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MULTI TOPIC meeting: The impact of viral hepatitis treatment and vaccination non-responders and occult hepatitis on public health

Meeting objectives:

- Hepatitis C Treatment hurdles: non-responders - reinfection – relapse

  • Define treatment failures based on scientific data (definitions)
  • Discuss the impact of treatment failure on the public health

- Hepatitis B Vaccine Non-Responders

  • Discuss the definition of a non-responder on hepatitis B vaccination
  • Discuss the (potential) impact of non-responders on public health
  • Review guidelines how to address hepatitis B vaccine non-responders

- Occult Hepatitis B:

  • Define occult infections for hepatitis and the incidence
  • Discuss the importance of occult infection on the effectiveness of the vaccination program
  • Discuss the different aspects of the importance of occult infection on public health and review existing guidelines how to address occult hepatitis B
     

Background document (Pdf, 1.580 kB)

 

Thursday, April 25th 

OPENING AND OBJECTIVES       
Chairs: Daniel Lavanchy – John Ward

09:00-09:30 Welcome and opening of the meeting (Pdf, 1.701 kB)

  • Welcome and opening
  • Introduction of the participants
  • Introduction of the VHPB
  • Objectives of the meeting 

09:30-09:50 Introduction
What Is Needed to Eliminate Hepatitis B Virus and Hepatitis C Virus as Global Health Threats (Pdf, 1.157 kB)
John Ward (TASK FORCE for Global Health/ CDC – USA)
 

SESSION 1: TREATMENT OF HEPATITIS C NON-RESPONDERS - RELAPSE - REINFECTION

- Hepatitis C Treatment hurdles: non responders - reinfection – relapse

  • Define treatment failures based on scientific data (definitions)
  • Discuss the impact of treatment failure on the public health

SESSION 1.1:  IN THE AREA OF DAA's ARE TREATMENT NON-RESPONDERS/RELAPSE AN ISSUE?

09:50-10:10 Risk of Late Relapse or Reinfection With Hepatitis C Virus After Achieving a Sustained Virological Response: A Systematic Review and Meta-analysis (Pdf, 801 kB)
Graham Cooke (Imperial College London – UK).

10:10-10:30 Question and discussion

SESSION 1.2:  PREDICTIVE FACTORS FOR TREATMENT NON-RESPONDERS OR RELAPSE AND POSSIBLE SOLUTIONS 
Chairs: Françoise Roudot-Thoraval – Thomas Vanwolleghem 

10:50–11:10 Genetic Predictive Genetic Factors
Treatment of hepatitis C: the use of the new pangenotypic direct-acting antivirals in "special populations” (Pdf, 854 kB)
Stanislas Pol  (Universite Paris Descartes, Paris, France).

11:10–11:30 Risk factors for re-infection
Incidence, risk factors, and prevention of hepatitis C reinfection: a population-based cohort study. (Pdf, 1.007 kB)
Naveed Janjua (University of British Columbia, Canada)

11:30–11:50 Is Re-infection after DAA treatment an issue 
Understanding and addressing hepatitis C reinfection in the oral direct-acting antiviral era. (Pdf, 751 kB)
Oluwaseun Falade-Nwulia (Johns Hopkins University, Baltimore, MD, USA)

11:50–12:05 Question and discussion

SESSION 1.3: GROUPS DISCUSSION: THE IMPACT OF TREATMENT HURDLES ON PUBLIC HEALTH
Chairs: Mojca Maticic – Rui Tato Marinho 

12:05–12:25 Hepatitis C: Is eradication possible (Pdf, 2.331 kB)
Mario Mondelli (University of Pavia, Italy)

12:25–13:15 Followed by groups discussion  on impact of treatment hurdles on Public health and elimination goals

14:15-14:35 Presentation outcome groups discussion: Group A (Pdf, 120 kB), Group B (Pdf, 106 kB)
 

SESSION 2: HEPATITIS B VACCINATION NON-RESPONDERS

- Vaccination Non- Responders

  • Discuss the definition of a non-responder on hepatitis B vaccination
  • Discuss the (potential) impact of non-responders on public health
  • Look for potential solutions to avoid susceptibility and transmission of disease

SESSION 2.1: DEFINITIONS AND IMPACT OF NON-RESPONDING ON HEPATITIS VACCINATION
Chairs: Vana Papaevangelou – Silvia Bino

14:35-14:55 Review on definitions and impact of non-responders on hepatitis vaccination
Do we need better hepatitis B vaccines? (Pdf, 5.859 kB)
Dieter Glebe (Justus Liebig University Giessen, Institute of Medical Virology, National Reference Centre for Hepatitis B and D Viruses, Giessen, Germany)

