A Phase 2a, Open-Label Study to Evaluate the Safety and Efficacy of Selgantolimod (SLGN)-Containing Combination Therapies for the Treatment of Chronic Hepatitis B (CHB)
Phase: PHASE2
Conditions: Chronic Hepatitis B
Sponsor: Gilead Sciences

CLINICAL STUDY PROTOCOL
Study Title:
A Phase 2a, Open-Label Study to Evaluate the Safety and Efficacy 
of Selgantolimod (SLGN)-Containing Combination Therapies for 
the Treatment of Chronic Hepatitis B (CHB) 
Sponsor:
Gilead Sciences, Inc.
333 Lakeside Drive
Foster City, CA 94404
IND Number:
ANZCTR Trial ID:
EudraCT Number:
ClinicalTrials.gov 
Identifier:
This is a non-IND study
Not Available 
2021-000672-11
NCT04891770
Indication:
Chronic Hepatitis B
Protocol ID:
GS-US-465-4439
Contact Information:
The medical monitor name and contact information will be 
provided on the Key Study Team Contact List. 
Protocol Version/Date:
Original:
04 March 2021
Amendment 1:
20 April 2022 
Amendment 2:
12 April 2023
This study will be conducted in compliance with this protocol and in accordance with the ethical 
principles that have their origin in the Declaration of Helsinki, and that are consistent with 
International Council for Harmonisation (ICH) Good Clinical Practice (GCP) and applicable 
regulatory requirements.
CONFIDENTIALITY STATEMENT
The information contained in this document, particularly unpublished data, is the property or under 
control of Gilead Sciences, Inc., and is provided to you in confidence as an investigator, potential 
investigator, or consultant, for review by you, your staff, and an applicable institutional review board or 
independent ethics committee. The information is only to be used by you in connection with authorized 
clinical studies of the investigational drug described in the protocol. You will not disclose any of the 
information to others without written authorization from Gilead Sciences, Inc., except to the extent 
necessary to obtain informed consent from those persons to whom the drug may be administered.
GILEAU 

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 2
12 April 2023
TABLE OF CONTENTS
TABLE OF CONTENTS................................................................................................................................................2
LIST OF IN-TEXT TABLES .........................................................................................................................................6
LIST OF IN-TEXT FIGURES........................................................................................................................................6
PROTOCOL SYNOPSIS................................................................................................................................................7
GLOSSARY OF ABBREVIATIONS AND DEFINITION OF TERMS ....................................................................23
1.
INTRODUCTION................................................................................................................................................28
1.1.
Background..............................................................................................................................................28
1.2.
General Information About Study Drugs ................................................................................................29
1.2.1.
General Information About Selgantolimod...........................................................................29
1.2.2.
General Information About Nivolumab ................................................................................31
1.2.3.
General Information About Tenofovir Alafenamide (TAF) .................................................31
1.2.4.
General Information About VIR-2218 ..................................................................................32
1.3.
Rationale for the Current Study...............................................................................................................32
1.3.1.
Rationale for Modifications to Study Design........................................................................32
1.3.2.
Rationale for This Study as Originally Designed..................................................................33
1.4.
Rationale for Dose Selection of Study Drugs..........................................................................................33
1.4.1.
Rationale for Dose Selection of Selgantolimod ....................................................................33
1.4.2.
Rationale for Dose Selection of Nivolumab..........................................................................34
1.4.3.
Rationale for Dose Selection of TAF ....................................................................................34
1.4.4.
Rationale for Dose Selection of VIR-2218 ...........................................................................35
1.5.
Benefit/Risk Assessment for the Study ...................................................................................................36
1.6.
Compliance..............................................................................................................................................40
2.
OBJECTIVES.......................................................................................................................................................41
3.
STUDY DESIGN.................................................................................................................................................42
3.1.
Endpoints.................................................................................................................................................42
3.2.
Study Design ...........................................................................................................................................42
3.2.1.
Changes to Study Design.......................................................................................................42
3.3.
Study Treatments.....................................................................................................................................43
3.4.
Duration of Treatment .............................................................................................................................44
3.5.
Follow-up Period.....................................................................................................................................45
3.6.
Treatment Discontinuation Criteria.........................................................................................................45
3.7.
End of Study............................................................................................................................................45
3.8.
Poststudy Care.........................................................................................................................................45
3.9.
Source Data .............................................................................................................................................45
3.9.1.
Biomarker Samples to Address the Study Objectives...........................................................45
3.9.4.
Pharmacokinetic Assessments...............................................................................................47
4.
PARTICIPANT POPULATION..........................................................................................................................49
4.1.
Number of Participants and Participant Selection...................................................................................49
4.1.1.
Participant Replacement........................................................................................................49
4.2.
Inclusion Criteria.....................................................................................................................................49
4.3.
Exclusion Criteria....................................................................................................................................50
5.
INVESTIGATIONAL MEDICINAL PRODUCTS.............................................................................................53
CCI

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 3
12 April 2023
5.1.
Randomization and Treatment Assignment ............................................................................................53
5.1.1.
Randomization/Enrollment....................................................................................................53
5.1.2.
Blinding .................................................................................................................................53
5.2.
Description and Handling of SLGN, TAF, and VIR-2218, and Nivolumab...........................................53
5.2.1.
Formulation ...........................................................................................................................53
5.2.2.
Packaging and Labeling ........................................................................................................54
5.2.3.
Storage and Handling ............................................................................................................55
5.3.
Dosage and Administration of SLGN, TAF, VIR-2218, and Nivolumab...............................................56
5.3.1.
Selgantolimod........................................................................................................................56
5.3.2.
Nivolumab .............................................................................................................................56
5.3.3.
Tenofovir Alafenamide .........................................................................................................56
5.3.4.
VIR-2218...............................................................................................................................56
5.4.
Prior and Concomitant Medications........................................................................................................56
5.5.
Accountability for Investigational Medicinal Product: SLGN, TAF, VIR-2218, and 
Nivolumab ...............................................................................................................................................60
5.5.1.
Investigational Medicinal Product Return or Disposal .........................................................61
6.
STUDY PROCEDURES......................................................................................................................................62
6.1.
Study Procedure Details ..........................................................................................................................62
6.1.1.
Medical History.....................................................................................................................62
6.1.2.
Complete Physical Examination............................................................................................62
6.1.3.
Vital Signs .............................................................................................................................62
6.1.4.
12-Lead Electrocardiograms .................................................................................................62
6.1.5.
Clinical Laboratory Tests/Assessments for Safety Evaluations............................................63
6.1.6.
Creatinine Clearance .............................................................................................................64
6.1.7.
Ophthalmologic Examination................................................................................................64
6.1.8.
HBV Sequence Analysis .......................................................................................................64
6.1.9.
Digital Droplet Polymerase Chain Reaction .........................................................................64
6.1.10.
Sparse PK Sampling..............................................................................................................64
6.1.12.
Biomarker Samples ...............................................................................................................65
6.1.15.
Management of Participants Impacted by the COVID-19 Pandemic ...................................66
6.2.
Participant Enrollment and Treatment Assignment ................................................................................66
6.3.
Pretreatment Assessments .......................................................................................................................66
6.3.1.
Prescreening Visit..................................................................................................................66
6.3.2.
Screening Visit ......................................................................................................................66
6.3.3.
Baseline/Day 1 Assessments .................................................................................................68
6.4.
Randomization.........................................................................................................................................69
6.5.
Treatment Schedule.................................................................................................................................70
6.6.
Post-Day 1 Treatment Assessments ........................................................................................................70
6.7.
Follow-up Assessments...........................................................................................................................72
6.8.
Immunologic Testing...............................................................................................................................73
6.8.1.
Biomarker Sample Collection During Treatment Period ......................................................74
6.8.2.
Biomarker Sample Collection During Follow-up .................................................................74
6.9.
Assessments for Early Discontinuation of Study Treatment...................................................................74
6.9.1.
Criteria for Discontinuation of Study Treatment...................................................................74
6.9.2.
Criteria for Individual Dose Modification.............................................................................76
6.9.3.
Study and/or Cohort Discontinuation Criteria.......................................................................76
6.9.4.
Premature Study Discontinuation..........................................................................................76
6.10.
End of Study............................................................................................................................................77
6.11.
Poststudy Care.........................................................................................................................................77
6.12.
Sample Storage........................................................................................................................................77
CCI
CCI

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 4
12 April 2023
7.
ADVERSE EVENTS AND TOXICITY MANAGEMENT................................................................................78
7.1.
Definitions of Adverse Events and Serious Adverse Events...................................................................78
7.1.1.
Adverse Events......................................................................................................................78
7.1.2.
Serious Adverse Events.........................................................................................................78
7.1.3.
Study Drugs and Gilead Concomitant Therapy Special Situations Reports .........................79
7.2.
Assessment of Adverse Events and Serious Adverse Events..................................................................80
7.2.1.
Assessment of Causality for Study Drugs and Procedures ...................................................80
7.2.2.
Assessment of Severity..........................................................................................................80
7.3.
Investigator Reporting Requirements and Instructions ...........................................................................81
7.3.1.
Requirements for Collection Prior to Study Drug Initiation .................................................81
7.3.2.
Adverse Events......................................................................................................................81
7.3.3.
Serious Adverse Events.........................................................................................................81
7.3.4.
Study Drug Special Situations Reports .................................................................................81
7.3.5.
Concomitant Therapy Reports...............................................................................................81
7.4.
Reporting Process for Serious Adverse Events and Special Situation Reports.......................................82
7.4.1.
Serious Adverse Event Reporting Process ............................................................................82
7.4.2.
Special Situations Reporting Process ....................................................................................83
7.5.
Gilead Reporting Requirements ..............................................................................................................85
7.6.
Clinical Laboratory Abnormalities and Other Abnormal Assessments as Adverse Events or 
Serious Adverse Events...........................................................................................................................85
7.7.
Toxicity Management..............................................................................................................................86
7.7.1.
Grades 1 and 2 Laboratory Abnormality or Clinical Event ..................................................86
7.7.2.
Grade 3 Laboratory Abnormality or Clinical Event..............................................................86
7.7.3.
Grade 4 Laboratory Abnormality or Clinical Event..............................................................87
7.7.4.
Toxicity Management of Immune-Related Adverse Events Observed 
With Nivolumab....................................................................................................................87
7.7.5.
ALT Elevation or Flare Management on Treatment and Treatment-Free 
Follow-up ..............................................................................................................................88
8.
STATISTICAL CONSIDERATIONS.................................................................................................................91
8.1.
Analysis Objectives and Endpoints.........................................................................................................91
8.1.1.
Analysis Objectives...............................................................................................................91
8.1.2.
Primary Endpoint...................................................................................................................92
8.1.3.
Secondary Endpoint...............................................................................................................92
8.2.
Planned Analyses.....................................................................................................................................92
8.2.1.
Primary Analysis ...................................................................................................................92
8.2.2.
Final Analysis........................................................................................................................92
8.3.
Analysis Conventions..............................................................................................................................92
8.3.1.
Analysis Sets .........................................................................................................................92
8.4.
Demographic and Baseline Characteristics Analysis..............................................................................93
8.5.
Efficacy Analysis.....................................................................................................................................94
8.5.1.
Primary Analysis ...................................................................................................................94
8.5.2.
Secondary Analyses...............................................................................................................94
8.5.3.
Analysis of Other Endpoints of Interest ................................................................................94
8.6.
Safety Analysis........................................................................................................................................94
8.6.1.
Extent of Exposure ................................................................................................................95
8.6.2.
Adverse Events......................................................................................................................95
8.6.3.
Laboratory Evaluations .........................................................................................................96
8.6.4.
Other Safety Evaluations.......................................................................................................96
8.7.
Pharmacokinetic Analysis .......................................................................................................................96
8.9.
Sample Size .............................................................................................................................................97
9.
RESPONSIBILITIES...........................................................................................................................................98
CCI

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 5
12 April 2023
9.1.
Investigator Responsibilities ...................................................................................................................98
9.1.1.
Good Clinical Practice...........................................................................................................98
9.1.2.
Financial Disclosure ..............................................................................................................98
9.1.3.
Institutional Review Board/Independent Ethics Committee Review and 
Approval................................................................................................................................98
9.1.4.
Informed Consent ..................................................................................................................98
9.1.5.
Confidentiality.......................................................................................................................99
9.1.6.
Study Files and Retention of Records ...................................................................................99
9.1.7.
Case Report Forms ..............................................................................................................101
9.1.8.
Investigator Inspections.......................................................................................................101
9.1.9.
Protocol Compliance ...........................................................................................................101
9.2.
Sponsor Responsibilities .......................................................................................................................101
9.2.1.
Protocol Modifications ........................................................................................................101
9.2.2.
Study Reports and Publications...........................................................................................102
9.3.
Joint Investigator/Sponsor Responsibilities ..........................................................................................102
9.3.1.
Payment Reporting ..............................................................................................................102
9.3.2.
Access to Information for Monitoring.................................................................................102
9.3.3.
Access to Information for Auditing or Inspections .............................................................102
9.3.4.
Premature Study Termination..............................................................................................102
10.
REFERENCES...................................................................................................................................................103
11.
APPENDICES....................................................................................................................................................108
11.1.
Investigator Signature Page...................................................................................................................109
11.2.
Pandemic Risk Assessment and Mitigation Plan ..................................................................................110
11.3.
Study Procedures Tables .......................................................................................................................113
11.4.
Pregnancy Precautions, Definition for Female of Childbearing Potential, and Contraceptive 
Requirements.........................................................................................................................................124
11.5.
GSI Grading Scale for Severity of Adverse Events and Laboratory Abnormalities.............................128
11.6.
Management of Clinical and Laboratory Adverse Events ....................................................................152
11.7.
Amendment History ..............................................................................................................................152
11.7.1.
Amendment 2 (12 April 2023) ............................................................................................152

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 6
12 April 2023
LIST OF IN-TEXT TABLES
Table 1.
Dose Modification and Monitoring .........................................................................................12
Table 2.
Starting Commercial NUC Treatment Criteria........................................................................13
Table 3.
Estimated Median VIR-2218 Liver Tissue Exposure in Humans Based on PK-PD 
Model.......................................................................................................................................36
Table 4.
List of Agents Disallowed Due to Potential Interaction With SLGN .....................................58
Table 5.
Disallowed Concomitant Medications While on TAF ............................................................60
Table 6.
Dose Modification and Monitoring .........................................................................................89
Table 7.
Starting Commercial NUC Treatment Criteria........................................................................90
LIST OF IN-TEXT FIGURES
Figure 1.
GS-US-465-4439: Study Design Schema*..............................................................................43

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 7
12 April 2023
PROTOCOL SYNOPSIS
Gilead Sciences, Inc.
333 Lakeside Drive
Foster City, CA 94404
Study Title: 
A Phase 2a, Open-Label Study to Evaluate the Safety and Efficacy 
of Selgantolimod (SLGN)-Containing Combination Therapies for 
the Treatment of Chronic Hepatitis B (CHB)
IND Number:
ANZCTR Trial ID:
Clinical Trials.gov 
Identifier:
This is a non-IND study
Not Available
NCT04891770
EudraCT Number:
2021-000672-11
Study Centers 
Planned:
Approximately 30 centers globally 
Objectives:
The primary objectives of this study are as follows:
•
To evaluate the safety and tolerability of study treatment(s)
•
To evaluate the efficacy of study treatment(s) as measured by 
the proportion of participants who achieve functional cure, 
defined as negative qualitative hepatitis B surface antigen 
(HBsAg loss) and hepatitis B virus (HBV) DNA < lower limit 
of quantitation (LLOQ) at Follow-up (FU) Week 24
The secondary objectives of this study are as follows: 
•
To evaluate the proportion of participants with HBsAg loss with 
and without anti-HBsAg seroconversion during the study 
•
To evaluate in participants with CHB who are hepatitis B e 
antigen (HBeAg) positive at baseline the proportion of 
participants who achieve HBeAg loss with and without 
anti-HBeAg seroconversion during the study
•
To evaluate the proportion of participants who remain off 
nucleos(t)ide(s) (NUC) treatment during FU
•
To evaluate the proportion of participants experiencing HBV 
virologic breakthrough (defined as confirmed HBV DNA 
≥ LLOQ after 2 consecutive HBV DNA < LLOQ in participants 
who are complying with NUC therapy OR confirmed HBV 
DNA ≥ 1 log10 IU/mL increase from nadir on treatment) during 
study treatment(s)
 
CCI

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 8
12 April 2023
CCI

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 9
12 April 2023
Study Design:
This is a Phase 2, open-label study to evaluate the safety and 
efficacy of SLGN-containing combination therapies in CHB 
participants. The study will consist of 2 cohorts (Cohorts 1, and 2).
Approximately 40 NUC-suppressed and 60 viremic CHB-infected 
participants, may be enrolled and assigned into a cohort below. 
Each cohort will enroll a minimum of 20% HBeAg-positive 
participants, and up to 20% of participants can have HBsAg 
≤ 100 IU/mL.
NUC-suppressed Cohort
Cohort 1 (n = 40):
•
Tenofovir alafenamide (TAF) 25-mg tablet administered orally 
once daily for 36 weeks
•
VIR-2218 200 mg administered as subcutaneous (SC) injection 
once every 4 weeks for 24 weeks (total 6 doses)
At Week 12, add-on and initiate the below treatment:
•
SLGN 3 mg (2  1.5-mg tablets) administered orally while 
fasting once a week on the same day for 24 weeks (total 
24 doses)
•
Nivolumab 0.3 mg/kg administered intravenously (IV) once 
every 4 weeks for up to 24 weeks (up to 6 doses)
Viremic Cohort (Cohort 2)
Cohort 2 (n = 60):
Participants will be randomized 2:1 into Cohort 2 Groups A and B 
and stratified by HBsAg > or ≤ 3 log10 IU/mL.
Group A (n = 40):
•
VIR-2218 200 mg administered as SC injection once every 
4 weeks for 24 weeks (total 6 doses)
At Week 12, add-on and initiate the below treatment:
•
SLGN 3 mg (2  1.5-mg tablets) administered orally while 
fasting once a week on the same day for 24 weeks (total 
24 doses)
•
Nivolumab 0.3 mg/kg administered IV once every 4 weeks for 
up to 24 weeks (up to 6 doses)
Group B (n = 20):
•
SLGN 3 mg (2  1.5-mg tablets) administered orally while 
fasting once a week on the same day for up to 24 weeks (up to 
24 doses)
•
Nivolumab 0.3 mg/kg administered IV once every 4 weeks for 
up to 24 weeks (up to 6 doses)

