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hepatitis-B vaccine + 1018-ISS (V270 / V270 / Heplisav)

✓ Approved

Merck & Co. · TLR9 · 重组蛋白

什么是 hepatitis-B vaccine + 1018-ISS？

hepatitis-B vaccine + 1018-ISS 是一种重组蛋白，由Merck & Co.研发。该药已获批，用于治疗相关适应症，给药途径：Injectable (Others)、Intramuscular (IM) Injection。

药物档案

商品名V270, V270, Heplisav
公司Merck & Co.
药物类别重组蛋白, 疫苗
分子靶点TLR9,
给药途径Injectable (Others), Intramuscular (IM) Injection
状态Approved
来源： ClinicalTrials.gov, Merck & Co.

作用机制

分子靶点

hepatitis-B vaccine + 1018-ISS 作用于 2 个分子靶点：

TLR9toll like receptor 9 (CD289)
(S)
需要更深入的分析？Noah AI 可解释复杂机制并与同类药物比较。

治疗适应症

hepatitis-B vaccine + 1018-ISS 针对 1 个适应症，涉及 1 个治疗领域。

治疗领域疾病/病症分期
Infections and infestationsHepatitis B✓ Approved

相关研究文献

PubMedJournal of the International AIDS Society2026-10-26

Impact of HIV Pre-Exposure Prophylaxis on HIV Incidence and Hepatitis B Outcomes Among Sex Workers Living With Hepatitis B: A Modelling Analysis in Côte D'Ivoire.

Mohareb Amir M AM, Kim Arthur Y AY, Kouamé Menan Gérard MG, Nouaman Marcellin M et al.

Nearly 10% of sex workers in sub-Saharan Africa live with chronic hepatitis B virus (HBV). HIV pre-exposure prophylaxis (PrEP) using tenofovir/emtricitabine (TDF/FTC) has not been studied in this population, possibly due to concerns of hepatitis flares following TDF/FTC cessation. Using a microsimulation model of HIV and HBV disease and data from 2016 to 2024, we compared the clinical impact of TDF/FTC as PrEP versus no TDF/FTC among women who sell sex with HBV in Côte d'Ivoire. We incorporated the anti-HBV effects of TDF/FTC and the increased probability of hepatitis flares and HBV surface antigen (HBsAg) loss following TDF/FTC cessation. We estimated input parameters from published literature: HIV incidence (1.9-3.0 per 100 person-years), PrEP adherence (55%), disengagement from PrEP care (4% per month for the first 12 months, then 12.5% per month), hepatitis flare incidence (2.0-4.0 per 100 person-years) and rate of HBsAg loss (1.0 per 100 person-years), which both increase following TDF/FTC cessation. Model outcomes included cumulative HIV incidence, average hepatitis flares, HBsAg loss and survival over 2, 5 and 10 years. We conducted sensitivity analyses varying HIV incidence, PrEP adherence, disengagement from PrEP care and hepatitis flare rate. Compared with no TDF/FTC, TDF/FTC would reduce cumulative HIV incidence: 4.1% versus 5.6% at 2 years and 10.1% versus 12.7% at 5 years. TDF/FTC would result in more hepatitis flares (mean 0.76 vs. 0.19 per person) and more HBsAg loss (8.4% vs. 5.7%) than no TDF/FTC after 5 years. Two- and five-year survival would be similar between the two strategies, and TDF/FTC would improve survival over longer horizons. Improving adherence and reducing disengagement from care would increase clinical benefits. Even with high disengagement from care and high risk of hepatitis flares, TDF/FTC would reduce HIV acquisition and improve overall long-term survival. Women who sell sex with HBV in Côte d'Ivoire would benefit from TDF/FTC as PrEP to avoid HIV acquisition. The increased risk of hepatitis flares, while challenging to manage in resource-limited settings, would be outweighed by the benefits of HIV prevention. Efforts should be made to scale up PrEP in sex workers, including women with chronic HBV.

PMID 42929139
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PubMedEuropean journal of pediatrics2026-10-26

Systematic STI screening in unaccompanied migrant minors: a 6-year experience with urine-based NAAT.

Milkova-Ivanova Sonia S, Mellado-Sola Isabel I, Bravo-Queipo-de-Llano Blanca B, Rodríguez-Molino Paula P et al.

