, T Cheung, ACM Yeung, et al. Response to booster doses of hepatitis B vaccine among young adults who had received neonatal vaccination. PloS One 2014;9 (9), e107163.

TT Lao, DS Sahota, SSH Suen, PKS Chan, TY Leung. Impact of neonatal hepatitis B vaccination programme on age-specific prevalence of hepatitis B infection in teenage mothers in Hong Kong. Epidemiology and Infection 2013;141 (10), 2131-2136.

TT Lao, DS Sahota, YKY Cheng, LW Law, TY Leung. Maternal hepatitis B surface antigen status and incidence of pre‐eclampsia. Journal of Viral Hepatitis 2013;20 (5), 343-349.

SSH Suen, TT Lao, OK Chan, TK Lau, TY Leung, PKS Chan. Relationship between age and prevalence of hepatitis B infection in first-year university students in Hong Kong. Infection 2013;41 (2), 529-535.

Biography:

Dr. Sharma joined the DRG Epidemiology team in Bangalore in 2016. She specializes in developing epidemiological forecasts and has worked on indications related to the field of infectious disease and primary nervous system epidemiology. Her qualifications include an MPH with special focus on Epidemiology from the Post Graduate Institute of Medical Education and Research, India and a bachelor degree in dental surgery. Prior to joining DRG she was a fellow at the National Health Systems Resource Centre. She was also the resident dental surgeon at UCMS, New Delhi.

Abstract:

Introduction:. The WHO estimates 130-150 million people worldwide, living with chronic hepatitis C virus (HCV) infection and the number is increasing despite improved treatment¹. In 2016, the WHO released a global health sector strategy on viral hepatitis based on the Sustainable Development Goals 2030 report¹. It enlists targets to be achieved with regard to HCV incidence, diagnosis and treatment, taking 2015 as the base year. This analysis aims to understand the global impact of successful achievement of the WHO targets on viremic prevalent cases.

Methods: HCV viremia is defined as the presence of HCV RNA in the serum. A systematic review of published literature was carried out to extract prevalence, incidence, and genotype distribution data for 45 countries, in addition to an analysis of NHANES data². Extracted estimates were trended to 2015 based on current diagnosis and drug treatment scenarios. Percentage changes according to the WHO targets were applied to 2015 to arrive at the number of cases in 2020 and 2030.

Results: Between 2015 and 2030, there is a considerable decrease in the number of prevalent viremic cases modeled according to the WHO targets. In 2020, the viremic prevalence is highest in Africa (1.54) and lowest in North America (0.76). In 2030, the viremic prevalence ranges from 0.15 in North America to 1.0 in Africa.

Conclusion: If the WHO targets are achieved, there would be a considerable decrease in the burden of viremic HCV. Results should be interpreted from a global perspective to better understand inequitable differences in the burden of HCV across geographic regions.

Publications:

1. WHO. World Health Organization. Global Health Sector Strategy on Viral Hepatitis: 2016–2021. Towards Ending Viral Hepatitis. www.who.int. 2016

2. CDC. Centers for Disease Control. National Center for Health Statistics (NCHS). National Health and Nutrition Examination Survey Data 2007-2014. https://wwwn.cdc.gov/nchs/nhanes/default.aspx. 2017

3. Gower E, et al. Global epidemiology and genotype distribution of the hepatitis C virus infection. J Hepatol. 2014;61:S45-S57

4. United Nations. Department of Economic and Social Affairs. Population Division. World Population Prospects: The 2015 Revision. https://esa.un.org/unpd/wpp/Download/Standard/Popu. 2015

5. DRG. Decision Resources Group. Epidemiology – Hepatitis C Virus – Mature Markets. 2017.

Biography:

Julio Cesar Aguilar Rubido completed his PhD in Biological Sciences. Titular Investigator, Project leader Therapeutic Vaccine against Chronic Infectious Diseases. Main author of 12 patent applications, 2 book chapters, 3 Review articles, 55 original research articles, 11 clinical protocols (phase I to Phase IV), 60 scientific presentations (Oral + Posters) in international meetings. He is the Young member of the Cuban Academy of Sciences, Cuban Society of Immunology.