Selgantolimod 
Protocol GS-US-465-4439 
Gilead Sciences, Inc. 
CONFIDENTIAL 
Final 
Amendment2 
NOTE: Nivolumab dosing was stopped in this study. This was a 
sponsor decision based on a benefit risk assessment of the use of 
nivolumab in HBV cure. 
As the study had completed emollment and all pa1ticipants were in 
treatment when the decision was made to stop nivolumab 
administration, the following amendments to the protocol were 
implemented: 
• 
Stop fmt her nivolumab administration for all study paiticipants 
across all coho1ts 
• 
Continue treatment with VIR-2218 and SLGN through Week 36 
for Coho1ts 1 and 2 (Group A) 
• 
Discontinue all study treatment for Coho1t 2 Group B 
pa1ticipants with next follow up visit being EOT for those still 
in treatment period 
• 
Stop all sample collections related to nivolumab 
• 
NUC therapy cessation is no longer required for our NUC 
treated patients (Coho1t 1) 
Follow-up Period: 
At the end of treatment, all paiticipants will enter a FU period 
• 
All paiticipants not on T AF treatment at end of treatment (EOT) 
will enter a treatment-free follow-up (TFFU) period 
• 
Paiticipants who ai·e on T AF treatment will continue T AF 
treatment over the duration of the follow up period 
Paiticipants who initiated TFFU prior to the approval of this 
amendment and stopped NUC treatment may continue offNUCs 
after discussion between participant and investigator on the benefits 
and risks of continuing off NUCs in TFFU. Those who decide to 
restait NUCs would initiate commercial NUC treatment. 
Pharmacokinetic assessments 
Sparse Pharmacokinetic Collection 
Spai·se (timed) plasma/semm PK samples will be obtained at 
specific in-clinic treatment visits at any time between 1 to 5 hours 
postdose relative to SLGN and/or VIR-2218 administration unless 
othe1wise indicated. 
Page 10 
12 April 2023 

Selgantolimod 
Protocol GS-US-465-4439 
Gilead Sciences, Inc. 
CONFIDENTIAL 
Alanine Aminotransferase (ALT) Elevation or Flare 
Management 
On-Treatment ALT Management 
Final 
Amendment2 
Paiiicipants with on-treatment sennn ALT elevation > 2 x nadir or 
> 2 x baseline value and ~ 5 x ULN, with or without associated 
symptoms should be managed according to the guidance below. 
Page 11 
12 April 2023 

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 12
12 April 2023
All elevated serum ALT should be confirmed as soon as possible 
and ideally within 3 days of receipt of results. During the visit, a 
clinical assessment of the participant should be performed. The 
assessment should include a physical examination, evaluation of the 
participant’s mental status, and the following laboratory tests: 
•
Laboratory parameters: serum ALT and aspartate 
aminotransferase (AST), total bilirubin, gamma-glutamyl 
transferase (GGT), international normalized ratio (INR), serum 
albumin, and alcohol screening.
•
If the ALT elevation is confirmed, the central clinical laboratory 
will conduct reflex testing for plasma HBV DNA, serology for 
HBV (HBsAg, HBsAb, HBeAg, and HBeAb), hepatitis D virus 
(HDV), hepatitis A virus (HAV) immunoglobulin M (IgM), 
hepatitis C virus (HCV), and hepatitis E virus (HEV).
•
Liver biopsy may be collected for participants meeting Hy’s law 
(ALT > 3  ULN and Total Bilirubin > 2  ULN; AST 
> 3  ULN and Total Bilirubin > 2  ULN) with suspected 
drug-induced-liver-injury (DILI)
Based on the results of the confirmatory tests, the following study 
treatment modifications are recommended (Table 1):
Table 1.
Dose Modification and Monitoring
Liver Toxicity Parameters
Action
Confirmed, ALT ≥ 10 × ULN 
without evidence of hepatic 
toxicity as defined below
Cohort 1: Hold VIR-2218 and SLGN treatment. 
Participant should be monitored weekly or more 
frequently if clinically indicated until ALT < 5 × 
ULN. Restarting study treatment (VIR-2218, 
SLGN) may be considered when ALT < 5  ULN 
in discussion with the medical monitor. Study 
treatment should be restarted in line with the 
original assigned administration schedule.
Cohort 2: Initiate TAF 25 mg once daily and 
hold SLGN, and/or VIR-2218 dose. Participant 
should be monitored weekly or more frequently if 
clinically indicated until ALT < 5 × ULN. 
Restarting study treatment (VIR-2218, and 
SLGN) may be considered when ALT < 5  ULN 
in discussion with the medical monitor. Study 
treatment should be restarted in line with the 
original assigned administration schedule.
Persistent ALT > 2 × baseline and 
≥ 5 × ULN without evidence of 
hepatic toxicity, as defined below
Continue study treatment(s), ALT should be 
evaluated every 2 weeks or more frequently as 
clinically needed, until ALT < 5 × ULN

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 13
12 April 2023
Confirmed ALT > 2 × nadir, with 
evidence of hepatic toxicity, 
defined as any one of the 
following confirmed laboratory 
abnormalities:
•
Total bilirubin > 2 × ULN
•
Elevated INR > 0.5 above 
baseline AND > ULN 
•
Abnormal serum albumin 
> 1 g/dL decrease from 
baseline 
Cohort 1: Permanently discontinue study 
treatment(s) except TAF 25 mg once daily. 
Participant should be monitored weekly until 
ALT < 5 × ULN, and total bilirubin, INR, and 
albumin values return to normal or baseline 
levels.
Cohort 2: Initiate commercially approved NUC 
treatment once daily and permanently discontinue 
study treatment(s). Participant should be 
monitored weekly until ALT < 5 × ULN, and 
total bilirubin, albumin, and/or INR values return 
to normal or baseline levels 
ALT = alanine aminotransferase; INR = international normalized ratio; 
NUC = nucleos(t)ide(s); SLGN = selgantolimod; TAF = tenofovir alafenamide; 
ULN = upper limit of normal
Treatment-Free Follow-up ALT Management
All eligible participants will enter a TFFU period after completion 
of study treatment, in which they will undergo close safety 
monitoring. The proportion of participants who achieve HBsAg loss 
or are able to remain off NUC therapy during TFFU period will be 
assessed. Table 2 provides guidance for initiating commercially 
approved NUC treatment, in participants who experience rebound 
of HBV DNA and ALT levels. Any deviation from Table 2 should 
be discussed in advance with the medical monitor. 
If unscheduled visits are required for ALT monitoring, a clinical 
assessment of the participant should be performed. The assessment 
should include a physical examination, evaluation of the 
participant’s mental status and the following laboratory tests: 
•
Laboratory parameters: serum ALT and AST, total and direct 
bilirubin, GGT, INR, serum albumin, plasma HBV DNA, 
quantitative HBsAg, peripheral blood mononuclear cells 
(PBMC) for immune profiling, and alcohol screen.
•
At the initial confirmatory visit, collect serology for HDV, HAV 
IgM, HCV, and HEV.
Participants with HBV DNA < LLOQ and ALT elevation/flare 
meeting any of the below table criteria, should be evaluated for 
alternative liver disease etiologies by the investigator and in 
discussion with the medical monitor. Liver biopsy may be collected 
at the investigator’s discretion.
Participants with HBV DNA > LLOQ and ALT elevation/flare 
should be managed according to the following table: 
Table 2.
Starting Commercial NUC Treatment 
Criteria
Liver Toxicity Parameters
Action
I 

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 14
12 April 2023
Confirmed ALT ≥ 10 × ULN with no 
evidence of hepatic toxicity, as 
defined below.
Initiate NUC treatment and monitor 
weekly until ALT < 5 × ULN, and 
every 2 weeks until ALT < 2  ULN, 
or more frequently if clinically 
indicated.
ALT ≥ 5  ULN without evidence of 
hepatic toxicity, as defined below
ALT should be evaluated every 
2 weeks or more frequently as 
clinically needed, until 
ALT < 2 × ULN. 
Confirmed ALT > ULN with 
evidence of hepatic toxicity, defined 
as any one of the following confirmed 
laboratory abnormalities: 
•
Total bilirubin > 2  nadir AND 
> 2.5 mg/dL in the absence of 
Gilbert’s disease
•
Elevated INR > 0.5 above nadir 
AND > ULN 
•
Abnormal serum albumin 
> 1 g/dL decrease from baseline
Initiate NUC treatment and monitor 
weekly or more frequently if 
clinically indicated until return to 
baseline levels or within normal 
reference range. Liver biopsy may be 
considered if appropriate for 
participant management.
Confirmed, HBV DNA 
> 20,000 IU/mL (HBeAg positive) or 
> 2,000 IU/mL (HBeAg negative) 
and
persistent ALT > ULN without 
evidence of hepatic toxicity, as 
defined above, for > 8 weeks
Initiating NUC treatment may be 
considered in discussion with medical 
monitor. 
ALT = alanine aminotransferase; DNA = deoxyribonucleic acid; HBV = hepatitis B virus; 
INR = international normalized ratio; NUC = nucleos(t)ide(s); ULN = upper limit of 
normal
Individual Treatment Modification Criteria
Study treatment(s) that are considered related by the investigator to 
any of the following event(s) will be held in a participant until 
resolution of the event:
•
Any study drug–related adverse event (AE) ≥ Grade 3
•
A confirmed, clinically significant laboratory test abnormality 
(other than ALT) ≥ Grade 3 considered study drug(s) related by 
the investigator.
Study treatment(s) may be reinitiated following resolution of the 
above event(s) after discussion with the medical monitor. Study 
treatment(s) should be restarted in line with their preassigned 
schedules.
Individual Treatment Discontinuation Criteria

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 15
12 April 2023
Study treatment(s) that are considered related by the investigator to 
any of the below events will be permanently discontinued:
•
Any on treatment uveitis confirmed by ophthalmologic 
evaluation
•
Any confirmed recurrence of study drug–related Grade 3 or 4 
(excluding laboratory abnormalities) AE following dose 
interruption mandates permanent discontinuation of study 
drug(s)
•
Any study drug–related ≥ Grade 3 AE not able to be medically 
managed (eg, nausea with antiemetics)
•
Any study drug–related Grade 4 AE (excluding laboratory 
abnormalities)
•
Unacceptable toxicity or toxicity that, in the judgment of the 
investigator, compromises the ability to continue study specific 
procedures or is considered not to be in the participant’s best 
interest
•
Any confirmed study drug–related laboratory abnormality 
≥ Grade 3 following rechallenge
•
A clinically significant Grade 4 laboratory abnormality
•
Virological breakthrough as defined in Section 2
Additional criteria for permanent discontinuation of study 
treatment(s):
•
Intercurrent illness that would, in the judgment of the 
investigator, affect assessments of clinical status to a significant 
degree
•
Hepatic disease progression or lack of efficacy defined as 
participants in Cohorts 1 or 2 (Group A), who do not achieve 
HBsAg decline ≥ 0.2 log10 IU/mL at Week 12
•
Participant requests to discontinue for any reason
•
Participant noncompliance
•
Pregnancy during the study
•
At the discretion of the investigator, Gilead, a regulatory agency 
or an institutional review board (IRB) or independent ethics 
committee (IEC)
Number of 
Participants 
Planned:
Approximately 100 participants

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 16
12 April 2023
Target Population:
Adult, noncirrhotic, participants with CHB infection who are 
viremic or virally suppressed on a commercially approved HBV 
NUC treatment.
Duration of 
Treatment:
TAF 25-mg tablet will be administered orally once daily for up to 
84 weeks, as applicable, in Cohort 1
VIR-2218 200 mg SC will be administered once every 4 weeks for 
24 weeks (6 doses) 
Nivolumab 0.3 mg/kg IV was administered once every 4 weeks for 
up to 24 weeks (up to 6 doses)
SLGN 3 mg (2  1.5-mg tablets) will be administered orally while 
fasting once a week on the same day for up to 24 weeks (up to 24 
doses) 
NOTE: Nivolumab dosing was stopped in this study. This was a 
sponor decision based on a benefit risk assessment on the use of 
nivolumab in HBV cure. SLGN was discontinued for Cohort 2 
Group B.
Diagnosis and Main 
Eligibility Criteria:
Male and nonpregnant female participants, ages 18 to 65 years, 
inclusive, with chronic HBV infection without the presence of 
cirrhosis, and who are viremic or virally suppressed on NUC 
treatment for at least 6 months may be eligible for the study.
Refer to Section 4 of the protocol for detailed Inclusion and 
Exclusion criteria.
Study Procedures/
Frequency:
This study includes prescreening (optional), screening, treatment, 
and follow-up assessments.
After consent is obtained, screening assessments will be completed 
within 45 days prior to the Baseline/Day 1 treatment. All 
participants will complete the study treatments described below. 
Cohort 1:
•
Screening Visit
•
Treatment Period Visits: Baseline/Day 1, Weeks 4, 8, 12, 13, 
14, 16, 20, 24, 28, 32, and 36 
•
FU Visits: Weeks 1, 4, 8, 12, 16 (for women of childbearing 
potential), 24 (Primary), 36, and 48
Cohort 2:
•
Screening Visit 
•
Group A:
Treatment Period Visits: Baseline/Day 1, Weeks 4, 8, 12, 
13, 14, 16, 20, 24, 28, 32, and 36

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 17
12 April 2023
FU Visits: Weeks 1, 4, 8, 12, 16 (for women of childbearing 
potential), 24 (Primary), 36, and 48
•
Group B: 
Treatment Period Visits: Baseline/Day 1, Weeks 1, 2, 4, 8, 
12, , 14, 16, 20, and 24
FU Visits: Weeks 1, 4, 8, 12, 16 (for women of childbearing 
potential), 24 (Primary), 36, and 48
Screening assessments include: 
•
Obtain informed consent 
•
Review of inclusion/exclusion criteria
•
Obtain medical history (including HBV disease and treatment 
history)
•
Review concomitant medications
•
Complete physical examination
•
Vital signs
•
Body weight and height
•
12-Lead electrocardiogram (ECG) (Participants must rest 
quietly in the supine position for a minimum of 5 minutes prior 
to the recording)
•
Chest x-ray
•
Ophthalmologic examination
•
FibroScan (where available and as necessary for liver disease 
staging)
•
Sample collection for:
Safety laboratory tests (hematology, chemistry, and 
coagulation)
AST to platelet ratio index (APRI), FibroTest, α-fetoprotein 
(computed tomography [CT] scan with contrast for 
participants with α-fetoprotein ≥ 50 ng/mL at screening)
Serology testing to exclude HCV, HDV, and HIV infection
Quantitative plasma HBV DNA
Quantitative HBV serum HBsAg, HBcrAg, HBeAg, and 
HBV RNA 
Qualitative HBV serology HBeAg, HBeAb, and HBsAg, 
HBsAb
Estimated CLcr (using the Cockcroft-Gault method)
Other screening laboratory tests: urinalysis, urine drug 
screen, alcohol screen, autoantibodies, quantification of 

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 18
12 April 2023
thyroid-stimulating hormone (TSH) levels, and serum 
β human chorionic gonadotropin (β-hCG) (females of 
childbearing potential only), follicle-stimulating hormone 
(FSH) (for female participants who are < 54 years old who 
are not on hormonal contraception and who have stopped 
menstruating for ≥ 12 months but do not have 
documentation of ovarian hormonal failure)
Serum sample for HBV viral sequencing, genotyping 
sample, and ddPCR
•
Record any serious adverse events (SAEs) and all AEs related to 
protocol mandated procedures occurring after signing of the 
consent form.
Treatment assessments include: 
•
Vital signs 
•
Weight 
•
Review AEs 
•
Review concomitant medications
•
Complete Physical Examination
•
Symptom-directed physical examination
•
12-Lead ECG (Participants must rest quietly in the supine 
position for a minimum of 5 minutes prior to the recording)
•
Symptoms-directed ophthalmologic examination
•
Sample collection for:
Safety laboratory tests (hematology and chemistry; 
coagulation)
APRI and FibroTest
Quantitative plasma HBV DNA 
Quantitative serum HBsAg, HBcrAg, HBeAg, and HBV 
RNA 
Qualitative HBV serology HBeAg, HBeAb, and HBsAg, 
HBsAb
Collection of PBMC, whole blood, serum, and plasma 
samples for biomarker analysis
Sparse PK samples
Urine pregnancy test (females of childbearing potential 
only) 
Urinalysis
Estimated CLcr (using Cockcroft-Gault method)

Selgantolimod 
Protocol GS-US-465-4439 
Gilead Sciences, Inc. 
CONFIDENTIAL 
• 
• 
Final 
Amendment2 
-
Sernm sample for HBV viral sequencing, genotyping 
sample, and ddPCR 
• 
Perfo1m study drng accountability, dispensation, and 
administration (TAF, as needed, nivolumab IV, SLGN, and 
VIR-2218 SC) 
Page 19 
12 April 2023 

Selgantolimod 
Protocol GS-US-465-4439 
Gilead Sciences, Inc. 
Test Product, Dose, 
and Mode of 
Administration: 
Reference Therapy, 
Dose, and Mode of 
Administration: 
CONFIDENTIAL 
Final 
Amendment2 
Selgantolimod will be supplied as tablets in strengths of 1.5 mg. 
SLGN 3 mg (2 x 1.5-mg tablets) will be administered while fasting, 
once a week, on the same day. Participants must be fasting for at 
least 8 hours overnight (no food or drinks, except water) and 
continue through the morning, with no food or drinks, including 
water, 1 hour before to 2 hours after dosing. After 2 hours postdose, 
water is allowed and after 4 hours postdose, participants are allowed 
food and drinks. Participants should take their other prescribed 
medications, including NUC treatment, no earlier than 2 hours after 
SLGN dosing or, if medications require dosing with food, no earlier 
than 4 hours after SLGN dosing. 
VIR-2218, 200 mg/mL, solution for injection will be supplied as 
0.5 mL single dose vials. VIR-2218 200 mg (2 x 0.5 mL solution) 
will be administered SC. 
Nivolumab (Opdivo®) 40 mg/4 mL solution for injection was 
supplied as single dose vials. Nivolumab 0.3 mg/kg was 
administered as IV infusion over 45-60 minutes. 
TAF 25-mg tablet orally once daily with food. 
None 
Page 20 
12 April 2023 

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 21
12 April 2023
Criteria for 
Evaluation:
Safety:
Safety will be evaluated by assessment of clinical laboratory tests 
and AEs collected through FU Week 48. The primary safety 
analysis will be evaluated through 30 days posttreatment of 
SLGN ± nivolumab ± VIR-2218.
Posttreatment is defined as the following:
•
For VIR-2218 and nivolumab, posttreatment will start 4 weeks 
after last dose. 
•
For SLGN, posttreatment will start 1 week after last dose.
Posttreatment for each cohort will be based on the last study drug(s) 
end of the treatment window duration that is the longest.
The safety analysis will also be conducted through FU Week 24 as a 
secondary safety analysis.
Efficacy:
Primary efficacy endpoint:
•
The proportion of participants who achieve functional cure, 
defined as HBsAg loss and HBV DNA < LLOQ at FU Week 24
Secondary efficacy endpoints:
•
The proportion of participants with HBsAg loss with and 
without anti-HBsAg seroconversion during the study
•
The proportion of participants with HBeAg loss with and 
without anti-HBeAg seroconversion during the study in 
participants with CHB who are HBeAg positive at baseline
•
The proportion of participants who remain off NUC treatment 
during FU
•
The proportion of participants experiencing HBV virologic 
breakthrough during study treatment(s)