Systematic screening for sexually transmitted infections (STI), beyond serology, is not standard in arrival protocols for unaccompanied migrant minors (UMM). In 2020, our center incorporated urine-based nucleic acid amplification tests (NAAT)-based screening into the existing serology-based protocol (HIV, syphilis, hepatitis B/C), and we describe the additional diagnoses of STI identified through NAAT. We conducted a retrospective observational descriptive study (2020-2025) of 226 UMM (99.6% male) in Madrid undergoing serological screening for HIV, syphilis, hepatitis B and C, with additional urine-based multiplex PCR (NAAT) screening for STI. Urine-based NAAT, performed in 163/226 participants (72.1%), identified six positive cases (3.7%, 95% CI 1.4-7.8%) of C. trachomatis, M. genitalium, or Ureaplasma spp. Of these, four patients (2.5%, 95% CI 0.7-6.2%) had actionable infections that were treated. Serology identified no HIV (0/218) or hepatitis C cases (0/212), one syphilis case (0.5%, 95% CI 0.0-2.6%, 1/209), and three chronic hepatitis B cases (1.4%, 95% CI 0.3-3.9%, 3/221). None of the cases had symptoms recorded. Urine NAAT identified six infections (four actionable) not detectable by serology. However, three of eight patients with actionable infections were lost to follow-up, highlighting that the benefit of systematic screening depends on strengthening linkage-to-care alongside testing. • Serological screening (HIV, syphilis, hepatitis B/C) is standard in arrival health assessments for unaccompanied migrant minors, but systematic STI screening beyond serology is not routinely protocoled. • Systematic screening is especially valuable in this population, as follow-up is often limited by care fragmentation and transfers between reception centers. • Urine-based NAAT screening identified additional STI in patients with no symptoms recorded, that were not detectable by serology alone.

PMID 42928391
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PubMedDiseases (Basel, Switzerland)2026-10-26

Tetanus in Serbia, 2015-2025: Epidemiological Overview and Lessons from Two Pediatric Cases.

Kovacevic Gordana G, Stijovic Vesna V, Kovacevic Branko B, Parezanovic Miro M et al.

Tetanus is a vaccine-preventable disease that has become rare in countries with sustained immunization programs. However, unvaccinated children remain at risk of severe disease. We provide an epidemiological overview of tetanus in Serbia and describe two cases of generalized tetanus in children. We retrospectively reviewed tetanus surveillance data and immunization coverage reports in Serbia for 2015-2025. Tetanus cases were recorded under ICD-10 code A35. We analyzed demographics, incidence, outcomes, case-fatality, and tetanus-containing vaccine coverage. Two pediatric cases were reviewed for clinical presentation, diagnostic challenges, management, and outcomes. Fourteen tetanus cases were reported during 2015-2025 (annual incidence, 0-0.06 per 100,000 population), including two children. Most cases occurred among women aged >60 years; the overall case-fatality proportion was 42.9%. Primary vaccination coverage ranged from 90.8% to 95.1%, while recommended revaccination coverage remained below the 95% target. Both pediatric patients had received only BCG and hepatitis B vaccination at birth with no subsequent routine immunization due to parental neglect or refusal. The 18-month-old boy presented with fever, otorrhea, and recurrent episodes of generalized stiffening and was initially evaluated for meningoencephalitis. The emergence of trismus, opisthotonus, and neck muscle rigidity led to the diagnosis of tetanus. The 6-year-old boy presented with odynophagia and involuntary tongue biting, followed by progressive trismus and limb spasms. Tetanus was suspected based on the clinical findings and absent immunization. He developed respiratory failure and autonomic instability. Both patients recovered following tetanus immunoglobulin, antimicrobial therapy, and supportive care. Although tetanus remains rare in Serbia and predominantly affects older adults, unvaccinated children remain at risk of severe disease. Atypical presentations may delay diagnosis, emphasizing the importance of early recognition and timely treatment. Maintaining high vaccination coverage and ensuring catch-up immunization remain essential for prevention.

PMID 42930012
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PubMedDiseases (Basel, Switzerland)2026-10-26

Cognitive-Affective Dimension After Virological Cure of Hepatitis C Virus Infection: WBSI Dynamics, Liver Status, and the Role of Comorbidities.

Baltă Alexia Anastasia Ștefania AAȘ, Lescai Alina-Maria AM, Stoian Valerian Ionut VI, Ignat Mariana Daniela MD et al.