SESSION 2.2: REASONS OR RISK FACTORS FOR NON-RESPONDING

- Risk factors

14:55-15:15 How response and non-response can immunologically be explained:
Transcriptome profiling in blood before and after hepatitis B vaccination shows significant differences in gene expression between responders and non-responders. (Pdf, 1.464 kB)
Pieter Meysman  (University of Antwerp/Antwerp University Hospital, Belgium)

15:15-15:35 Host risk factors (genetics, age, sex, BMI,  Vit D…)
Primary vaccine failure to routine vaccines: Why and what to do? (Pdf, 1.219 kB)
Erika Garner-Spitzer ( Medical University Vienna Austria)

15:35-15:50 Question and discussion

SESSION 2.3: POSSIBLE SOLUTIONS FOR NON-RESPONDERS
Chairs: Mira Kojouharova – Vladimir Chulanov

16:10-16:30 Alternative vaccination strategies for primary non-responders on hepatitis B vaccination (Pdf, 464 kB)
Stijn Raven (Radboud universitair medisch centrum, Nijmegen, The Netherlands)

16:30-17:00 Overview of the development of new vaccines, able to have non-responders, responding? (Pdf, 1.960 kB)
Daniel Shouval (Liver Unit, Hadassah University Hospital, Jerusalem, Israel)

17:00-17:15 Question and discussion

SESSION 2.4: GROUPS DISCUSSION: IMPACT OF NON-RESPONDERS ON PUBLIC HEALTH, IS IT A THREAT TO ELIMINATE HEPATITIS B. ARE NEW RECOMMENDATIONS FOR THE MANAGEMENT OF NON-RESPONDERS NEEDED?
Chairs: Antons Mozalevskis – Mark Kane

17:15-18:10 Groups discussion: Do the current guidelines (CDC, EASL,…) need adaptation to coop with non-responders and the impact they may have on public health.

 

Friday, April 26th

SESSION 3: OCCULT VIRAL HEPATITIS

- Occult infections

  • Define occult infections for hepatitis and the incidence
  • Discuss the importance of occult infection on the effectiveness of the vaccination program
  • Discuss the different aspects of the importance of occult infection on public health and review existing guidelines

SESSION 3.1 : DEFINITION OCCULT HEPATITIS B
Chairs: Helène Norder – Wolfgang Jilg

08:30 - 08:50 Presentation on Groups discussion on Hepatitis B Vaccination Non-responders

Group B (Pdf, 116 kB), Group C (Pdf, 82 kB)

08:50 - 09:20 Review on definitions based on EASL meeting in Taormina-Messina, Italy, Oct 18
Update on Biology and Clinical impact of Occult hepatitis B virus infection (Pdf, 1.728 kB)
Giovanni  Raimondo (University Hospital of Messina, Italy)

09:20 - 09:40 Molecular definition/ Immunological aspects
Molecular and immunological mechanisms of occult hepatitis B virus infection and pathogenesis (Pdf, 1.283 kB)
Mengji Lu (University Hospital of Essen, Germany)

09:40 - 10:00 Question and discussion

SESSION 3.2: DIAGNOSIS AND EPIDEMIOLOGY

10:00 - 10:20 Diagnosis of occult hepatitis
Diagnostic tools for occult hepatitis B (Pdf, 1.291 kB)
Yuen Man-Fung (University of Hong Kong/Queen Mary Hospital, Hong Kong)

10:20- 10:30 Question and discussion

SESSION 3.3: IMPLICATIONS OF OCCULT VIRAL HEPATITIS
Chairs: Daniel Shouval – Angela Dominguez

10:50 - 11:10 Clinical implication
Occult hepatitis B virus and hepatocellular carcinoma. (Pdf, 2.289 kB)
Teresa Pollicino (University Hospital of Messina, Italy)

11:10 - 11:30 Blooddonors
Residual risk of Hepatitis B Virus Transfusion-transmission: Need for Reappraisal of Blood Safety Measures? (Pdf, 412 kB)
Daniel Candotti (National Institute of Blood Transfusion, Paris, France)

11:30 - 11:50 Question and discussion

SESSION 3.4: GROUPS DISCUSSION: IMPACT OF OCCULT HEPATITIS B ON PUBLIC HEALTH, IS IT A THREAT FOR THE ELIMINATION OF VIRAL HEPATITIS?
Chairs: David Goldberg – Pierre Van Damme

11:50 - 12:50 Groups discussions

12:50 - 13:10 Presentation outcome groups discussions (Pdf, 73 kB)

SESSION 4: MEETING CONCLUSIONS
Chairs: Tatjana Reic – Johannes Hallauer

14:10 - 15:00 Meeting Conclusions (Pdf, 227 kB)
David FitzSimons

 

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