Selgantolimod 
Protocol GS-US-465-4439 
Gilead Sciences, Inc. 
Phannacokinetics: 
Statistical Methods: 
Final 
Amendment2 
Sparse PK blood samples will be collected at specific in-clinic 
treatment visits for all paiiicipants at the time points specified in the 
protocol. 
concentrations of SLGN and VIR-2218, and sernm concentrntions 
of nivolumab may be analyzed (as applicable, from existing 
samples). 
The primaiy analysis will be conducted after all participants within 
each coho1i have completed FU Week 24 or eai·ly tenninated from 
the study prior to FU Week 24. 
The primaiy efficacy endpoint is the proportion of participants who 
achieve functional cme, defined as HBsAg loss and HBV 
DNA < LLOQ at FU Week 24. 
The primaiy efficacy analysis will summai·ize the prima1y efficacy 
endpoint for each treatment coho1i . A point-estimate with 2-sided 
95% exact CI will be constrncted for the propo1iions using the 
binomial distribution (Clopper-Peai·son method). 
The secondaiy efficacy endpoints will be summai·ized by treatment 
coho1i. 
Continuous secondaiy endpoints will be summarized using 
conventional descriptive statistics (n, mean, SD, median, first 
quaitile [Ql], third quaitile [Q3], minimum, and maximum) by 
treatment coho1i. 
Categorical secondaiy endpoints will be summarized by number 
and percentage of paiiicipants who meet the endpoint by treatment 
cohort. 
Safety will be evaluated by treatment coho1i. It will be sUilllnai·ized 
by the number and percentage of participants with AEs or 
laborato1y abno1malities for categorical values or by the 
conventional descriptive statistics (n, mean, SD, median, Ql, Q3, 
minimum, and maximum) for continuous data. 
Sample Size 
pa1ticipants in each treatment coho1t was decided based on clinical 
expenence. 
This study will be conducted in accordance with the guidelines of Good Clinical Practice, 
including archiving of essential documents. 
CONFIDENTIAL 
Page 22 
12 April 2023 

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 23
12 April 2023
GLOSSARY OF ABBREVIATIONS AND DEFINITION OF TERMS
%AUCexp
percentage of AUC extrapolated between AUClast and AUCinf
z
terminal elimination rate constant, estimated by linear regression of the terminal 
elimination phase of the log concentration of drug versus time curve of the drug
Ab
antibody
ABW
actual body weight
ADR
adverse drug reaction
AE
adverse event
ALT
alanine aminotransferase
AMA
antimitochondrial antibodies
ANA
antinuclear antibodies
APRI
AST to Platelet Ratio Index
AST
aspartate aminotransferase 
AUC
area under the concentration versus time curve
AUC0-24
partial area under the concentration versus time curve from time “0” to time “24”
AUClast
area under the concentration versus time curve from time zero to the last quantifiable 
concentration
AUCinf
area under the concentration versus time curve extrapolated to infinite time, calculated 
as AUClast + (Clast/z)
β-hCG
β human chorionic gonadotropin
cccDNA
covalently closed circular DNA
CD
cluster of differentiation
CFR
Code of Federal Regulations
CHB
chronic hepatitis B
CI
confidence interval
CK
creatine kinase
Clast
last observed quantifiable concentration of the drug
CLcr
creatinine clearance
CL/F
apparent oral clearance
Cmax
maximum observed concentration of drug
COPD
chronic obstructive pulmonary disease 
COVID-19
coronavirus disease 19
CRF
case report form
CRO
contract (or clinical) research organization
CSR
clinical study report
CT
computed tomography
CTCAE
Common Terminology Criteria for Adverse Events
CYP
cytochrome P450
DDI
drug-drug interaction
ddPCR
digital droplet polymerase chain reaction

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 24
12 April 2023
DILI
drug-induced-liver injury
DNA
deoxyribonucleic acid
EC
ethics committee
ECG
electrocardiogram
eCRF
electronic case report form
ED
early discontinuation 
EDC
electronic data capture
ELIspot
enzyme-linked immunospot assay
EOT
end of treatment
ESC+
Enhanced Stabilization Chemistry Plus
EU
European Union
EudraCT
European Clinical Trials Database
FAS
Full Analysis Set
FDA
Food and Drug Administration
FIH
first-in-human
FSH
follicle-stimulating hormone
FU
follow-up
GalNAc
N-acetyl-galactosamine ligand
GCP
Good Clinical Practice
GGT
gamma-glutamyltransferase
Gilead
Gilead Sciences, Inc.
GSI
Gilead Sciences, Inc.
HAV
hepatitis A virus
HBV
hepatitis B virus
HBcrAg
hepatitis B core-related antigen
HBeAb
hepatitis B e antibody
HBeAg
hepatitis B e antigen
HBsAb
hepatitis B surface antibody
HBsAg
hepatitis B surface antigen
HCC
hepatocellular carcinoma
HCV
hepatitis C virus
HDL
high-density lipoprotein
HDPE
high-density polyethylene
HDV
hepatitis D virus
HEV
hepatitis E virus
HIV, HIV-1
human immunodeficiency virus, type 1
HLA
human leukocyte antigen
HLGT
high-level group term
HLT
high-level term
IB
investigator’s brochure

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 25
12 April 2023
ICF
informed consent form
ICH
International Conference on Harmonization (of Technical Requirements for 
Registration of Pharmaceuticals for Human Use)
IEC
independent ethics committee
IFN
interferon
Ig
immunoglobulin 
IgM
immunoglobulin M
IL
interleukin
IND
investigational new drug (application)
INR
international normalized ratio
irAE
immune-related AE
IRB
institutional review board
IRR
infusion-related reaction
ISR
injection site reaction
IV
intravenous
LDH
lactic acid dehydrogenase
LDL
low-density lipoprotein
LLOQ
lower limit of quantitation
LLT
lower-level term
mAb
monoclonal antibody
MCV
mean corpuscular volume
MedDRA
Medical Dictionary for Regulatory Activities
NCI
National Cancer Institute
NK
natural killer cells
NOAEL
no-observed-adverse-effect-level
NRTI
nucleoside reverse transcriptase inhibitor
NSAID
nonsteroidal anti-inflammatory drug
NUC
nucleos(t)ide(s)
OAV
oral antiviral
PBMC
peripheral blood mononuclear cells
PD
pharmacodynamic(s)
PD-1
programmed cell death protein 1
PEG
polyethylene glycol
PG
pharmacogenomic
PgRNA
pregenomic RNA
PHH
primary human hepatocytes
PI
principal investigator
PK
pharmacokinetic(s)
PS
PT
Patient Safety
preferred term

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 26
12 April 2023
QT
electrocardiographic interval between the beginning of the Q wave and termination of the 
T wave, representing the time for both ventricular depolarization and repolarization to 
occur
QTcF
QT interval corrected for heart rate using the Fridericia formulation
Q1
first quartile
Q3
third quartile
RBC
red blood cell
RNA
ribonucleic acid
RT
reverse transcriptase
SADR
serious adverse drug reaction
SAE
serious adverse event 
SC
subcutaneous(ly)
Scr
serum creatinine
SD
standard deviation
SDV
source data verification
siRNA
short interfering RNA
SLGN
selgantolimod
SMA
smooth muscle antibodies
SMQ
Standardised MedDRA Query
SNP
single-nucleotide polymorphism
SOC
system organ class
SOP
standard operating procedure
SSR
special situation report
SUSAR
suspected unexpected serious adverse reaction
TAF
tenofovir alafenamide (Vemlidy®)
TDF
tenofovir disoproxil fumarate
TEAE
treatment-emergent adverse event
TE
treatment emergent 
TFFU
treatment-free follow-up
TFV
tenofovir
Tlast
time (observed time point) of Clast
TLR
toll-like receptor
Tmax
the time (observed time point) of Cmax
TNF
tumor necrosis factor
TPO
thyroid peroxidase
TSH
thyroid-stimulating hormone
t1/2
estimate of the terminal elimination half-life of the drug, calculated by dividing the 
natural log of 2 by the terminal elimination rate constant (λz)
ULN
upper limit of normal
US, USA
United States, United States of America
WBC
white blood cell

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 27
12 April 2023
WHV
woodchuck hepatitis virus
WHsAg
woodchuck hepatitis virus surface antigen

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 28
12 April 2023
1.
INTRODUCTION
1.1.
Background
Chronic hepatitis B (CHB) is a major public health care issue worldwide and one of the principal 
causes of chronic liver disease, cirrhosis, and hepatocellular carcinoma (HCC). The hepatitis B 
virus (HBV) is easily transmissible through perinatal, percutaneous, and sexual exposure 
{World Health Organization (WHO) 2015b}. Following acute HBV infection, 5% to 10% of 
adults and up to 90% of children fail to produce an immune response adequate to clear the 
infection; these individuals become chronic carriers of the virus {Zuckerman 1996}. Individuals 
who develop CHB are at substantial risk of cirrhosis, hepatic decompensation, and HCC, which 
will afflict 15% to 40% of patients with CHB in the absence of effective treatment 
{Ratnam 2006, World Health Organization (WHO) 2015a}. Liver cancer is the third leading 
cause of cancer deaths globally, with the highest burden of disease found in regions where HBV 
is endemic {Global Burden of Disease Cancer Collaboration 2015}. Recent reports estimated 
that 250 to 350 million individuals were living with HBV (ie, are hepatitis B surface antigen 
[HBsAg]-positive) in 2010, representing a worldwide prevalence of 3.6%, with considerable 
geographic variability {Schweitzer 2015, World Health Organization (WHO) 2015c}. In 2015, 
an estimated 654,000 deaths were due to HBV infection and associated complications, placing it 
among the top 20 causes of mortality worldwide {G. B. D. Mortality Causes of Death 
Collaborators 2016}. 
The loss of HBsAg, accompanied by seroconversion to anti-HBsAg, is the accepted endpoint for 
anti-HBV therapy endorsed by the American Association for the Study of Liver Diseases, the 
European Association for the Study of the Liver, and the Asian Pacific Association for the Study 
of the Liver allowing for cessation of therapy {European Association for the Study of the Liver 
(EASL) 2012, European Association for the Study of the Liver (EASL) 2017, Lok 2009}, 
{Sarin 2015, Terrault 2016}. Clearance of HBsAg has been associated with improvements in 
liver histology, including the reversal of cirrhosis, a decreased risk of HCC, and prolonged 
survival, and is considered evidence of a functional cure {Benias 2011, Fattovich 1998, 
Kim 2013}. Nucleos(t)ide (NUC) analogs are the standard-of-care for CHB treatment, providing 
durable suppression of viral replication that results in long-term clinical benefits with a reduced 
risk of liver complications {Dienstag 2003, Liaw 2011, Lok 2013}. However, treatment with 
NUCs rarely results in clearance of HBsAg {Kwon 2011}. Thus, new treatment options that 
enhance rates of HBsAg clearance are needed; such treatments will allow patients to discontinue 
life-long oral antiviral (OAV) therapy and provide a finite-duration treatment option for a 
functional cure. A finite therapy is expected to be applicable to a broader population of those 
chronically infected with HBV, including immunotolerant patients who are currently untreated.
The host immune response to HBV infection plays a pivotal role in whether acute infection is 
resolved or becomes chronic. Individuals who are able to clear HBV infection spontaneously 
following an acute infection display a vigorous, polyclonal, HBV-specific cluster of 
differentiation (CD)8+ and CD4+ T-cell response {Rehermann 2005}. In contrast, CHB is 
associated with a limited and dysfunctional CD8+ T-cell response, as well as impaired natural 

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 29
12 April 2023
killer (NK) cell antiviral function {Peppa 2010, Rehermann 2005}. Suppression of HBV DNA 
with NUC analogs has been associated with overall improvements in the ability of the immune 
system to respond to HBV antigens {Evans 2008, Mizukoshi 2004, Sherman 2013}. The 
suppression of HBV DNA also results in the reduction of regulatory T cells, an increase in 
HBV-specific CD8+ T cells and reduction in exhaustion markers (such as programmed cell death 
protein 1 [PD-1]) on CD8+ T cells {Evans 2008, Sherman 2013}. These improvements, 
however, are modest and do not result in durable immune control with loss of HBsAg in the 
majority of treated participants. However, further control of HBV viral antigens with HBV DNA 
suppression and the enhancement of virus-specific immune responses, may theoretically enhance 
rates of durable control of HBV.
1.2.
General Information About Study Drugs
1.2.1.
General Information About Selgantolimod
Selgantolimod (SLGN, also GS-9688) is a Toll-like receptor 8 (TLR8) agonist that induces the 
cellular immune mediator interleukin (IL)-12 and the antiviral cytokines tumor necrosis factor 
(TNF)-α and interferon (IFN)- γ in vitro in peripheral blood mononuclear cells (PBMCs). 
Cytokine induction by SLGN is comparable in PBMCs from patients with CHB and from 
healthy donors. Selgantolimod induces little to no IFN-α (a cytokine induced by TLR7 agonists) 
in human PBMCs in vitro, indicating that SLGN is a potent and selective TLR8 agonist in 
primary human immune cells. Selgantolimod activates monocytes and professional antigen-
presenting cells (pAPCs) in vitro in PBMCs from healthy donors. It also activates NK cells and 
total CD8+ T cells in vitro in PBMCs isolated from both healthy donors and patients with CHB. 
Additionally, SLGN increases IFN-γ production and reduces expression of the inhibitory 
receptor PD-1 by HBV-specific CD8+ T cells. Cytokines induced by SLGN in healthy human 
donor PBMCs in vitro reduce the levels of HBV DNA, HBV RNA, HBsAg, and hepatitis B e 
antigen (HBeAg) in HBV-infected primary human hepatocytes (PHH). Prophylactic treatment 
with cytokines induced by SLGN prevents establishment of HBV covalently-closed circular 
DNA (cccDNA) in PHH in vitro.
In cynomolgus monkeys, dose-dependent induction of serum IL-12p40, IL-1RA, and other 
cytokines was observed following oral administration of SLGN at doses ≥ 0.3 mg/kg. These 
pharmacodynamic (PD) markers are consistent with TLR8 activation. In woodchucks chronically 
infected with the woodchuck hepatitis virus (WHV), once-weekly oral administration of 3 mg/kg 
SLGN for 8 weeks resulted in > 2 log10 IU/mL reduction of serum woodchuck hepatitis virus 
surface antigen (WHsAg) and WHV DNA in 4 of 6 woodchucks. This antiviral response was 
sustained in 3 of 6 woodchucks until the end of study. Moreover, these 3 animals developed 
detectable anti-WHsAg and had > 95% reduction in intrahepatic WHV cccDNA at the end of 
study.
Selgantolimod shows low systemic concentrations across multiple species (rat, dog, and 
cynomolgus monkey), indicating low potential for immune activation in the periphery. Mouse 
and cynomolgus monkey toxicology studies of ≥ 13 weeks (≥ 14 doses) demonstrated that SLGN 
was well tolerated and nonadverse at doses up to 10 mg/kg/week in the mouse and 
30 mg/kg/week in the monkey. At the highest observed exposure in a clinical study 
(GS-US-389-2022) with a clinical dose of 3 mg, the exposure margins at the no observed adverse 

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 30
12 April 2023
effect level (NOAEL) based on the AUC are approximately 192-fold and 37-fold for mouse and 
cynomolgus monkey, respectively.
A first-in-human (FIH) pharmacokinetic (PK) and food-effect study (GS-US-389-2021) was 
completed in healthy participants. For the 48 participants who received a single dose of 0.5, 1.5, 
3, or 5 mg of SLGN, the dose was generally safe and resulted in dose-dependent increases in 
serum IL-12p40 and IL-1RA. For the 12 participants who received a single dose of 1.5 mg in 
both the fed and fasted states, SLGN plasma concentrations were similar between the 2 states, 
whereas serum IL-12p40 and IL-1RA were strongly reduced when SLGN was dosed with food. 
Based on these data, subsequent clinical evaluations are conducted under fasted conditions. 
A drug-drug interaction (DDI) study (GS-US-389-5545) to evaluate the PK and 
pharmacodynamics (PD) of SLGN upon coadministration with a representative proton pump 
inhibitor (omeprazole) or histamine 2 receptor antagonist (famotidine) was completed in healthy 
participants. Statistical comparisons of SLGN AUC between SLGN administered alone versus in 
combination with either omeprazole or famotidine were within the predefined no-effect DDI 
boundary of 70% to 143%, indicating a lack of significant effect on SLGN PK. There was no 
clinically significant impact of omeprazole or famotidine on relevant PD markers of SLGN. 
These data demonstrate that SLGN may be administered without regard to acid-reducing agents 
such as omeprazole or famotidine thereby not warranting any dosing adjustments.
Limited dosing of SLGN has been evaluated in participants with CHB (Studies 
GS-US-389-2022, GS-US-389-2024, and GS-US-389-2025) and was shown to be generally safe 
and well tolerated. In the GS-US-389-2022 study, doses of 1.5 mg and 3 mg resulted in 
dose-dependent induction of IL-12p40 and IL-1RA, with no evidence of tachyphylaxis with up 
to 4 doses of SLGN. Pharmacokinetic data show similar exposures in participants with CHB 
compared with healthy participants in the FIH study, with no accumulation over time. At the 
interim Week 48 analysis for Study GS-US-389-2024, 1 participant (HBeAg negative in the 
SLGN 1.5-mg dose group) met the primary endpoint of ≥ 1 log10 IU/mL decline from baseline in 
HBsAg at Week 24. Based on the interim safety data from Studies GS-US-389-2024 and 
GS-US-389-2025, nausea, vomiting, and iridocyclitis were added as adverse drug reactions 
(ADRs) for SLGN at the current stage of development.
For further information on SLGN, refer to the investigator’s brochure (IB) for SLGN.
1.2.1.1.
Ongoing Studies
There is an ongoing Phase 1b study assessing safety, tolerability, and efficacy of once-weekly 
administration of SLGN 3 mg in special populations with CHB (GS-US-389-5458). This study is 
evaluating SLGN in 3 populations with CHB: (1) immune tolerant HBV with HBV DNA 
≥ 1  107 IU/mL, (2) patients with inactive HBV (HBV DNA ≤ 2000 IU/mL) at screening, and 
(3) HBV/hepatitis D virus (HDV) coinfected participants on suppressive NUC therapy. Based on 
the interim safety data at Week 24, no new safety issues for SLGN have been observed.

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 31
12 April 2023
1.2.2.
General Information About Nivolumab 
Nivolumab (Opdivo®, BMS), an anti-PD-1 immunoglobulin (Ig)G4 monoclonal antibody (mAb), 
is approved for the treatment of metastatic melanoma and is under development for other 
malignancies including lung cancer and HCC. The clinical dose of nivolumab is 3 mg/kg 
intravenously (IV) every 2 weeks, though initial dose ranging studies in melanoma demonstrated 
equivalent receptor occupancy of peripheral lymphocyte PD-1 at doses as low as 0.1 mg/kg 
{Topalian 2012}. In those studies, clinical effect for melanoma was observed at all doses tested. 
The lowest doses of 0.1 mg/kg and 0.3 mg/kg were not associated with Grade 3 or 4 serious 
adverse events (SAEs) or Grade 3 or 4 adverse events (AEs) of special interest (including 
autoimmune AEs) and had lower rates of treatment-related Grade 3 or 4 AEs compared with 
higher dose groups. 
Nivolumab has also been studied in a single dose study in hepatitis C virus (HCV) (N = 45) with 
dose ranges of 0.03 mg/kg to 10 mg/kg {Gardiner 2013}. The majority of AEs were Grade 1 or 2 
with a single Grade 4 alanine aminotransferase (ALT) elevation in the highest dose evaluated. 
All immune-related AEs (irAE) were mild to moderate and resolved without intervention. 
Reductions in HCV RNA were modest and seen in 5/45 (11%) of treated participants at doses as 
low as 0.1 mg/kg, although the highest dose of 10 mg/kg induced a > 4 log10 IU/mL reduction in 
HCV RNA in 3 participants (n = 20 total at this dose).
Nivolumab has also been evaluated for HCC (related to HCV, HBV or neither), where a 
subpopulation of 66 HBV-infected participants with HCC were dosed with nivolumab at doses 
of 0.1 mg/kg to 3.0 mg/kg IV every 2 weeks. No participants with HBV in either the dose 
escalation phase or in the expansion phase discontinued treatment due to study drug toxicity. 
Among the HBV-infected participants with HCC who received nivolumab at 3.0 mg/kg IV every 
2 weeks (n = 51), no participants experienced Grade 3 or 4 ALT/aspartate aminotransferase 
(AST) increases and 6% (n = 3) experienced a Grade 3 or 4 treatment-related AE 
{El-Khoueiry 2017}.
For further information on nivolumab, refer to the current approved product label for nivolumab.
1.2.2.1.
Ongoing Studies 
There are no other ongoing Gilead-sponsored studies with nivolumab. 
1.2.3.
General Information About Tenofovir Alafenamide (TAF)
Vemlidy® (TAF, GS-7340) is a novel oral prodrug of tenofovir (TFV), a NUC analog that 
inhibits HIV-1 reverse transcription. Tenofovir is metabolized intracellularly to the active 
metabolite, tenofovir diphosphate, a competitive inhibitor of HIV-1 reverse transcriptase (RT) 
and HBV RT that terminates the elongation of the viral DNA chain. 
For further information on TAF, please refer to the approved product label for TAF.