Virological cure in chronic infection with hepatitis C virus (HCV) is followed by important clinical and biological benefits, including psychological ones. The White Bear Suppression Inventory (WBSI) assesses the tendency to suppress intrusive thoughts and was used in this study as a tool to provide a cognitive-affective assessment of patients with chronic HCV infection-both at the start of antiviral therapy and five years after achieving virological cure. This study aimed to characterize patients with HCV infection who received antiviral therapy and completed the WBSI, to assess longitudinal changes in WBSI scores, and to identify clinical, biological, and comorbidity-related factors associated with these changes. The study employed an ambispective observational longitudinal cohort study design conducted on a sample of 386 patients, of whom 81 completed the WBSI both at baseline and at follow-up. The WBSI subsample did not differ significantly from the remainder of the cohort in terms of age, cytolysis markers, bilirubin, albumin, platelet count, or major comorbidities. The WBSI score decreased significantly from baseline to follow-up, from 61.36 to 54.16, with a mean difference of 7.20 points (t = 6.32; p < 0.001). The correlation between the baseline and follow-up scores was very strong (r = 0.899; p < 0.001), indicating substantial interindividual stability. ΔWBSI was weakly but significantly correlated with the change in total bilirubin (r = 0.254; p = 0.022), with no significant correlations with the other biological markers. In the multivariable model, cardiovascular comorbidities (B = -8.469; p < 0.001) and metabolic comorbidities (B = -9.869; p = 0.002) were independent negative predictors of WBSI scoring, whereas fibrosis evolution, age, sex, and baseline total bilirubin had no significant influence. Improvements in WBSI scores observed only in specific patient subgroups, one year after achieving HCV virological cure, underscore the need to integrate psychological assessment into long-term monitoring, particularly for patients with cardiovascular and metabolic comorbidities.

PMID 42930013
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PubMedClinical microbiology reviews2026-10-26

Hepatitis E virus infections in immunocompromised patients.

Sridhar Siddharth S, Ma Xiaodan X, Ho Siu Fung Stanley SFS

SUMMARYHepatitis E virus (HEV) is an important cause of viral hepatitis globally. Historically considered an acute and self-limiting illness, HEV has emerged as a significant pathogen in various immunocompromised patient groups in the last 15 years. Vulnerable patients include transplant recipients, people living with advanced HIV infection, and patients with hematological malignancies, rheumatological disorders, or autoimmune diseases. These individuals are vulnerable to chronic hepatitis and extrahepatic manifestations due to HEV. These risks are also relevant to emerging modalities of immunosuppression such as new targeted drug therapies and chimeric antigen receptor T-cell therapies. Besides unique clinical implications, immunocompromised hosts have also been at the center of new developments in the hepatitis E field on zoonotic reservoirs, transmission routes, disease models, and pathogenesis. In this review, we present a comprehensive integrative summary of the epidemiology, clinical manifestations, pathogenesis, diagnosis, and management strategies of HEV infections in immunocompromised hosts.

PMID 42929522
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PubMedCureus2026-10-26

Persistent Type B Hyperlactataemia as a Diagnostic Clue to Occult Diffuse Large B-cell Lymphoma-Associated Haemophagocytic Lymphohistiocytosis.

Hassan Nasiba N, Khatib Kavish K

Haemophagocytic lymphohistiocytosis (HLH) is a rare, life-threatening hyperinflammatory disorder characterised by excessive immune activation. It may be primary or secondary, with secondary HLH associated with a range of triggers; the most common are infections, autoimmune and autoinflammatory conditions, haematological malignancies and other immune‑dysregulatory states. We present a case of a man in his 70s who presented with a two-week history of exertional dyspnoea, profound fatigue and anorexia. Initial investigations demonstrated marked hyperferritinaemia, thrombocytopenia, mild anaemia, cholestatic liver dysfunction and disproportionately elevated lactate without acidosis. Despite intravenous fluids, lactate remained persistently elevated, consistent with type B hyperlactataemia. Computed tomography (CT) of the abdomen and pelvis demonstrated appearances suggestive of hepatitis but no organomegaly, significant lymphadenopathy or biliary obstruction. Despite empirical antibiotics and fluid resuscitation, he developed progressive pancytopenia, worsening liver dysfunction and rising lactate. Further investigations supported secondary HLH, with an HScore of 186, hypertriglyceridaemia and markedly elevated lactate dehydrogenase. Initial treatment with corticosteroids and anakinra resulted in limited response. An autoimmune trigger was initially considered given his Raynaud's phenomenon and ongoing connective tissue disease investigation. However, bone marrow biopsy subsequently confirmed diffuse large B-cell lymphoma (DLBCL). Reduced-dose rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone/prednisolone (R-mini-CHOP) was commenced, resulting in the resolution of hyperlactataemia, normalisation of blood counts and liver function and improvement in performance status. PET-CT after two cycles demonstrated a complete metabolic response. This case highlights the importance of considering secondary HLH in patients with unexplained cytopenias, hyperferritinaemia, liver dysfunction and persistent hyperlactataemia. Persistent hyperlactataemia despite adequate fluid resuscitation should prompt the consideration of systemic causes beyond tissue hypoperfusion. Bone marrow biopsy is crucial for identifying occult malignancy when conventional imaging fails to show overt malignancy. The early recognition of HLH and investigation for an underlying aetiology may facilitate timely definitive treatment.

PMID 42928750
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