Abstract:

Chronic hepatitis B (CHB) infection constitutes a major cause of HCC, liver cirrhosis worldwide. HeberNasvac is a novel therapeutic vaccine based in the recombinant HBsAg and HBcAg. These proteins contain adjuvant and immunomodulatory properties that supported the clinical development of HeberNasvac. Materials & Methods: Four clinical trials evaluated the administration of HeberNasvac, three of them in CHB patients. Two studies were carried out in treatment-naïve patients and a third was conducted in non-responders to IFN- therapy. The viral load was monitored as main variable in all the studies involving CHB patients. Serological evaluations for HBe and HBsAg and their corresponding antibodies were also conducted. The transaminases, bilirubin and other liver and hematological markers were evaluated to assess product safety. Balb/c mice, rabbits and AAV HBV transfected/HLA double transgenic mice were used as models to evaluate the capacity of the nasal route of immunization to generate systemic and especially liver immune responses. Results: Clinical trials evidenced a significant reduction of the viral load to undetectable levels and under 10⁴ copies/mL, both at end of treatment and after 24/48 weeks follow-up evaluations, evidencing the sustained control of the virus. Liver function tests and hematological variables evidenced the safety of this product. Serological responses were higher to PegIFN treatment. Action mechanism studies related to the route of immunization evidenced the role of the nasal route of immunization in the induction of T cells at the target organ, the liver. Conclusions: The vaccination with HeberNasvac is effective and safe, supporting its use as therapy against CHB infection. The studies of immunogenicity in novel model of CHB infection evidenced the effect of the nasal route of immunization in the liver homing of effector T cells. These results suggest that HeberNasvac may contribute as a novel treatment for CHB.

Publications:

1: Lobaina Y, Hardtke S, Wedemeyer H, Aguilar JC, Schlaphoff V. In vitro stimulation with HBV therapeutic vaccine candidate Nasvac activates B and T cells from chronic hepatitis B patients and healthy donors. Mol Immunol. 2015 Feb; 63(2):320-7.

2: Al-Mahtab M, Akbar SM, Aguilar JC, Uddin MH, Khan MS, Rahman S. Therapeutic potential of a combined hepatitis B virus surface and core antigen vaccine in patients with chronic hepatitis B. Hepatol Int. 2013 Oct;7(4):981-9.

3: Bourgine M, Dion S, Godon O, Guillen G, Michel ML, Aguilar JC. Optimization of immune responses induced by therapeutic vaccination with cross-reactive antigens in a humanized hepatitis B surface antigen transgenic mouse model. Virology. 2012 Aug 15; 430(1):10-9.

4: Lobaina Y, Trujillo H, García D, Chacon Y, Aguilar JC. The effect of the parenteral route of administration on the immune response to simultaneous nasal and parenteral immunizations using a new HBV therapeutic vaccine candidate. Viral Immunol. 2010 Oct;23(5):521-9.

5: Loureiro CL, Aguilar JC, Aguiar J, Muzio V, Pentón E, et al. HBV genotypic variability in Cuba. PLoS One. 2015 Mar 5;10(3):e0118959.

Biography:

Prof. Sharma is a Medical Graduate and did his Post Graduation in Medical Microbiology. He has published more than 35 papers in various journals and presented 40 papers at different national and international conferences. His research works are in the field of Hepatitis A, Hepatitis B,Hepatitis C and Delta virus infections in adults and children. He has also worked in HIV-HCV co-infection among intravenous drug abusers. He has been given several awards at national conferences. His research focus is on changing trends in vaccine preventable disease specially of Hepatitis A and Hepatitis B virus among children,adolescents and adults.Other research interests include prevention,natural history,molecular virology of Hepatitis B and Hepatitis C virus. He has delivered various guest lectures at different national and international forums on viral gastroenteritis,HCV diagnostic dilemma and on Hepatitis A vaccination.

Abstract:

Background: Hepatitis B virus (HBV) infection is a major public health problem in many countries. Besides infection of hepatitis a virus (HAV) in chronic liver disease (CLD) lead to decompensation with frequent hospitalisation. The immune status against HAV and HBV of children with CLD admitted in this hospital is not known whom vaccination can be advised.

Aim: The aim is to evaluate anti HBs status and exposure to hepatitis A virus (anti HAV IgG) among children with chronic liver disease attending Gastroenterology Department, Nehru Hospital, PGIMER, Chandigarh.

Methods: 182 children (103 males,79 females) of chronic liver disease admitted between April 2017 to April 2017 were included in the study (exclusion - Chronic HBV and Chronic HCV patients). Clinical features of patients, routine diagnostic investigations including abdominal ultrasound findings were recorded. Two ml of blood was collected from every patient and their serum stored at -20°C. Tests for detection of HBsAg, anti HCV, anti HAV IgG, and anti HBs were uniformly done on all samples by ELISA.

Results: Overall 143 children with CLD (78.5%, 143/182) had undetectable level of anti HBs antibody. Among 182 children of CLD, 156 patients (85.7%) were non-reactive for anti HAV IgG by ELISA. All patients were non-reactive for HBsAg and anti-HCV.

Conclusion: 78.5% children with chronic liver disease undergoing hospital treatment were susceptible for hepatitis B virus infection. 85.7% of these admitted children were also susceptible for hepatitis A virus infection. These patients needed recommendations for vaccination against HBV and HAV in present scenario.