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 32
12 April 2023
1.2.4.
General Information About VIR-2218
VIR-2218 is a short interfering RNA (siRNA) that targets a region of the HBV genome that is 
common to all HBV viral transcripts. The siRNA is chemically modified using Enhanced 
Stabilization Chemistry Plus (ESC+) consisting of 2’-fluoro (2’F), 2’-O-methoxy (2’OMe) 
ribose sugar modifications, phosphorothioate backbone modifications, glycol nucleic acid 
modification, and conjugation to a triantennary N-acetyl-galactosamine ligand (GalNAc) at the 
3’ end of the sense strand, to facilitate delivery to hepatocytes through the asialoglycoprotein 
receptor. The drug product, VIR-2218, is the drug substance of VIR-2218 formulated in water 
for subcutaneous (SC) injection. VIR-2218 is pharmacologically active against HBV genotypes 
A through J; see the current IB for additional information on VIR-2218. The use of siRNA offers 
a novel strategy for the treatment of chronic HBV infection. The siRNAs are 19-21 base-pair 
RNA duplexes that exploit the endogenous RNA-interference pathway to enable 
sequence-specific RNA cleavage and degradation. One siRNA can have multiple antiviral 
effects, including degradation of the pregenomic RNA (pgRNA), thus inhibiting viral replication, 
and degradation of all viral messenger RNA transcripts, thereby preventing expression of viral 
proteins. This may result in the return of a functional immune response directed against HBV, 
especially if combined with other therapies, in particular, immune modulatory agents.
By contrast, nucleoside reverse transcriptase inhibitors (NRTIs) act at a distinct part of the viral 
life cycle and have a different mechanism of action than VIR-2218. NRTIs inhibit the action of 
HBV RNA polymerase, blocking the reverse transcription of the viral pgRNA to viral DNA and 
preventing the production of infectious virions. NRTIs, however, do not directly impact the 
production of viral proteins such as HBsAg. Reduction of HBsAg-containing noninfectious 
subviral particles by VIR-2218 is considered an important differentiator from current treatments.
For further information, refer to the IB for VIR-2218.
1.3.
Rationale for the Current Study
1.3.1.
Rationale for Modifications to Study Design
Nivolumab was chosen in the initial study design, as an immunomodulator, in order to reverse 
HBV mediated T-cell exhaustion to induce an HBV-specific immune response to subsequently 
achieve an HBV functional cure. 
Nivolumab dosing was stopped for all participants in this study. This was a sponsor decision 
based on a benefit risk assessment of the use of nivolumab in HBV cure. For Cohort 2 Group B, 
where participants were originally designed to be treated with SLGN and nivolumab, Gilead 
made the decision to stop all treatment in this cohort on account of low likelihood of efficacy 
with SLGN alone, based on results from previous studies {Gane 2023, Janssen 2021}. Study 
participants in Cohorts 1 and 2 (Group A) will continue all other treatments (SLGN and 
VIR-2218) up to Week 36.

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 33
12 April 2023
1.3.2.
Rationale for This Study as Originally Designed 
Given the low rate of HBsAg loss with currently available therapies and the treatment burden 
associated with life-long treatment to maintain viral suppression, there is a need to identify new 
therapies that may provide durable HBsAg loss with a finite treatment duration. The host 
immune response to HBV infection plays a pivotal role in whether acute infection is resolved or 
becomes chronic. Individuals who are able to clear HBV infection spontaneously following an 
acute infection display a vigorous, polyclonal, HBV-specific CD8+ and CD4+ T-cell response 
{Rehermann 2005}. In contrast, CHB is associated with a limited and dysfunctional CD8+ T-cell 
response, as well as impaired NK-cell antiviral function {Peppa 2010, Rehermann 2005}. The 
primary objective of this Phase 2 study is to evaluate the safety, tolerability, and efficacy of 
novel HBV immunomodulatory containing combination regimens in association with or without 
a HBV targeted siRNA for the treatment of participants with CHB.
This Phase 2 study was originally intended to evaluate the safety and efficacy of combination 
treatment with 2 immunomodulatory agents, a toll-like receptor 8 (TLR8) agonist, SLGN, and a 
PD-1 checkpoint inhibitor, nivolumab, with and/or without siRNA, VIR-2218, in both virally 
suppressed and viremic participants with CHB. The aim of the virally suppressed cohort was to 
evaluate the hypothesis that maximum viral and antigen reduction before immunomodulation 
therapy will improve HBV-specific immune response to combination treatment. In contrast, the 
aim of the viremic cohorts is to evaluate the hypothesis that immune modulation in the presence 
of active liver inflammation caused by HBV infection will improve HBV-specific immune 
response to treatment. Immune active, viremic patients have been well characterized by a 
pro-inflammatory state with the presence of high viral burden and active liver inflammation. The 
effectiveness of immunomodulatory agents targeting functional improvement of exhausted 
HBV-specific CD8+ T cell in immune active patients with and without an siRNA has not yet 
been evaluated. 
Multiple studies have recently demonstrated that NUCs can be safely stopped with a close safety 
monitoring plan in a noncirrhotic patient population {Buti 2019}. Therefore, participants who 
are virally suppressed, HBeAg negative and have HBsAg < 100 IU/mL at end of treatment 
(EOT), will enter a treatment-free follow-up (TFFU) period after completion of study treatment, 
where they will be closely followed with safety visits every 4 weeks in the first 3 months and 
then every 8 weeks for a total of 48 weeks. Criteria for initiation of NUC treatment during 
follow-up (FU) period have been defined to guide investigators and allow for evaluation of 
predictors of response. The aim of the TFFU period will be to evaluate the continued 
off-treatment response to siRNA and/or SLGN plus nivolumab, which have all demonstrated 
prolonged/sustained activity beyond the dosing period {Gane 2020}. 
1.4.
Rationale for Dose Selection of Study Drugs
1.4.1.
Rationale for Dose Selection of Selgantolimod
The safety, PD, and PK of SLGN have been evaluated in healthy volunteers and participants 
with CHB. Selgantolimod has demonstrated dose-dependent induction of IL-12p40 and IL-1RA, 
PD markers of SLGN pharmacological activity, and comparable PK in both populations 

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 34
12 April 2023
(GS-US-389-2021 and GS-US-389-2022). Food effect evaluation on SLGN disposition in the 
FIH study (GS-US-389-2021) showed comparable SLGN plasma exposures in the fed and fasted 
state, however, the PD markers markedly reduced in the presence of food which led to dosing of 
SLGN in fasted conditions in subsequent clinical evaluations.
The safety and efficacy of SLGN 1.5 mg and 3 mg weekly for 24 weeks in combination with 
NUC therapy has been evaluated in 2 ongoing Phase 2 studies in virally suppressed and viremic 
participants with CHB (GS-US-389-2024 and GS-US-389-2025, respectively) and in the 
Phase 1b study assessing safety and efficacy of once-weekly administration of SLGN 3 mg 
coadministered with nivolumab (dosed IV every 4 weeks) in virally suppressed participants 
(GS-US-493-5342). Safety data from these studies indicate that SLGN treatment (at doses of 
1.5 mg and/or 3 mg, once weekly) was generally safe and well tolerated.
Based on the collective clinical data available to date, in this study, once-weekly dosing of 
SLGN 3 mg (the higher of the 2 evaluated doses) for 24 weeks in fasted state was proposed for 
administration with nivolumab ± VIR-2218.
For further information, refer to the current IB for SLGN.
1.4.2.
Rationale for Dose Selection of Nivolumab
In a Phase 1 study, GS-US-330-1938, the safety and efficacy of a single IV dose of nivolumab 
0.3 mg/kg was evaluated in virally suppressed participants with CHB. After the single IV 
administration, 3 out of 22 (14%) participants had > 0.5 log10 IU/mL reduction in HBsAg with 
1 participant achieving > 1 log10 IU/mL reduction. This participant achieved HBsAg loss and 
anti-HBs seroconversion 10 weeks after completing the study, as reported by the investigator 
{Gane 2019}. Overall, single IV administration of nivolumab 0.3 mg/kg was safe and well 
tolerated. No deaths, SAEs, Grade 3 or 4 AEs, or laboratory abnormalities, except for the 
1 participant who achieved HBsAg loss and had a Grade 3 ALT flare, were reported. The only 
nivolumab-related AEs as determined by the investigator were fatigue, headache, and cough 
which were reported in only 1 participant each. Additionally, in Study GS-US-493-5342, 
nivolumab 0.3 mg/kg once every 4 weeks (dosed IV for 12 weeks), alone or in combination with 
SLGN in virally suppressed participants with CHB, was shown to be generally safe.
Based on these data, this study will evaluate the safety and efficacy of 0.3 mg/kg nivolumab 
dosed IV once every 4 weeks for 24 weeks in combination with: SLGN and VIR-2218 in virally 
suppressed participants with CHB, and SLGN ± VIR-2218 in viremic participants with CHB.
1.4.3.
Rationale for Dose Selection of TAF
TAF 25 mg administered orally once daily with food is the approved dose for the treatment of 
CHB virus infection in adults (≥ 18 years of age) with compensated liver disease 
{VEMLIDY 2020}.

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 35
12 April 2023
1.4.4.
Rationale for Dose Selection of VIR-2218
Available safety, tolerability, antiviral activity, and PK/PD data from Parts A-C of Study 
VIR-2218-1001 were considered when selecting dose levels for VIR-2218 in combination with 
VIR-3434. In Part A of the VIR-2218-1001 study, a single SC dose of VIR-2218 was 
administered to healthy participants over the dose range of 50 to 900 mg. In Parts B and C of the 
study, 2 doses of VIR-2218 given 4 weeks apart, ranging from 20 to 200 mg were administered 
to participants with chronic HBV infection. VIR-2218 was well tolerated across all dose levels 
evaluated, with no significant safety signals observed. 
In healthy adult participants, VIR-2218 was absorbed after SC injection with median Tmax of 4 to 
7 hours in plasma. Consistent with rapid GalNAc-mediated liver uptake {Nair 2017}, VIR-2218 
was not measurable in plasma beyond 48 hours for any participant. PK data following a single 
SC dose suggest that VIR-2218 AUC0-12 and Cmax exposures increase with dose and were slightly 
greater than dose-proportional across the dose range evaluated. Available PK data from HBV 
participants were similar to that observed in healthy participants. No accumulation of VIR-2218 
in plasma was evident following a second dose of VIR-2218 administered 4 weeks apart in 
participants with chronic HBV infection. 
Despite rapid elimination of VIR-2218 from plasma, prolonged presence is anticipated in the 
liver, based on tissue PK of VIR-2218 in nonclinical species and data from other 
GalNAc-conjugated siRNA molecules {Janas 2018}. Since no direct measurement of liver PK 
was available from human participants in the study, liver PK data from nonclinical studies were 
initially used to predict human liver PK based on allometric scaling. Using a model describing 
the onset, peak, and durability of PD response for a chemically similar ESC-GalNAc-siRNA 
{Attarwala 2017} and available rat tissue PK data for VIR-2218, the human liver half-life of 
VIR-2218 was previously estimated to be approximately 40 days. An updated analysis was 
conducted using measured HBsAg following VIR-2218 treatment in participants with chronic 
HBV infection (from Study VIR-2218-1001 Parts B and C). A sequential PK-PD modeling 
approach was applied to estimate PK parameters of VIR-2218 in plasma, then an effect 
compartment representing the site of drug action in liver was used to link the plasma PK and 
HBsAg reduction observed over time in an indirect response PK-PD model. The PK-PD model 
described the observed VIR-2218 plasma PK and HBsAg data well and predicted a half-life of 
approximately 80 days in the liver.
The liver half-life of VIR-2218 of 80 days was used to estimate VIR-2218 liver tissue exposure 
in humans (Table 3). The median liver exposures for the proposed VIR-2218 doses (6 doses of 
200 mg given every 4 weeks) are estimated to not exceed the projected liver exposure of the 
highest dose at which the safety and tolerability of VIR-2218 has been demonstrated (ie, 900 mg 
single dose).

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 36
12 April 2023
Table 3.
Estimated Median VIR-2218 Liver Tissue Exposure in Humans Based 
on PK-PD Model
Simulated Dosing Regimen
Cmax (μg/g)
AUC (h*μg/g)
900 mg single dose
61.1
34,300 (135,000) a
200 mg Q4W  6
52.9
34,100 b
PD = pharmacodynamics; PK = pharmacokinetics; Q4W = once every 4 weeks
a
For single dose regimens, partial AUClast up to Day 29 is presented; AUCinf is also presented in parenthesis.
b
For multiple dose regimens, AUC refers to AUClast during the 28-day dosing interval following 2 or 6 doses of VIR-2218.
Taken together, the observed safety and tolerability of VIR-2218, in conjunction with 
estimations of VIR-2218 liver exposure, support the VIR-2218 regimen selected for this study 
1.5.
Benefit/Risk Assessment for the Study
Chronic hepatitis B remains a global health concern with significant morbidity worldwide. The 
loss of HBsAg with seroconversion is the gold standard endpoint for anti- HBV therapy and 
allows for cessation of treatment {European Association for the Study of the Liver (EASL) 2012, 
Liaw 2012, Lok 2009}. Loss of serum HBsAg is associated with improvement in both the rates 
of liver cirrhosis and the development of HCC in patients with CHB, and in increased survival 
rate {Idilman 2012, Kim 2013, Moucari 2009, Simonetti 2010}. While HBsAg loss is the 
ultimate goal of treatment, it occurs at a very low rate and over several years: less than 1% of 
patients treated with NUC analogs achieve clearance of HBsAg. Thus, new treatment options 
that enhance rates of HBsAg loss with seroconversion are needed.
Selgantolimod 
Selgantolimod treatment alone have been evaluated in multiple Phase 1 and Phase 2 studies in 
both healthy volunteers and participants with CHB. The longest durations of treatment were 
evaluated in 2 Phase 2 studies, GS-US-389-2024 (NUC-suppressed participants with CHB) and 
GS-US-389-2025 (treatment-naive participants with CHB), that administered placebo, SLGN 
1.5 mg, or 3 mg once weekly with a NUC for 24 weeks to 93 participants with CHB. 
Selgantolimod up to 3 mg once weekly was safe and well tolerated in 102 participants with CHB 
(48 participants in Study GS-US-389-2024 and 54 participants in Study GS-US-389-2025). 
Based on pooled safety review of the SLGN studies, 3 potential ADRs related to SLGN of 
nausea, vomiting, and iridocyclitis were identified. Majority of these ADRs reported have been 
mild or moderate in severity. To mitigate the impact of ADR of nausea and vomiting for SLGN, 
the use of antiemetic (eg, ondansetron) is allowed in the study. A Grade 2 iridocyclitis (in the 
SLGN 1.5-mg dose group) was the only SAE reported that was considered related to SLGN by 
the investigator and led to early study drug discontinuation. This occurred in a participant who 
tested positive for the human leukocyte antigen (HLA)-B27 haplotype, a genetic risk factor 
associated with various immune disorders including anterior uveitis. No Grade 3 or 4 AEs 
considered related to SLGN treatment have been reported in the studies, except for 1 Grade 3 AE 
of rhinorrhea considered possibly related by the investigator that was reported in Study 
GS-US-389-2025. Additional safety results can be found in the IB for SLGN. 

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 37
12 April 2023
Nivolumab
In oncology, nivolumab treatment alone has been well characterized and the risks of irAEs are 
listed in the approved product label for nivolumab {OPDIVO 2022}. 
The risk of irAEs has been observed upon administration of nivolumab and other anti PD-1 
mAbs in the oncology setting {Friedman 2016}. These events are a class effect of all immune 
checkpoint inhibitors including nivolumab.
The use of nivolumab in HBV cure was based on the hypothesis that lower doses of the product 
with less frequent dosing would result in a reduced risk of irAEs. In Gilead studies, including 
Study GS-US-465-4439, nivolumab has been dosed at approximately 1/10th of the clinically 
approved oncology dose and is administered as only 1 infusion every 4 weeks for up to 6 doses. 
In prior Gilead studies involving patients with HBV, the use of nivolumab alone, or in 
combination with SLGN for up to 3 doses every 4 weeks, was well tolerated {Gane 2019}. 
However, irAEs have been observed at low doses of other anti-PD1 mAbs in non-oncology 
indications {Gubser 2022}. Therefore, the sponsor decision was to stop further dosing of 
nivolumab based on a benefit-risk assessment of the use of nivolumab in HBV cure.
VIR-2218
VIR-2218 is an siRNA that targets a specific sequence in the HBV virus. The safety and 
tolerability of VIR-2218 has been evaluated in an ongoing Phase 1/2 study, VIR-2218-1001 that 
evaluated single doses of VIR-2218 up to 900 mg administered SC in healthy participants 
(Part A) and a regimen of 2 doses administered 4 weeks apart at doses up to 200 mg in 
participants with CHB (Part B/C). In Part A, 59.5% of VIR-2218 participants (22 of 37) and 50% 
of placebo participants (6 of 12) had at least 1 AE, each of which was Grade 1 or 2 in severity 
with the exception of a single Grade 3 AE of respiratory tract infection (considered not related to 
study drug). The most common AEs in VIR-2218 participants were headache (24.3%; 9 of 37 
participants), and upper respiratory tract infection, contact dermatitis, injection site bruising, and 
injection site pain (8.1% each; 3 of 37 participants). Three VIR-2218 participants (8.1%) had 
AEs considered related to study drug by the investigator, including headache, injection site pain, 
and abdominal pain, each of which was Grade 1 in severity. Seven VIR-2218 participants 
(18.9%) had injection site reactions (ISRs). All ISRs were Grade 1 in severity and resolved 
within 12 days of onset. 
In Part B/C, 54.2% of VIR-2218 participants (13 of 24) and 25% of placebo participants (2 of 8) 
had at least 1 AE, each of which was Grade 1 or 2 in severity with the exception of 1 Grade 3 
nonserious AE of hypophosphatemia (considered not related to study drug), a known ADR of 
tenofovir disoproxil fumarate (TDF) with which the participant was receiving treatment. The 
most common AEs in VIR-2218 participants were headache (25.0%; 6 of 24 participants), and 
dizziness, fatigue, and myalgia (8.3% each; 2 of 24 participants). Five participants (20.8%) had 
AEs considered related to study drug by the investigator, including headache, injection site pain, 
and pyrexia, each of which was Grade 1 or 2 in severity. Two VIR-2218 participants (8.3%) each 
had 1 ISR. All ISRs were Grade 1 in severity and resolved within 3 days of onset. Injection site 
reactions were reported in the 50-mg and 100-mg dose cohorts. One treatment-emergent (TE) 

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 38
12 April 2023
SAE was reported in Study VIR-2218-1001 in a participant administered 100 mg VIR-2218. The 
SAE of headache was Grade 2 in severity and considered related to study drug by the 
investigator, but the Gilead determined that the constellation of concurrent symptoms (fever, 
headache, nausea, vomiting, and dehydration) was more consistent with a viral syndrome than a 
drug reaction and assessed the event as not related to study drug. Two participants had a non-TE 
SAE considered not related to study drug by the investigator; 1 participant had depression and 
1 participant committed suicide (outcome of death). The death (suicide) occurred approximately 
9 months after last study drug administration.
Selgantolimod + Nivolumab 
In the Phase 1b study, GS-US-493-5342, the combination of SLGN 3 mg oral once weekly plus 
nivolumab 0.3 mg/kg IV every 4 weeks for 12 weeks was evaluated in 14 participants with CHB. 
The combination treatment for 12 weeks was generally safe and well tolerated. The most 
common (> 1 participant) AEs considered related to study drugs by the investigator were nausea 
(n = 6), vomiting (n = 5), headache (n = 2), diarrhea (n = 2), and fatigue (n = 2). To mitigate the 
risk of nausea and vomiting, the use of antiemetics (eg, ondansetron) was allowed during the 
study. No Grade 3 or 4 AEs or SAEs were reported, and no Grade 3 laboratory abnormalities 
were observed. A single Grade 4 laboratory abnormality of elevated lipase was reported 
in 1 asymptomatic participant at posttreatment Week 4 that resolved to below upper limit of 
normal (ULN) 12 weeks later.
Selgantolimod + Nivolumab + VIR-2218
The risk of SLGN plus nivolumab with VIR-2218 is unknown. In nonclinical studies, the 
primary finding for both SLGN and nivolumab was inflammatory cell infiltrates of various 
organs and tissues; an anticipated pharmacological effect of each of the single agents. With 
SLGN at ≥ 3 mg/kg/week in the mouse, nonadverse findings included mononuclear cell 
infiltrates in multiple tissues. Effects became adverse at 30 mg/kg in the kidney, esophagus, 
thymus, spleen, mesenteric lymph node, mandibular salivary gland, Harderian gland, and/or 
lacrimal gland. These findings were partially reversed and/or not observed following the 4-week 
recovery period. In the monkey, SLGN-related nonadverse microscopic findings of inflammatory 
cellular infiltrates were observed in the liver and stomach; All effects exhibited reversibility at 
the end of the recovery phase. The NOAEL in mice and monkeys for SLGN was 10 mg/kg and 
30 mg/kg orally once weekly for 26 weeks and 13 weeks, respectively, and for nivolumab was 
50 mg/kg IV twice weekly for 13 weeks. These doses were associated with exposures (AUC) 
that were 192, 37 and 21 higher, respectively, than the human exposure after a single oral 
3 mg dose of SLGN (selgantolimod IB) and 3 mg/kg dose every 2 weeks IV of nivolumab (Food 
and Drug Administration [FDA] Pharmacology Review 4 Dec 2014). For VIR-2218, the liver 
(rats), kidney (rats), and injection site (rats and monkeys) were identified as potential target 
tissues in the pivotal 6-month (rat), and 9-month (monkey) repeat-dose toxicity studies, typical 
findings of the siRNA class. In rats, nonadverse microscopic liver findings included 
hepatocellular hypertrophy, vacuolation, increased mitoses, single cell necrosis, and basophilic 
granules in Kupffer cells. Basophilic granules were also observed in renal tubular epithelial cells. 
These changes were accompanied by minimal increases in bilirubin (female rats at high dose in 

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 39
12 April 2023
4-week study) or minimal to mild increases in ALT and AST (male rats at mid-dose in 6-month 
study). The microscopic changes were partially reversible and the clinical pathology changes 
were fully reversible at the end of the 13-week recovery period. In rats and monkeys, nonadverse 
microscopic findings at the injection sites and draining lymph nodes were noted at all dose levels 
in both sexes and were only partially reversible at the end of the recovery period. The NOAELs 
were 150 mg/kg (rats) and 300 mg/kg (monkeys); the highest doses tested. At the proposed 
clinical dose of 200 mg in this study, the estimated AUClast in humans is approximately 48-fold 
lower compared to the NOAEL in the 6-month rat study, and 187-fold lower compared to the 
NOAEL in the 9-month monkey study.
Based on the large exposure margins in the toxicology studies for the single agents, the risk for 
an exaggerated inflammatory response from the combination of these agents at the proposed 
doses in this Phase 2 clinical study is considered low. The potential for unpredicted off-target 
effects with the combination is considered negligible since nivolumab as an mAb is specific for 
its intended target and off-target activity has not been observed with SLGN even at very high 
exposure margins. While the liver and kidney were identified as target organs for VIR-2218, 
effects were observed at high exposure margins and exaggerated toxicity with SLGN at clinically 
relevant doses is low. Combination toxicity study of the 3 agents were not conducted since the 
potential risks of combining the 3 agents are predictable with low probability of occurrence at 
the proposed doses in this study. Therefore, the nonclinical studies of the single agents are 
considered sufficient for supporting this Phase 2 proof-of-concept study of the combination of 
3 mg SLGN orally once weekly and 0.3 mg/kg nivolumab IV once every 4 weeks and VIR-2218 
every 4 weeks.
Overall Benefit/Risk
Based on emerging safety data from the study, the sponsor decision was to 1) stop further dosing 
of nivolumab across all cohorts based on a benefit-risk assessment of the use of nivolumab in 
HBV cure, and to 2) stop all treatment in Cohort 2 Group B on account of low likelihood of 
efficacy of continuing with SLGN alone {Gane 2023, Janssen 2021}. Cohort 1 and Cohort 2 
(Group A) will continue receiving all study treatment without nivolumab administration.
Gilead has determined that all participants will complete the protocol-specified follow-up period 
through posttreatment Week 48, including those who have completed treatment or have stopped 
study treatment, and that the benefit-risk profile of this study is considered to remain positive 
following amendments to the protocol described above.
All participants enrolled in Cohort 1 were switched from their prescribed antiviral to TAF 
(25 mg) in order to ensure consistency of treatment. Additional risk mitigation strategies that 
have been incorporated into the protocol from the beginning of the study include a requirement 
for participants enrolled in this study to have adequate hematologic function at study entry and 
sufficient hepatic reserve (F0-F2). The protocol will follow participants closely with frequent 
virtual or in-clinic visits to routinely monitor AEs, laboratory abnormalities, ophthalmologic 
examinations, and vital sign changes. The study also allows for more frequent monitoring visits 
based on investigator’s discretion for safety monitoring. In addition, specific parameters that 
would lead to dose modification, interruption, or discontinuation are included in Section 6.9.1 

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 40
12 April 2023
and toxicity management of irAEs are included in Section 7.7.4. Based on historical enrollment 
rates (internal data), participants with CHB in this study will be enrolled in a staggered fashion 
over the course of at least 8 to 12 months. Enrollment in Cohorts 1 and 2 will be enrolled in 
parallel. In summary, potential risks of the novel HBV treatment regimens evaluated in this study 
have been minimized by dose selection, study design, and inclusion criteria.
An infectious disease pandemic may pose additional risks to study drug availability, study visit 
schedule, and adherence to protocol-specified safety monitoring or laboratory assessments. 
Refer to Appendix 11.2 further details on the pandemic risk assessment and mitigation plan.
1.6.
Compliance
This study will be conducted in compliance with this protocol, Good Clinical Practice (GCP), 
and all applicable regulatory requirements.

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 41
12 April 2023
2.
OBJECTIVES
The primary objectives of this study are as follows:
•
To evaluate the safety and tolerability of study treatment(s)
•
To evaluate the efficacy of study treatm’ent(s) as measured by the proportion of participants 
who achieve functional cure, defined as HBsAg loss and HBV DNA < lower limit of 
quantitation (LLOQ) at FU Week 24
The secondary objectives of this study are as follows: 
•
To evaluate the proportion of participants with HBsAg loss with and without anti-HBsAg 
seroconversion during the study
•
To evaluate in participants with CHB who are HBeAg positive at baseline, the proportion of 
participants who achieve HBeAg loss with and without anti-HBeAg seroconversion during 
the study
•
To evaluate the proportion of participants who remain off NUC treatment during FU
•
To evaluate the proportion of participants experiencing HBV virologic breakthrough (defined 
as confirmed HBV DNA ≥ LLOQ after 2 consecutive HBV DNA < LLOQ in participants 
who are complying with NUC therapy OR confirmed HBV DNA ≥ 1 log10 IU/mL increase 
from nadir on treatment) during study treatment(s)
CCI

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 42
12 April 2023
3.
STUDY DESIGN
3.1.
Endpoints
The primary endpoint of this study is as follows:
•
The proportion of participants who achieve functional cure, defined as HBsAg loss and HBV 
DNA < LLOQ at FU Week 24
The secondary endpoints of this study are as follows:
•
The proportion of participants with HBsAg loss with and without anti-HBsAg 
seroconversion during the study
•
The proportion of participants with HBeAg loss with and without anti-HBeAg 
seroconversion during the study in participants with CHB who are HBeAg positive at 
baseline
•
The proportion of participants who remain off NUC treatment during FU
•
The proportion of participants experiencing HBV virologic breakthrough during study 
treatment(s) as defined in Section 2
3.2.
Study Design
This is an open-label study to evaluate the safety and efficacy of SLGN-containing combination 
therapies in participants with CHB. 
Approximately 40 NUC-suppressed and 60 viremic CHB-infected participants, may be enrolled 
and assigned into a cohort below (Section 3.3). Each cohort will enroll a minimum of 20% of 
HBeAg-positive participants, and up to 20% of participants can have HBsAg ≤ 100 IU/mL.
3.2.1.
Changes to Study Design
Nivolumab dosing was stopped by Gilead based on emerging safety data from this study, other 
studies, and pertinent patient and prescriber insights {Cohen C. 2020}. As the study had 
completed enrollment and all participants were in treatment when the decision was made to stop 
nivolumab administration, the following measures were implemented:
•
Stop further nivolumab administration for all study participants across all cohorts.
•
Continue treatment with VIR-2218 and SLGN through Week 36 for Cohorts 1 and 2 
(Group A).

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 43
12 April 2023
•
Discontinue all study treatment for Cohort 2 Group B participants with next follow-up visit 
being EOT for those still in treatment period.
•
Stop all sample collections related to nivolumab. 
•
NUC therapy cessation is no longer required for our NUC treated patients (Cohort 1).
Figure 1.
GS-US-465-4439: Study Design Schema* 
IV = intravenous; NUC = nucleos(t)ide(s); PO = oral; Q4W = every 4 weeks; QD = once daily; QW = every week; 
SLGN = selgantolimod; SC = subcutaneous; TAF = tenofovir alafenamide 
a
Viremic participants who meet criteria to initiate NUC treatment will receive TAF 25 mg once daily for up to 36 weeks 
during the study. 
b
SLGN dosed while fasting once a week, on the same day, for 24 weeks.
c
Participants will continue to receive TAF per Section 3.5.
*
NOTE: Nivolumab dosing was stopped in this study and all treatments in Cohort 2 Group B were discontinued. This was a 
sponor decision based on a benefit risk assessment on the use of nivolumab in HBV cure. Rationale is provided in Section 1.3.1.
3.3.
Study Treatments
NUC-suppressed Cohort
Cohort 1 (n = 40):
•
TAF 25-mg tablet administered orally once daily for 36 weeks
•
VIR-2218 200 mg administered via SC injection once every 4 weeks for 24 weeks (total 
6 doses)
At Week 12, add-on and initiate the below treatment:
•
SLGN 3 mg (2  1.5-mg tablets) administered orally while fasting once a week on the same 
day for 24 weeks (total 24 doses)
•
Nivolumab 0.3 mg/kg administered IV once every 4 weeks for up to 24 weeks (up to 6 doses)
2:1 ratio
COHORT 1
(n = 40)
COHORT 2
Group A (n = 40) 
and 
Group B (n = 20)
TAF 25 mg PO administered QD for up to 36 weeks plus
VIR-2218 200 mg SC Q4W for 24 weeks
At Week 12, add-on the below treatment:
SLGN 3 mg PO administered QW for 24 weeks plus
nivolumab 0.3 mg/kg IV Q4W for up to 24 weeks
Group B: SLGNb 3 mg PO administered QW for up to 24 
weeks plus
nivolumab 0.3 mg/kg IV administered Q4W for up to 24 weeks
FOLLOW-UP 
FOR 
48 WEEKSc
Group A: VIR-2218 200 mg SC administered Q4W for 24 
weeks
At Week 12, add-on the below treatment:
SLGNb 3 mg PO administered QW for 24 weeks plus
nivolumab 0.3 mg/kg IV administered Q4W for up to 24 weeks 
NUC-SUPPRESSED
COHORT
(40 
PARTICIPANTS)
VIREMIC 
COHORTS
a
 (60 
PARTICIPANTS)
;--~-~i-----' 
.--------'-----
H 
\ I 
t 
i 
' 

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 44
12 April 2023
Viremic Cohort 
Cohort 2 (n = 60)
Participants will be randomized 2:1 into Cohort 2 (Groups A and B) and stratified by 
HBsAg > or ≤ 3 log10 IU/mL. 
Group A (n = 40): 
•
VIR-2218 200 mg administered via SC injection once every 4 weeks for 24 weeks (total 
6 doses)
At Week 12, add-on and initiate the below treatment:
•
SLGN 3 mg (2  1.5-mg tablets) administered orally while fasting once a week on the same 
day for 24 weeks (total 24 doses)
•
Nivolumab 0.3 mg/kg administered IV once every 4 weeks for up to 24 weeks (up to 6 doses)
Group B (n = 20): 
•
SLGN 3 mg (2  1.5-mg tablets) administered orally while fasting once a week on the same 
day for up to 24 weeks (up to 24 doses)
•
Nivolumab 0.3 mg/kg administered IV once every 4 weeks for up to 24 weeks (up to 6 doses)
3.4.
Duration of Treatment
The duration of study treatment are as follows: 
•
TAF 25-mg tablet will be administered orally once daily up to 84 weeks (inclusive of 
48 Week FU), as applicable, in Cohort 1.
•
VIR-2218 200 mg SC will be administered once every 4 weeks for 24 weeks (6 doses).
•
Nivolumab 0.3 mg/kg IV will be administered once every 4 weeks for up to 24 weeks (up to 
6 doses).
•
SLGN 3 mg (2  1.5-mg tablets) will be administered orally while fasting once a week on the 
same day for up to 24 weeks (up to 24 doses).
After completing study treatments all participants will undergo 48 weeks of FU.
NOTE: Nivolumab dosing was stopped in this study and all treatments in Cohort 2 Group B were 
discontinued. Rationale is provided in Section 1.3.1.

Selgantolimod 
Protocol GS-US-465-4439 
Gilead Sciences, Inc. 
3.5. 
Follow-up Period 
At the end of treatment, all participants will enter the FU period. 
• 
All pa1ticipants not on T AF treatment at EOT will enter a TFFU period. 
Final 
Amendment2 
• 
Paiticipants who are on T AF ti·eatment will continue T AF ti·eatment over the duration of 
study follow-up. 
• 
Paiticipants who initiated TFFU prior to the approval of this amendment and stopped NUC 
ti·eatment may continue off NUCs after discussion between paiticipant and investigator on 
the benefits and risks of continuing offNUCs in TFFU. Those who decide to restait NUCs 
would initiate commercial NUC treatment. 
3.6. 
Treatment Discontinuation Criteria 
Refer to Section 6.9 for detailed individual and ti·eatinent discontinuation criteria. 
3.7. 
End of Study 
The end of this study will be last paiticipant's last observation. 
3.8. 
Poststudy Care 
Once a paiticipant has completed study paiticipation, the long-tenn care of the paiticipant will be 
the responsibility of their primaiy ti·eating physicians. 
3.9. 
Source Data 
The source data for this study will be obtained from electronic data capture (EDC), centi·al 
laborato1y , local laborato1y, specialty laborato1y (for PK and/or PD data). 
3.9.1. 
Biomarker Samples to Address the Study Objectives 
T e spec1 1c ana yses may mc u e, ut w1 not e nmte to, t e 10mar ers 
and assays listed below. Because biomai·ker science is a rapidly evolving ai·ea of investigation, 
and AEs ai·e difficult to predict, it is not possible to specify prospectively all tests that will be 
done on the specimens provided. The testing outlined below is based upon the current state of 
scientific knowledge. It may be modified during or after the end of the study to remove tests no 
longer indicated and/or to add new tests based upon the growing state of the art knowledge. 
CONFIDENTIAL 
Page45 
12 April 2023 

Selgantolimod 
Protocol GS-US-465-4439 
Gilead Sciences, Inc. 
• 
Evaluation of HBV-specific T-cells response to hepatitis B antigen peptides by 
enzyme-linked immunospot assay (ELispot) 
• 
Evaluation of T-cell, NK-cell, and B-cell subsets by flow cytometiy 
• 
Evaluation of peripheral gene expression 
• 
Evaluation of peripheral T-cell and B-cell receptor repe1ioire 
• 
Evaluation of sernm and plasma cytokine levels 
• 
Evaluation of TLR8 single-nucleotide polymorphism (SNP) 
• 
Evaluation of HLA genotypes 
• 
Evaluation of whole blood ti·anscriptome profiling 
Final 
Amendment2 
Samples collected for biomarker assessments will be desn-oyed no later than 15 years after the 
end of the study or per countiy requirements. 
-
CONFIDENTIAL 
Page46 
12 April 2023 

Selgantolimod 
Protocol GS-US-465-4439 
Gilead Sciences, Inc. 
-
3.9.4. 
3.9.4.1. 
Pharmacokinetic Assessments 
Sparse Phaimacokinetic Collection 
Final 
Amendment2 
Spai·se (timed) blood PK samples will be obtained at specific in-clinic treatment visits at any 
time between 1 to 5 hours postdose relative to SLGN and/or VIR-2218 administration unless 
othe1wise indicated. 
See Section 6.1.10 for sparse PK sampling collection visit details. 
CONFIDENTIAL 
Page 47 
12 April 2023 

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 48
12 April 2023
CCI

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 49
12 April 2023
4.
PARTICIPANT POPULATION
4.1.
Number of Participants and Participant Selection
Cohorts 1 and 2 will enroll approximately 100 male and nonpregnant female participants, 
ages 18 to 65 years, inclusive, with CHB infection without the presence of cirrhosis, and who are 
viremic or virally suppressed on NUC treatment for at least 6 months. 
4.1.1.
Participant Replacement
Participants who discontinue before the end of study will not be replaced.
4.2.
Inclusion Criteria
Participants must meet all of the following inclusion criteria to be eligible for participation in this 
study:
1) Must have the ability to understand and sign a written informed consent form (ICF), which 
must be obtained prior to initiation of study procedures
2) Adult male and nonpregnant, nonlactating female participants, 18 to 65 years (19-65 years of 
age in Republic of Korea) of age inclusive based on the date of the screening visit
3) Documented evidence of chronic HBV infection (eg, HBsAg positive for more than 
6 months) with detectable HBsAg levels (> 1.5 log10 IU/mL) at screening
4) Screening electrocardiogram (ECG) without clinically significant abnormalities and with 
QTcF interval (QT corrected using Fridericia’s formula) ≤ 450 msec for males and 
≤ 470 msec for females.
5) Females of childbearing potential (as defined in Appendix 11.4) must have a negative serum 
pregnancy test at screening and a negative urine pregnancy test at baseline prior to 
enrollment
6) Male and female participants of childbearing potential who engage in heterosexual 
intercourse must agree to use protocol-specified method(s) of contraception as described in 
Appendix 11.4. Must be willing and able to comply with all study requirements.
Participants in Cohort 1 should meet the following additional criteria to be eligible to participate 
in this study:
7) Have been on a commercially available HBV NUC treatment(s) (ie, TAF, TDF, entecavir, 
adefovir, lamivudine, telbivudine, either as single agents or in combination) with no change 
in regimen for 3 months prior to screening and willing to initiate TAF 25 mg.

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 50
12 April 2023
8) Have a historical HBV DNA < LLOQ, measured at least once at local laboratory, 6 or more 
months prior to screening.
9) HBV DNA < LLOQ by central laboratory at screening 
Participants in Cohort 2 should meet the following additional criterion at screening to be eligible 
to participate in this study:
10) HBV DNA > 2000 IU/mL (HBeAg negative) and HBV DNA > 20,000 IU/mL (HBeAg 
positive) 
4.3.
Exclusion Criteria
Participants who meet any of the following exclusion criteria are not eligible to be enrolled in 
this study:
1) Extensive bridging fibrosis or cirrhosis as defined clinically by any 1 of the following:
a) Metavir ≥ 3 or Ishak fibrosis score ≥ 4 by a liver biopsy within 1 year of screening, or, in 
the absence of an appropriate liver biopsy, either:
b) Screening FibroTest score of > 0.48 and AST to platelet ratio index (APRI) > 1 by central 
laboratory, or
c) Historical (within ≤ 6 months of screening) or current FibroScan with a result > 9 kPa 
If liver biopsy is available, the liver biopsy result supersedes (b) and/or (c, if available)
If an appropriate liver biopsy is not available, fibrosis will be evaluated by (b) and/or (c, if 
available). In the event of discordance between (b) and (c), the FibroScan results will take 
precedence.
2) Participants meeting any of the following laboratory parameters at screening:
a) Hemoglobin < 12 g/dL (for males) or < 11 g/dL (for females)
b) White blood cell (WBC) count < 2500 cells/mm3
c) Neutrophil count < 1500 cell/mm3 (or < 1000 cell/mm3 if considered a physiological 
variant in a participant of African descent)
d) ALT ≥ 2  ULN (Cohort 1 only), ALT > 5  ULN (Cohort 2)
e) International normalized ratio (INR) > ULN unless the participant is stable on an 
anticoagulant regimen affecting INR
f)
Albumin < 3.5 g/dL

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 51
12 April 2023
g) Direct bilirubin > 1.5  ULN
h) Platelet Count < 100,000/μL
i)
Positive autoantibodies, defined as any one or more of the following:
i)
Antinuclear antibodies (ANA) > 1:80
ii) Smooth muscle antibodies (anti-SMA) > 1:80
iii) Antimitochondrial antibodies (AMA) > 1:40
iv) Anti-thyroid peroxidase (anti-TPO) > 35 IU/mL
j)
Estimated creatinine clearance (CLcr) < 60 mL/min (using the Cockcroft-Gault method) 
based on serum creatinine and actual body weight as measured at the screening 
evaluation, ie,
Male:
(140 − Age [years])  (Weight [kg]) = CLcr (mL/min)
72  (Serum Creatinine [mg/dL])
Female: 
(140 − Age [years])  (Weight [kg])  0.85 = CLcr (mL/min)
72  (Serum Creatinine [mg/dL])
3) Participants in Cohort 2: Received OAV treatment for HBV within 6 months of screening. 
Participants who meet criteria for initiation of NUC treatment as judged by the principal 
investigator (PI) during screening should be excluded from Cohort 2.
4) Coinfection with HIV, HCV, or HDV. Participants who are HCV antibody (Ab) or HDV Ab 
positive, but have a documented negative HCV RNA or HDV RNA, respectively, are 
eligible.
5) Current or prior history of HCC (eg, as evidenced by prior imaging) or screening 
α-fetoprotein ≥ 50 ng/mL without imaging to rule out HCC
6) Current or prior history of clinical hepatic decompensation (eg, ascites, encephalopathy, or 
variceal hemorrhage).
7) Malignancy within 5 years prior to screening, with the exception of specific cancers that are 
cured by surgical resection (eg, basal cell skin cancer). Participants under evaluation for 
possible malignancy are not eligible
8) Significant cardiovascular, ophthalmological, pulmonary, or neurological disease in the 
opinion of the investigator

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 52
12 April 2023
9) Diagnosis of any autoimmune disease (eg, systemic lupus erythematosus, rheumatoid 
arthritis, inflammatory bowel disease, ulcerative colitis, pneumonitis, autoimmune hepatitis, 
sarcoidosis, psoriasis of greater than mild severity, autoimmune uveitis, autoimmune 
nephritis, thyroiditis), poorly controlled diabetes mellitus, significant psychiatric illness, 
severe chronic obstructive pulmonary disease (COPD), hemoglobinopathy, retinal disease, or 
are immunosuppressed
10) Chronic liver disease of a non-HBV etiology (eg, Wilson’s disease, hemochromatosis, 
alpha-1-antitrypsin deficiency, cholangitis), except for nonalcoholic fatty liver disease
11) Received solid organ or bone marrow transplant
12) Received prolonged therapy with immunomodulators (eg, corticosteroids) or biologics 
(eg, mAb, IFN, nivolumab) within 6 months of screening
13) Have received inactivated vaccinations (eg, injectable influenza or pneumococcal) within 
4 weeks prior to randomization or received live vaccinations within 4 weeks prior to 
screening
14) Use of another investigational agent within 90 days of screening, unless allowed by the 
sponsor
15) Current alcohol or substance abuse judged by the investigator to potentially interfere with 
participant compliance
16) Known hypersensitivity to study drug or formulation excipients
17) Women who are breastfeeding, pregnant, or who wish to become pregnant during the course 
of the study
18) Female participants unwilling to refrain from egg donation and in vitro fertilization during 
and until at least 5 months after last study drug dose.
19) Male participants unwilling to refrain from sperm donation during and until at least 5 months 
after the last study drug dose
20) Use of any prohibited concomitant medications as described in Section 5.4
21) Believed by the study investigator to be inappropriate for study participation for any reason 
not otherwise listed.

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 53
12 April 2023
5.
INVESTIGATIONAL MEDICINAL PRODUCTS
5.1.
Randomization and Treatment Assignment
5.1.1.
Randomization/Enrollment
Entry into screening does not guarantee enrollment into the study. In order to manage the total 
study enrollment, Gilead, at its sole discretion, may suspend screening and/or enrollment at any 
site or study-wide at any time.
Screening and enrollment may be placed on hold based on investigator’s discretion, or in 
accordance with local regulation due to COVID-19 impact.
Cohort 1 and 2 will enroll in parallel. 
Cohort 2 (Group A and B): In the viremic cohorts, participants will be randomized 2:1 into 
Cohort 2 Groups A and B and stratified by HBsAg > or ≤ 3 log10 IU/mL. 
5.1.2.
Blinding
Blinding of treatment response is critical to the integrity of this clinical study and therefore, 
quantitative HBsAg will be blinded to the investigative sites for the duration of the study. The 
sponsor or designee may unblind investigators to individual participant results as needed for 
safety reasons.
5.2.
Description and Handling of SLGN, TAF, and VIR-2218, and Nivolumab
5.2.1.
Formulation
5.2.1.1.
Selgantolimod
Selgantolimod tablets, 1.5 mg, have been formulated with microcrystalline cellulose, mannitol, 
croscarmellose sodium, and magnesium stearate. Tablets are round, plain-faced, film-coated, and 
white. The white tablet film-coating contains polyvinyl alcohol, titanium dioxide, polyethylene 
glycol (PEG) 3350, and talc.
5.2.1.2.
Nivolumab
Commercially available product of nivolumab injection will be used for this study. Further 
information regarding formulation is available in the current approved product label for 
nivolumab.
NOTE: Nivolumab dosing was stopped by Gilead based on a sponsor benefit risk assessment. 
Rationale is provided in Section 1.3.1.

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 54
12 April 2023
5.2.1.3.
Tenofovir Alafenamide
Each film-coated tablet contains tenofovir alafenamide fumarate equivalent to 25 mg of TAF and 
have been formulated with croscarmellose sodium, lactose monohydrate, magnesium stearate, 
and microcrystalline cellulose. The tablets are yellow, round, film-coated, and debossed with 
“GSI” on one side of the tablet and “25” on the other side of the tablet.
5.2.1.4.
VIR-2218
VIR-2218 is a clear, colorless to pale yellow solution, which will be supplied by Gilead as a 
sterile solution for SC injection at a free acid concentration of 200 mg/mL. 
5.2.2.
Packaging and Labeling
5.2.2.1.
Selgantolimod
Selgantolimod, 1.5 mg, tablets are packaged in clear polyvinyl chloride 
(PVC)/polychlorotrifluoroethylene (PCTFE) film blister strips and sealed with aluminum foil 
lidding material. Each blister strip contains 4 round tablets sealed with an aluminum push 
through lidding material. Selgantolimod blister strips in the quantity needed for a 4-week supply 
of SLGN (ie, 2 strips/8 tablets) are placed into a paperboard child-resistant wallet system in 
accordance with the dosage strategy.
Study drug(s) to be distributed to centers in participating countries shall be labeled to meet 
applicable requirements of the United States (US) FDA, European Union (EU) Guideline to 
Good Manufacturing Practice -Annex 13 (Investigational Medicinal Products), and/or other local 
regulations.
5.2.2.2.
Nivolumab
Commercially available product of nivolumab injection will be used for the study. Study drug(s) 
to be distributed to centers in participating countries shall be labeled to meet applicable 
requirements of the US FDA, EU Guideline to Good Manufacturing Practice -Annex 13 
(Investigational Medicinal Products), and/or other local regulations (See Section 1.3.1).
5.2.2.3.
Tenofovir Alafenamide
TAF tablets are packaged in white, high-density polyethylene (HDPE) bottles and enclosed with 
a polypropylene continuous-thread, child-resistant cap, lined with an induction activated 
aluminum foil liner. Each bottle contains 30 tablets, silica gel desiccant, and polyester coil. Study 
drug(s) to be distributed to centers in participating countries shall be labeled to meet applicable 
requirements of the US FDA, EU Guideline to Good Manufacturing Practice -Annex 13 
(Investigational Medicinal Products), and/or other local regulations.

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 55
12 April 2023
5.2.2.4.
VIR-2218 
VIR-2218 Solution for Injection, 200 mg/mL, are packaged in 2R vials. Each vial is filled with 
0.5 mL solution. Study drug(s) to be distributed to centers in participating countries shall be 
labeled to meet applicable requirements of the US FDA, EU Guideline to Good Manufacturing 
Practice -Annex 13 (Investigational Medicinal Products), and/or other local regulations. 
5.2.3.
Storage and Handling
5.2.3.1.
Selgantolimod
The SLGN tablets are packaged in blister strips/wallet system should be stored below 30 °C. 
Storage conditions are specified on the label.
All drug products should be stored in a securely locked area, accessible only to authorized site 
personnel. To ensure the stability of the study drug and to ensure proper product identification, 
the drug product should not be stored in a container other than the container in which they are 
supplied. Measures that minimize drug contact with the body should always be considered 
during handling, preparation, and disposal procedures. Appropriate precautions should be 
followed to avoid direct eye contact or exposure when handling. Any unused study drug should 
be disposed of in accordance with local requirements.
5.2.3.2.
Nivolumab
Nivolumab vials must be stored in a secure area at 2-8 °C. Commercial product of nivolumab 
injection will be used for the study. Further information regarding storage and handling are 
available in the current approved product label for nivolumab (See Section 1.3.1).
5.2.3.3.
Tenofovir Alafenamide
TAF bottles should be stored at 25 C (77 F); excursions permitted from 15 C to 30 C (59 °F 
to 86 °F). Storage conditions are specified on the label. All drug products should be stored in a 
securely locked area, accessible only to authorized site personnel. To ensure the stability of the 
study drug and to ensure proper product identification, the drug product should not be stored in a 
container other than the container in which they are supplied. Measures that minimize drug 
contact with the body should always be considered during handling, preparation, and disposal 
procedures. Appropriate precautions should be followed to avoid direct eye contact or exposure 
when handling. Any unused study drug should be disposed of in accordance with local 
requirements.
5.2.3.4.
VIR-2218 
VIR-2218 solution for injection should be stored upright, at 2C to 8C. Storage conditions are 
specified on the label. Measures that minimize drug contact with the body should always be 
considered during handling, preparation, and disposal procedures. Appropriate precautions 
should be followed to avoid direct eye contact or exposure when handling. Any unused study 
drug should be disposed of in accordance with local requirements.

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 56
12 April 2023
5.3.
Dosage and Administration of SLGN, TAF, VIR-2218, and Nivolumab
5.3.1.
Selgantolimod
Selgantolimod will be supplied as tablets in strengths of 1.5 mg. SLGN 3 mg (2  1.5-mg tablets) 
will be administered while fasting once a week, on the same day. Participants must be fasting for 
at least 8 hours overnight (no food or drinks, except water) and continue through the morning, 
with no food or drinks, including water, 1 hour before to 2 hours after dosing. After 2 hours 
postdose, water is allowed; and after 4 hours postdose, participants are allowed food and drinks. 
Participants should take their other prescribed medications, including NUC treatment, no earlier 
than 2 hours after SLGN dosing or, if medications require dosing with food, no earlier than 
4 hours after SLGN dosing.
5.3.2.
Nivolumab
Nivolumab 40 mg/4 mL solution for injection will be supplied as single dose vials. Nivolumab 
0.3 mg/kg will be administered as IV infusion over 45-60 minutes. This slower rate of infusion 
was shown in a PK study of nivolumab to lower the risk of infusion-related reactions (IRRs) 
compared with a rapid rate of infusion over 30 minutes {OPDIVO 2022} (See Section 1.3.1).
5.3.3.
Tenofovir Alafenamide 
TAF 25-mg tablet orally once daily with food.
5.3.4.
VIR-2218 
VIR-2218, 200 mg/mL, solution for injection will be supplied as 0.5 mL single dose vials. 
VIR-2218 200 mg (2  0.5 mL solution) will be administered SC. 
5.4.
Prior and Concomitant Medications
Concomitant/previous medications including over-the-counter medications, vitamins, and 
supplements that have been taken up to 30 days prior to screening, and the ones taken up to 
4 weeks after discontinuation of study treatment need to be recorded in the source documents 
and electronic case report forms (eCRFs). 
For participants requiring treatment with a concomitant medication (including treatment of an 
AE) after starting study drug(s), the participant’s continued participation in the study should be 
re-evaluated by the investigator, in consultation with the medical monitor (or designee) on an 
ongoing, case-by-case basis. The investigator is authorized to administer acetaminophen or 
ibuprofen for the treatment of minor ailments occurring on study without prior consultation with 
the medical monitor. Acetaminophen is the preferred agent, followed by ibuprofen. The medical 
monitor should be consulted before administering acetaminophen at doses ≥ 2 g/day and 
ibuprofen as a single dose of > 200 mg or > 400 mg/day. Where an alternative to acetaminophen 
is needed, ibuprofen may be administered with milk or a light snack to minimize the chance of 
gastrointestinal side effects. Coadministration of an antiemetic (eg, ondansetron) at the discretion 
of the investigators is allowed in this study. Antiemetics will be administered following local 
guidelines and regulations.

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 57
12 April 2023
There are no substantial safety data regarding the concomitant administration of the COVID‑19 
vaccines and SLGN, TAF, VIR-2218, and nivolumab. Participants are allowed to receive the 
COVID‑19 vaccine, and study visits should continue as planned if vaccination occurs while the 
participant is on the study. Investigators should follow local guidelines for concomitant 
administration of the COVID-19 vaccines with the study drugs.
The following medications, not including protocol-specified study treatment(s), are prohibited in 
all cohorts for the entirety of the screening period through the end of study treatment due to 
interaction with study treatment(s) or the underlying HBV infection: 
•
Systemic chemotherapeutic agents, systemic corticosteroids (prednisone equivalent of 
> 10 mg/day for > 2 weeks, except short-term use of prednisone as a steroid burst [< 1 week 
of use] and treatment of irAEs in this study), immunosuppressants (eg, azathioprine), mAbs 
(eg, infliximab), or immunomodulating agents 
•
Investigational agents or devices for any indication (unless approved by Gilead) 
•
Hematologic-stimulating agents (eg, erythropoiesis-stimulating agents, granulocyte colony 
stimulating factor, thrombopoietin mimetics)
Additional Concomitant Medication Restrictions:
For Cohorts 1 and 2 (Group A)
During treatment with SLGN, use of the medications listed below and in Table 3 are prohibited 
for a minimum of 21 days prior to the first dose of SLGN through the last dose of SLGN plus 
7 days.
For Cohort 2 (Group B)
During treatment with SLGN, use of the medications listed below and in Table 4 are prohibited 
during the screening period and for a minimum of 21 days prior to the baseline/Day 1 visit 
through the last dose of SLGN plus 7 days.
Data from the DDI study indicates that cytochrome P450 (CYP)3A plays a major role in SLGN 
metabolism and therefore the administration of potent CYP3A inhibitors/inducers is not 
permitted in this study. Additionally, participants will be required to refrain from consumption of 
grapefruit juice, grapefruits, Seville oranges and Seville orange juice 72 hours prior to the first 
dose of SLGN and through the last dose of study treatment(s) plus 7 days.
The following list of medications and nutritional products are prohibited (as indicated above) due 
to potential interaction with SLGN. This is not an exhaustive list of agents. Any medications not 
in Table 4 should be reviewed with Gilead prior to dosing during the specified period.

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 58
12 April 2023
Table 4.
List of Agents Disallowed Due to Potential Interaction With SLGN
Drug Class
Agents Disallowed 
Antibiotics
Clarithromycin, rifabutin, rifampin, rifapentine, telithromycin, 
troleandomycin
Anticonvulsants
Carbamazepine, oxcarbazepine, phenobarbital, phenytoin
Antimycobacterials
Rifapentine, rifabutin, rifampin
Antidepressants
Nefazodone
Antifungals
Fluconazole, itraconazole, ketoconazole, posaconazole, voriconazole
Antiviral
VIEKIRA PAK (ombitasvir/paritaprevir/ritonavir & dasabuvir), telaprevir, 
danoprevir, boceprevir
Cardiac Medications
Mibefradil
Diuretics
Conivaptan
GI Motility Agentsa
Cisapride, metoclopramide, domperidone, mosapride citrate, pruclopride, 
itopride hydrochloride, levosulpride
Hematologic-stimulating agents 
Erythropoiesis-stimulating agents; granulocyte colony stimulating factor 
(GCSF); and thrombopoietin (TPO) mimetics
Herbal/Natural Supplements
St. John’s Wort, Echinacea, Milk thistle (ie, silymarin), Chinese herb 
sho-saiko-to (or Xiao-Shai-Hu-Tang)
Other
Apalutamide, avasimive, enzalutamide, idelalisib, lumacaftor, nitotane 
GI = gastrointestinal; SLGN = selgantolimod
a
GI motility agents are prohibited starting 2 days prior to SLGN dosing and for the 24 hours postdose.
There are no DDIs or contraindications mentioned in the product information for nivolumab 
{OPDIVO 2022}.
Additionally, given the safety profile of multiple doses of VIR-2218 has not been well 
characterized and the use of VIR-2218 in combination with IFN has not previously been 
assessed, the administration of any potentially hepatotoxic medications during the study should 
be considered only if no therapeutic alternative can be identified and after a careful consideration 
of the potential risks and benefits for the participant. Medications that are potentially hepatotoxic 
or associated with drug-induced liver injury (DILI) include, but are not limited to, the following 
{Bjornsson 2016}:
•
Aspirin > 3 g/day or ibuprofen ≥ 1.2 g/day
•
Tricyclic antidepressants
•
Valproate
•
Phenytoin
•
Amiodarone

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 59
12 April 2023
•
Anabolic steroids
•
Allopurinol
•
Amoxicillin-clavulanate
•
Minocycline
•
Nitrofurantoin
•
Sulfamethoxazole/trimethoprim
•
Erythromycin
•
Rifampin
•
Azole antifungals
•
Herbal or natural remedies
During treatment with TAF, use of the following medications listed below and in Table 5 are 
prohibited for a minimum of 21 days prior to the baseline/Day 1 visit through the end of study:
•
Investigational agents or devices for any indication
•
Agents that reduce renal function or compete for active tubular secretion with TFV 
(eg, cidofovir, acyclovir, valacyclovir, ganciclovir, famciclovir, valganciclovir, high dose or 
multiple nonsteroidal anti-inflammatory drugs [NSAIDs], probenecid)
•
Nephrotoxic agents (eg, aminoglycosides, amphotericin B, vancomycin, cidofovir, foscarnet, 
cisplatin, pentamidine, cyclosporine, tacrolimus)
•
Systemic chemotherapeutic agents, systemic corticosteroids (except short-term use of 
prednisone as a steroid burst [≤ 1 week of use] and treatment of irAEs in this study), 
immunosuppressant, or immunomodulating agents
Concomitant use of certain medications or herbal/natural supplements (inducers of drug 
transporters such as, P-glycoprotein) with study drug(s) may result in PK interactions. Any 
medications not on the list above should be reviewed with Gilead prior to randomization and 
during the study treatment.

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 60
12 April 2023
Table 5.
Disallowed Concomitant Medications While on TAF
Medication Class
Prohibited Medications
Anticonvulsants
Carbamazepine, oxcarbazepine, phenobarbital, phenytoin: 
may lower concentration of TAF and/or TFV
Antimycobacterials
Rifapentine, rifabutin, rifampin
Herbal/Natural Supplements
St. John’s Wort, echinacea, milk thistle (ie, silymarin), 
Chinese herb sho-saiko-to (or Xiao-Shai-Hu-Tang)
TAF = Tenofovir alafenamide; TFV = tenofovir
5.5.
Accountability for Investigational Medicinal Product: SLGN, TAF, 
VIR-2218, and Nivolumab
The investigator is responsible for ensuring adequate accountability of all used and unused study 
drug. This includes acknowledgment of receipt of each shipment of study drug (quantity and 
condition). All used and unused study drug dispensed to participants must be returned to the site.
Each study site must keep accountability records that capture:
•
The date received and quantity of study drug 
•
The date, participant number, and the study drug kit number dispensed
•
The date, quantity of used and unused study drug returned, along with the initials of the 
person recording the information

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 61
12 April 2023
5.5.1.
Investigational Medicinal Product Return or Disposal
Gilead recommends that used and unused study drug supplies be destroyed at the site. If the site 
has an appropriate standard operating procedure (SOP) for drug destruction as determined by 
Gilead, the site may destroy used (empty or partially empty) and unused study drug supplies in 
accordance with that site’s approved SOP. A copy of the site’s approved SOP will be obtained 
for electronic trial master file. If study drug is destroyed at the site, the investigator must 
maintain accurate records for all study drugs destroyed. Records must show the identification 
and quantity of each unit destroyed, the method of destruction, and the person who disposed of 
the study drug. Upon study completion, copies of the study drug accountability records must be 
filed at the site. Another copy will be returned to Gilead. 
If the site does not have an appropriate SOP for drug destruction, used and unused study drug 
supplies are to be sent to the designated disposal facility for destruction. The study monitor will 
provide instructions for return.
The study monitor will review study drug supplies and associated records at periodic intervals.

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 62
12 April 2023
6.
STUDY PROCEDURES
The study procedures to be conducted for each participant enrolled in the study are presented in 
tabular form in Appendix 11.3 and described in the text that follows. 
The investigator must document any deviation from the protocol procedures and notify Gilead or 
the contract (or clinical) research organization (CRO).
6.1.
Study Procedure Details 
6.1.1.
Medical History
Medical history including details regarding illnesses and allergies, date(s) of onset, and whether 
condition(s) is currently ongoing; history of prior and current use of nicotine or 
nicotine-containing products, alcohol, and illegal drugs; and history of current and prior (within 
previous 30 days) medication; and all prior medication administered to treat HBV infection
6.1.2.
Complete Physical Examination
A complete physical examination must include source documentation of general appearance, and 
the following body systems: head, neck, and thyroid; eyes, ears, nose, throat, mouth, and tongue; 
chest (excluding breasts); respiratory; cardiovascular; lymph nodes, abdomen; skin, hair, nails; 
musculoskeletal; neurological.
6.1.3.
Vital Signs
Assessment of vital signs will include measurement of resting blood pressure, pulse, respiratory 
rate, and oral, ear or forehead temperature. 
Blood pressure will be measured using the following standardized process:
•
Participant should sit for ≥ 5 minutes with feet flat on the floor and measurement arm 
supported so that the midpoint of the manometer cuff is at heart level
•
Use a mercury sphygmomanometer or automatic blood pressure device with an appropriately 
sized cuff with the bladder centered over the brachial artery
•
Measure and record the blood pressure to the nearest 2 mm Hg mark on the manometer or to 
the nearest whole number on an automatic device
6.1.4.
12-Lead Electrocardiograms
Participants will be required to rest in a supine position for 5 minutes prior to making a 
recording. The investigator (or qualified designee) should review the ECG traces recorded in real 
time for clinically significant abnormalities. On-treatment ECGs should be compared with the 
participant’s Day 1 as part of routine safety monitoring.

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 63
12 April 2023
QTc interval will be reported using Fridericia’s correction: QTcF = QT/RR1/3.
6.1.5.
Clinical Laboratory Tests/Assessments for Safety Evaluations
Blood and urine samples for safety evaluations will be collected throughout the study as outlined 
in Appendix 11.3.
•
Hematology: hematocrit, hemoglobin, platelet count, red blood cell (RBC) count, WBC 
count with differential (absolute and percentage), including lymphocytes, monocytes, 
neutrophils, eosinophils, basophils, and mean corpuscular volume (MCV)
•
Chemistry: alkaline phosphatase, AST, ALT, total bilirubin, direct and indirect bilirubin, 
total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), 
triglycerides, total protein, albumin, lactic acid dehydrogenase (LDH), creatine kinase (CK), 
bicarbonate, blood urea nitrogen, calcium, chloride, creatinine (see below), glucose, 
phosphorus, magnesium, potassium, sodium, uric acid, and lipase (reflex amylase testing is 
performed in participants with total lipase > 1.5 × ULN)
•
Coagulation panel: prothrombin time, activated partial thromboplastin time, and INR
•
Qualitative HBV serology (HBeAg and hepatitis B e antibody [HBeAb]; and HBsAg [reflex 
HBsAb if HBsAg is negative])
•
Quantitative HBV serology (HBsAg, HBcrAg, HBeAg [if applicable], and HBV RNA)
•
Serum sample for HBV viral sequencing, genotyping sample, and ddPCR
•
Quantitative plasma HBV DNA
•
Thyroid-stimulating hormone (TSH) levels
•
Pregnancy test: serum or urine β human chorionic gonadotropin (β-hCG) pregnancy test (if 
positive, requires immediate confirmation with serum β-hCG)
Follicle-stimulating hormone (FSH) testing (FSH test is required for female participants 
who are < 54 years old who are not on hormonal contraception and who have stopped 
menstruating for ≥ 12 months but do not have documentation of ovarian hormonal 
failure)
•
Urinalysis: appearance, blood, color, glucose, leukocyte esterase, pH, protein, urobilinogen. 
Reflex to microscopic urinalysis if dipstick result is abnormal.
•
Urine drug (amphetamines, cocaine, methadone, opiates) and alcohol screen
•
Autoantibodies: ANA, anti-SMA, AMA, and anti-TPO

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 64
12 April 2023
6.1.6.
Creatinine Clearance
Creatinine clearance is calculated by the Cockcroft-Gault equation {Cockcroft 1976} using 
actual body weight (ABW).
Male: 
CLcr (mL/min) = [140 - age (years)]  ABW(kg)
72  Scr
Female:
 CLcr (mL/min) = [140 - age (years)]  ABW(kg)  0.85
72  Scr
Scr = serum creatinine (mg/dL)
ABW = actual body weight
6.1.7.
Ophthalmologic Examination
Ophthalmologic examinations will be performed as applicable for Cohorts 1 and 2 during 
screening, at Week 12, 24, 36, and early discontinuation (ED) to assess ophthalmologic findings, 
including slit lamp and fundoscopic examination (both eyes). An examination of the full retinal 
field should be conducted noting changes or abnormalities.
Additional symptoms-directed ophthalmologic examinations may be conducted at investigator’s 
discretion during the study for all participants in Cohorts 1 and 2.
See Section 6.6 and Schedule of Assessments in Appendix 11.3 for more details on time points 
for examination in specific cohorts. 
6.1.8.
HBV Sequence Analysis 
Sequence analysis of the HBV full genome may be performed (if applicable) to assess if the 
presence of mutations at baseline and/or enrichment at posttreatment time points are associated 
with treatment response. As it may not be known at the time of the visit whether a participant is 
viremic or if it will be their last study visit, a separate virology sample for potential sequence 
analyses will be collected at each study visit.
6.1.9.
Digital Droplet Polymerase Chain Reaction
If participant has HBV DNA ≤ LLOQ, ddPCR will be conducted. 
6.1.10.
Sparse PK Sampling
Sparse (timed) blood PK samples will be obtained at specific in-clinic treatment visits at any 
time between 1 to 5 hours postdose relative to SLGN and/or VIR-2218 administration unless 
otherwise indicated.

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 65
12 April 2023
Plasma concentrations of SLGN and VIR-2218 may be analyzed. Serum concentrations of 
nivolumab may be analyzed (as applicable, from existing samples).
•
Sparse PK collection visits for VIR-2218 in Cohort 1 and Cohort 2 Group A:
Baseline/Day 1 (predose and postdose), Weeks 12 and 20
•
Sparse PK collection visits for SLGN in Cohort 1 and Cohort 2 Group A: 
Weeks 12, 20, and 32 
•
Sparse PK collection visits for SLGN in Cohort 2 Group B:
Baseline/Day 1, Weeks 12 and 20 
6.1.12.
Biomarker Samples
Whole blood, serum, and plasma samples will be collected as detailed in Appendix 11.3 for 
biomarker analysis. Additional whole blood samples will be collected for PBMC isolation and 
gene expression (PaxGene RNA).
Reference Section 3.9 for additional information on Biomarker Samples.
CCI

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 66
12 April 2023
6.1.15.
Management of Participants Impacted by the COVID-19 Pandemic
Local regulation and guidance should be followed in the management of participants impacted 
by the COVID-19 pandemic. Study-specific guidance provided by Gilead regarding crisis 
management communications should also be referenced.
6.2.
Participant Enrollment and Treatment Assignment
Entry into screening does not guarantee enrollment into the study. In order to manage the total 
study enrollment, Gilead, at its sole discretion, may suspend screening and/or enrollment at any 
site or study-wide at any time.
Screening and enrollment may be placed on hold based on investigator’s discretion, or in 
accordance with local regulation due to COVID-19 impact.
6.3.
Pretreatment Assessments
6.3.1.
Prescreening Visit
At the investigator’s discretion, participants may be asked to consent to HBeAg testing prior to 
screening procedures in order to ensure the required minimum of 20% HBeAg-positive 
participants for each cohort. Once a participant’s HBeAg status has been confirmed, the 
participant may then be able to complete the screening procedures.
6.3.2.
Screening Visit
Participants will be screened within 45 days prior to baseline Day 1 visit. 
With Gilead’s approval, candidates who fail to meet eligibility criteria by screening evaluations 
may be re-screened if there is a reasonable expectation that the candidate will be eligible after 
repeat screening. Gilead must approve all re-screening requests.
CCI
CCI

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 67
12 April 2023
Retests of screening laboratory parameters are permitted once only if there is reason to believe 
the retest value will be within accepted parameters, if the initial value was either due to a sample 
processing error, inconsistent with a recent local laboratory result, or due to an extenuating 
circumstance (eg, intercurrent infection).
The following will be performed and documented at screening:
•
Written informed consent
•
Review of inclusion/exclusion criteria
•
Obtain medical history (including HBV disease, treatment history, and historical HBV 
genotype [if available] for cohort 1 only)
•
Review concomitant medications
•
Complete physical examination
•
Vital signs
•
Body weight and height
•
12-Lead ECG (participants must rest quietly in the supine position for a minimum of 
5 minutes prior to the recording)
•
Chest x-ray
•
Ophthalmologic examination
•
FibroScan (where available and as necessary for liver disease staging)
•
Sample collection for:
Safety laboratory tests (hematology, chemistry, and coagulation)
APRI, FibroTest, α-fetoprotein (computed tomography [CT] scan with contrast for 
participants with α-fetoprotein ≥ 50 ng/mL at screening)
Serology testing to exclude HCV, HDV, and HIV infection
Quantitative plasma HBV DNA
Serum sample for HBV viral sequencing (resistance surveillance) and ddPCR
Quantitative HBV serum HBsAg, HBcrAg, HBeAg (if not performed during 
prescreening), and HBV RNA 

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 68
12 April 2023
Qualitative HBV serology HBeAg, HBeAb (if not performed during prescreening), and 
HBsAg, HBsAb
Estimated CLcr (using the Cockcroft-Gault method)
Other screening laboratory tests: urinalysis, urine drug screen, alcohol screen, 
autoantibodies, quantification of TSH levels and serum β-hCG (females of childbearing 
potential only), FSH (test is required for female participants who are < 54 years old who 
are not on hormonal contraception and who have stopped menstruating for ≥ 12 months 
but do not have documentation of ovarian hormonal failure)
•
Record any SAEs and all AEs related to protocol-mandated procedures occurring after 
signing of the ICF.
Participants meeting all of the inclusion criteria and none of the exclusion criteria will return to 
the clinic within 45 days after screening for randomization into the study.
From the time of obtaining informed consent through the first administration of study drug, 
record all SAEs, as well as any AEs related to protocol-mandated procedures on the AE eCRF. 
All other untoward medical occurrences observed during the screening period, including 
exacerbation or changes in medical history, are to be considered medical history. See Section 7, 
Adverse Events and Toxicity Management, for additional details.
6.3.3.
Baseline/Day 1 Assessments
All baseline tests and procedures must be completed prior to the receipt of the first dose of study 
drug(s). Participants screened within 45 days before baseline will be eligible to participate in the 
study.
Initiation of treatment with study drug(s) should take place on the day of the baseline visit 
(Day 1). 
Cohorts 1 and 2
•
Vital signs 
•
Weight 
•
Review AEs 
•
Review concomitant medications
•
Complete physical examination 
•
12-Lead ECG (Participants must rest quietly in the supine position for a minimum of 
5 minutes prior to the recording)

Selgantolimod 
Protocol GS-US-465-4439 
Gilead Sciences, Inc. 
• 
Symptoms-directed ophthalmologic examination 
• 
Sample collection for: 
-
Safety laborato1y tests (hematology and chemistiy; coagulation) 
-
APRI and FibroTest 
-
Quantitative plasma HBV DNA 
-
Quantitative HBV sennn HBsAg, HBcrAg, HBeAg, and HBV RNA 
-
Qualitative HBV serology HBeAg, HBeAb, HBsAg, and HBsAb 
-
Sernm sample for HBV viral sequencing and genotyping sample (baseline) 
-
Sparse PK ( sparse PK for SLGN not required for Coho1is 1 and 2 [ Group A]) 
-
Urine pregnancy test (females of childbearing potential only) 
-
Urinalysis 
-
Estimated CLcr (using Cockcroft-Gault method) 
• 
I 
Final 
Amendment2 
• 
Perfo1m study diug dispensation, and adininisti·ation (TAF, as needed, VIR-2218 SC, and 
SLGN) 
• 
Biomarker Samples: collection of PBMC, whole blood, sennn, and plasma samples for 
biomarker analysis 
6.4. 
Randomization 
Viremic Cohort 2 (Group A and B) Only 
Paiiicipants will be randomized 2:1 into Coho1i 2 Group A and Band su-atified by HBsAg > or 
:S 3 log10 ID/mL. 
CONFIDENTIAL 
Page 69 
12 April 2023 

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 70
12 April 2023
6.5.
Treatment Schedule
Cohort 1:
•
Baseline/Day 1, Week 4, and Week 8 - SC VIR-2218 
•
Week 12, 16, and 20 - SC VIR-2218; add-on IV nivolumab 
•
Week 24, 28, and 32 - IV nivolumab
•
Oral TAF dose daily for 36 weeks 
•
Oral SLGN dose weekly for 24 weeks, starting Week 12 through Week 35
Cohort 2:
Group A:
•
Baseline/Day 1, Weeks 4 and 8 - SC VIR-2218
•
Weeks 12, 16, and 20 - SC VIR-2218; add-on IV nivolumab 
•
Weeks 24, 28, and 32 - IV nivolumab 
•
Oral SLGN dose weekly for 24 weeks, starting Week 12 through Week 35
Group B:
•
Baseline/Day 1, Weeks 4, 8, 12, 16, and 20 - IV nivolumab 
•
Oral SLGN dose weekly for 24 weeks, starting Day 1 through Week 23 
6.6.
Post-Day 1 Treatment Assessments
The post-Day 1 treatment assessments have a visit window of ± 2 days (except for 
Weeks 13 and 14 in Cohort 1 and Weeks 1, 2, 13, 14 in Cohort 2), and EOT will have a window 
of −5 days. Posttreatment assessments include the following, performed in a fasted state at all 
visits from baseline/Day 1 through EOT or in event of ED, unless specifically noted:
All participants will complete the following post-Day 1 study visits:
Cohort 1: Weeks 4, 8, 12, 13*, 14, 16, 20, 24, 28, 32, and 36 (EOT)
Cohort 2 Group A: Weeks 4, 8, 12, 13*, 14, 16, 20, 24, 28, 32, and 36 (EOT)
Cohort 2 Group B: Weeks 1*, 2, 4, 8, 12, 14, 16, 20, and 24 (EOT)

Selgantolimod 
Protocol GS-US-465-4439 
Gilead Sciences, Inc. 
Final 
Amendment2 
• 
Vital signs 
• 
Symptom-directed physical examination (at Weeks 4, 8, 14 to 32, if applicable) 
• 
Complete physical examination ( at Weeks 12 and EOT) 
• 
Weight (at Week 12, and EOT) 
• 
Review AEs and concomitant medications (at Weeks 1 *, 2, 4, 8, 12, 13*, and 14 to EOT) 
• 
12-lead ECG (Paiiicipants must rest quietly in the supine position for a minimum of 
5 minutes prior to the recording) (at Weeks 12 and EOT) 
• 
Sample collection for: 
• 
-
Safety laborato1y tests (hematology and chemistiy; coagulation) (at Weeks 4, 8, 12, 14 to 
EOT) 
-
APRI and FibroTest (at Weeks 12, and EOT) 
-
Quantitative plasma HBV DNA (at Weeks 4, 8, 12, 14 to EOT) 
-
Quantitative HBV sennn HBsAg, HBcrAg, HBeAg, and HBV RNA (at Weeks 4, 8, 12, 
14 to EOT) 
-
Qualitative HBV serology HBeAg, HBeAb, HBsAg, and HBsAb (at Weeks 4, 8, 12, 14 
to EOT) 
-
Spai·se PK samples (Coho1is 1 and 2 [Group A] at Day 1, Weeks 12, 20, and 32; Cohort 2 
[Group B] at Weeks 12 and 20) 
-
Sernm sample for HBV viral sequencing and genotyping sample (at Weeks 4, 8, 12, 14 to 
EOT) 
-
Urinalysis (4, 8, 12, 16 to EOT) 
-
Urine pregnancy test (females of childbeai·ing potential only; at Weeks 4, 8, 12, 16, 20, 
and EOT; and at Weeks 24, 28, and 32, if applicable) 
-
Estimated CLcr (using Cockcroft-Gault method) (at Weeks 12 and EOT) 
-
Quantification ofTSH levels at EOT (Coho1i 1 and 2 [Group A], Weeks 24 and 36; 
Coho1i 2 [Group B], Weeks 12 and 24) 
CONFIDENTIAL 
Page 71 
12 April 2023 

Selgantolimod 
Protocol GS-US-465-4439 
Gilead Sciences, Inc . 
• 
• 
Ophthalmologic Examination (- 4 to + 10 days of visit) 
-
Coho1i 1 and 2 [Group A]: Week 24 and 36 
Final 
Amendment2 
-
Coho1i 2 [Group B]: Week 12 and 24 and EOT for participants who stop dosing before 
Week 24. 
-
Symptom-directed ophthalmologic examination (at Weeks 4, 8, 14 to 32, if applicable) 
• 
Study treatment 
-
Study drng accountability and review dosing diaiy 
-
Study diug dispensation 
-
Study diug administration (Oral TAF, as needed, SC VIR-2218, and oral SLGN) 
* Treatment Assessments on Week 1 and Week 13 (Phone CallNirtual Visit) 
The following evaluations ai·e to be completed at phone call or virtual visit: 
• 
Review of AEs and concomitant medications 
• 
Review of dosing diaiy and treatment compliance 
6.7. 
Follow-up Assessments 
The FU assessments have the following visit windows: Coho1i 1: Week 1 (+ 3 days), Weeks 4 to 
16 (± 5 days), and Weeks 24 to 48 (± 14 days); Coho1i 2: Weeks 1 (± 2 days), and Weeks 4 to 16 
(± 5 days), and Weeks 24 to 48 (± 14 days). FU assessments include the following: 
• 
All paiticipants will complete following FU visits: Weeks 1 *, 4, 8*, 12, 16* (for women of 
childbeai·ing potential), 24 (Primaiy), 36, and 48 
• 
Vital signs (at Weeks 4 to 48) 
• 
Symptom-directed physical examination (at Weeks 4 to 48) 
• 
Symptom-directed ophthalmologic examination (at Weeks 4 to 48) 
CONFIDENTIAL 
Page 72 
12 April 2023 

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 73
12 April 2023
•
Weight (At Week 48 only)
•
12-lead ECG (At Week 48 only)
•
Review AEs and concomitant medications (At Week 1*, 8*, 16*, at Weeks 4 to 48)
•
Sample collection for:
Safety laboratory tests (hematology and chemistry; coagulation) (at Weeks 4 to 48)
APRI and FibroTest (at Weeks 12 and 48)
Quantitative plasma HBV DNA (at Weeks 4 to 48)
Quantitative HBV serum HBsAg, HBcrAg, HBeAg, and HBV RNA (at Weeks 4 to 48) 
Qualitative HBV serology HBeAg, HBeAb, HBsAg, and HBsAb (at Weeks 4 to 48)
•
Urine pregnancy test (females of childbearing potential only, every 4 weeks through 
Week 48; Week 8 and Week 16 collection will be a virtual/telephonic visit)
•
Serum sample for HBV viral sequencing and genotyping sample (baseline) (at Weeks 4 to 
48)
•
Estimated CLcr (using Cockcroft-Gault method) (at Week 48 only)
*FU Visit Week 1, Week 8, and Week 16 (Phone Call/Virtual Visit)
The following evaluations are to be completed at the FU Week 1 phone call or virtual visit:
•
Review of AEs and concomitant medications
•
Review of laboratory results from EOT visit to determine entry into TFFU
Participants who discontinue the study treatment(s) prematurely will be followed for the 
reminder of the study according to the defined study visits and procedures.
6.8.
Immunologic Testing
CCI

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 74
12 April 2023
6.8.1.
Biomarker Sample Collection During Treatment Period
Cohort 1
Baseline/Day 1 (predose), Week 12 (pre-SLGN dose, 4 and 24-72 hours postdose), Week 14 
(predose), Week 32 (pre-SLGN dose, 4 and 24-72 hours postdose).
Cohort 2
Group A:
Baseline/Day 1 (predose), Week 12 (pre-SLGN dose, 4 and 24-72 hours postdose), Week 14 
(predose), Week 32 (pre-SLGN dose, 4 and 24-72 hours postdose)
Group B:
Baseline/Day 1 (pre-SLGN dose, 4, and 24-72 hours postdose), Week 2 (predose), Week 20 
(pre-SLGN dose, 4, and 24-72 hours postdose) 
6.8.2.
Biomarker Sample Collection During Follow-up 
Biomarker samples will be collected at FU Week 24 for Cohorts 1 and 2.
6.9.
Assessments for Early Discontinuation of Study Treatment
6.9.1.
Criteria for Discontinuation of Study Treatment 
Study treatment(s) that are considered related by the investigator to any of the below event(s) 
will be held in a participant until resolution of the event:
•
Any study drug–related AE ≥ Grade 3
•
A confirmed, clinically significant laboratory test abnormality (other than ALT) ≥ Grade 3 
considered study drug(s) related by the investigator
CCI

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 75
12 April 2023
Study treatment(s) may be reinitiated following resolution of the above event(s) after discussion 
with the medical monitor. Study treatment(s) should be restarted in line with their preassigned 
schedules.
Study treatment(s) that are considered related by the investigator to any of the below events will 
be permanently discontinued:
•
Any on-treatment uveitis, confirmed by ophthalmologic evaluation
•
Any confirmed recurrence of study drug–related Grade 3 or 4 (excluding laboratory 
abnormalities) AE following dose interruption mandates permanent discontinuation of study 
drug(s)
•
Unacceptable toxicity or toxicity that, in the judgment of the investigator, compromises the 
ability to continue study-specific procedures or is considered not to be in the participant’s 
best interest
•
Any study drug–related Grade 4 AE (excluding laboratory abnormalities)
•
Any study drug–related ≥ Grade 3 AE not able to be medically managed (eg, nausea with 
antiemetics)
•
Any confirmed study drug–related laboratory abnormality ≥ Grade 3 following rechallenge
•
A clinically significant Grade 4 laboratory abnormality
•
Virological breakthrough: as defined in Section 2
Additional criteria for permanent discontinuation of study treatment(s):
•
Intercurrent illness that would, in the judgment of the investigator, affect assessments of 
clinical status to a significant degree
•
Hepatic disease progression or lack of efficacy defined as participants in Cohorts 1 and 2 
(Group A) who do not achieve HBsAg decline ≥ 0.2 log10 IU/mL at Week 12
•
Participant requests to discontinue for any reason
•
Participant noncompliance
•
Pregnancy during the study 
•
At the discretion of the investigator, Gilead, a regulatory agency or an institutional review 
board (IRB), or independent ethics committee (IEC).

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 76
12 April 2023
If a participant discontinues study dosing (eg, as a result of an AE), every attempt should be 
made to keep the participant in the study and continue to perform the required study-related FU 
and procedures.
6.9.2.
Criteria for Individual Dose Modification 
Dose modification and discontinuation criteria for participants with ALT elevations or flare by 
treatment and cohort are provided in Section 7.7 Toxicity Management
6.9.3.
Study and/or Cohort Discontinuation Criteria
Study treatment(s) that is considered related by the investigator(s) to the graded toxicities in a 
cohort will be held in all participants if ≥ 3 participants experience a Grade 3 AE or 
≥ 2 participants experience a Grade 4 or SAE (excluding ALT), in the same system organ class 
(SOC). Decisions to reinitiate continuation of dosing will be made by the medical monitor upon 
review of all safety data generated by participants dosed to date.
Study and/or cohort may be discontinued at the request of Gilead, a regulatory agency, or an IRB 
or IEC.
6.9.4.
Premature Study Discontinuation
A primary goal of this study is to assess the safety of a combination of products in participants 
with CHB. Therefore, every effort should be made to retain participants on study to assess safety 
outcomes. Participants who stop study treatments must therefore be maintained on study and 
continue study evaluations. 
If this is not possible or acceptable to the participant or investigator, the participant may be 
withdrawn from the study and an early study discontinuation visit should be performed. The 
early study discontinuation visit should be performed within 14 days from determination by 
participant or investigator of study discontinuation.
Other reasons for study discontinuation:
•
Request by participant to withdraw from study
•
Request by study investigator or participant’s primary physician/provider
The following assessments will be performed at the study discontinuation visit:
•
Perform complete physical examination
•
Ophthalmologic examination and chest x-ray, as needed
•
Collect vital signs and body weight

Selgantolimod 
Protocol GS-US-465-4439 
Gilead Sciences, Inc. 
Final 
Amendment2 
• 
12-lead ECG (Paiiicipant must rest quietly in the supine position for a minimum of 5 minutes 
prior to the recording) 
• 
Review AEs and concomitant medications 
• 
Obtain blood samples for laborato1y assessments as follows: 
-
Safety laborato1y tests (hematology and chemistiy and coagulation) 
-
Urinalysis 
-
Qualitative and quantitative HBV serology (HBsAg, HBcrAg, HBeAg, and HBV RNA) 
-
Quantitative plasma HBV DNA 
-
Sernm sample for HBV viral sequencing 
-
Sernm pregnancy test (females of childbeai·ing potential only) 
-
Estimated CLcr (using Cockcroft-Gault method) 
-
APRI and FibroTest 
-TSH 
6.10. 
End of Study 
The end of this study will be last paiiicipant's last observation. 
6.11. 
Poststudy Care 
Once a paiiicipant has completed their study paiiicipation, the long-tenn care of the paiiicipant 
will return to the responsibility of their primaiy ti·eating physicians. 
6.12. 
Sample Storage 
The stored biological samples may be used by Gilead or its research pa1iner for future testing to 
provide additional data. to answer questions that relate to the main study. At the end of this study, 
these sam les ma be retained in stora e b Gilead for a eriod u to 15 ears. 
CONFIDENTIAL 
Page 77 
12 April 2023 

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 78
12 April 2023
7.
ADVERSE EVENTS AND TOXICITY MANAGEMENT
7.1.
Definitions of Adverse Events and Serious Adverse Events
7.1.1.
Adverse Events
An AE is any untoward medical occurrence in a clinical study participant administered a study 
drug, which does not necessarily have a causal relationship with the treatment. An AE can 
therefore be any unfavorable and/or unintended sign, symptom, or disease temporally associated 
with the use of a study drug, whether or not the AE is considered related to the study drug. 
Adverse events may also include pretreatment or posttreatment complications that occur as a 
result of protocol-specified procedures or special situations (Section 7.1.3). 
An AE does not include the following:
•
Medical or surgical procedures such as surgery, endoscopy, tooth extraction, and transfusion. 
The condition that led to the procedure may be an AE and must be reported.
•
Preexisting diseases, conditions, or laboratory abnormalities present or detected before the 
screening visit that do not worsen.
•
Situations where an untoward medical occurrence has not occurred (eg, hospitalization for 
elective surgery, social and/or convenience admissions).
•
Overdose without clinical sequelae (Section 7.1.3).
•
Any medical condition or clinically significant laboratory abnormality with an onset date 
before the ICF is signed and not related to a protocol-associated procedure is not an AE but 
rather considered to be preexisting and should be documented as medical history.
Preexisting events that increase in severity or change in nature after study drug initiation or 
during or as a consequence of participation in the clinical study will also be considered AEs.
7.1.2.
Serious Adverse Events
An SAE is defined as an event that, at any dose, results in the following:
•
Death
•
A life-threatening situation (Note: The term “life-threatening” in the definition of “serious” 
refers to an event in which the participant was at risk of death at the time of the event; it does 
not refer to an event that hypothetically might have caused death if it were more severe.)
•
In-patient hospitalization or prolongation of existing hospitalization

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 79
12 April 2023
•
Persistent or significant disability/incapacity
•
A congenital anomaly/birth defect
•
A medically important event or reaction: Such events may not be immediately 
life-threatening or result in death or hospitalization but may jeopardize the participant or may 
require intervention to prevent one of the other outcomes constituting SAEs. Medical and 
scientific judgment must be exercised to determine whether such an event is reportable under 
expedited reporting rules. Examples of medically important events include intensive 
treatment in an emergency room or at home for allergic bronchospasm; blood dyscrasias or 
convulsions that do not result in hospitalization; and development of drug dependency or 
drug abuse. 
7.1.3.
Study Drugs and Gilead Concomitant Therapy Special Situations Reports
Special situation reports (SSRs) include all reports of medication error, abuse, misuse, overdose, 
occupational exposure, drug interactions, exposure via breastfeeding, unexpected benefit, 
transmission of infectious agents via the product, counterfeit of falsified medicine, and 
pregnancy regardless of an associated AE. 
Medication error is any unintentional error in the prescribing, dispensing, preparation for 
administration or administration of a study drug while the medication is in the control of a health 
care professional, patient, or consumer. Medication errors may be classified as a medication error 
without an AE, which includes situations of missed dose, medication error with an AE, 
intercepted medication error, or potential medication error.
Abuse is defined as persistent or sporadic intentional excessive use of a study drug by a 
participant.
Misuse is defined as any intentional and inappropriate use of a study drug that is not in 
accordance with the protocol instructions or the local prescribing information.
An overdose is defined as an accidental or intentional administration of a quantity of a study 
drug given per administration or cumulatively which is above the maximum recommended dose 
as per protocol or in the product labeling (as it applies to the daily dose of the participant in 
question). In cases of a discrepancy in drug accountability, overdose will be established only 
when it is clear that the participant has taken the excess dose(s). Overdose cannot be established 
when the participant cannot account for the discrepancy, except in cases in which the 
investigator has reason to suspect that the participant has taken the additional dose(s).
Occupational exposure is defined as exposure to a study drug as a result of one’s professional or 
nonprofessional occupation.
Drug interaction is defined as any drug/drug, drug/food, or drug/device interaction.

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 80
12 April 2023
Unexpected benefit is defined as an unintended therapeutic effect where the results are judged to 
be desirable and beneficial. 
Transmission of infectious agents is defined as any suspected transmission of an infected agent 
through a Gilead study drug.
Counterfeit or falsified medicine: Any study drug with a false representation of (a) its identity, 
(b) its source, or (c) its history.
7.2.
Assessment of Adverse Events and Serious Adverse Events
The investigator or qualified subinvestigator is responsible for assessing AEs and SAEs for 
causality and severity, and for final review and confirmation of accuracy of event information 
and assessments.
7.2.1.
Assessment of Causality for Study Drugs and Procedures
The investigator or qualified subinvestigator is responsible for assessing the relationship to study 
drug using clinical judgment and the following considerations:
•
No: Evidence exists that the AE has an etiology other than the study drug. For SAEs, an 
alternative causality must be provided (eg, preexisting condition, underlying disease, 
intercurrent illness, concomitant medication).
•
Yes: There is reasonable possibility that the AE may have been caused by the study drug.
It should be emphasized that ineffective treatment should not be considered as causally related in 
the context of AE reporting. 
The relationship to study procedures (eg, invasive procedures such as venipuncture or biopsy) 
should be assessed using the following considerations:
•
No: Evidence exists that the AE has an etiology other than the study procedure.
•
Yes: The AE occurred as a result of protocol procedures (eg, venipuncture).
7.2.2.
Assessment of Severity 
The severity of AEs will be graded using the Gilead Sciences Inc. (GSI) Toxicity Grading Scale, 
Version 01 April 2015, with the exception of IRRs. For each episode, the highest grade attained 
should be reported as defined in the Toxicity Grading Scale (Appendix 11.5).
Grading of IRRs will be done according to the Common Terminology Criteria for Adverse 
Events (CTCAE) Version 5.0 found on the National Cancer Institute (NCI) website:
https://ctep.cancer.gov/protocoldevelopment/electronic_applications/docs/CTCAE_v5_Quick_R
eference_5x7.pdf

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 81
12 April 2023
7.3.
Investigator Reporting Requirements and Instructions 
7.3.1.
Requirements for Collection Prior to Study Drug Initiation
After informed consent, but prior to initiation of study medication, the following types of events 
must be reported on the applicable eCRFs: all SAEs and AEs related to protocol-mandated 
procedures.
7.3.2.
Adverse Events
Following initiation of study medication, collect all AEs, regardless of cause or relationship, 
until the end of the study including the posttreatment FU visit and report them on the eCRFs as 
instructed.
All AEs should be followed until resolution or until the AE is stable, if possible. Gilead may 
request that certain AEs be followed beyond the protocol-defined FU period.
7.3.3.
Serious Adverse Events
All SAEs, including deaths regardless of cause or relationship, that occur after the participant 
first consents to participate in the study (ie, signing the ICF) and throughout the duration of the 
study, including the posttreatment FU visit, must be reported on the applicable eCRFs and to 
Patient Safety (PS, formerly Global Patient Safety) as instructed below in this section. This also 
includes any SAEs resulting from protocol-associated procedures performed after the ICF is 
signed.
Investigators are not obligated to actively seek SAEs after the protocol-defined FU period; 
however, if the investigator learns of any SAEs that occur after the protocol-defined FU period 
has concluded and the event is deemed relevant to the use of study drug, the investigator should 
promptly document and report the event to Gilead PS.
Instructions for reporting SAEs are described in Section 7.4.1.
7.3.4.
Study Drug Special Situations Reports
All study drug SSRs that occur from study drug initiation and throughout the duration of the 
study, including the posttreatment FU visit, must be reported to Gilead PS (Section 7.4.2). 
Adverse events and SAEs resulting from SSRs must be reported in accordance to the AE and 
SAE reporting guidance (Section 7.3).
7.3.5.
Concomitant Therapy Reports
7.3.5.1.
Gilead Concomitant Therapy Special Situations Report
Special situation reports involving a Gilead concomitant therapy (not considered study drug), 
that occurs after the participant first consents to participate in the study (ie, signing the ICF) and 

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 82
12 April 2023
throughout the duration of the study, including the posttreatment FU visit, must be reported to 
Gilead PS utilizing the paper SSR (Section 7.4.2.2).
7.3.5.2.
Non-Gilead Concomitant Therapy Report
Special situations involving non-Gilead concomitant medications does not need to be reported on 
the SSR form; however, for special situations that result in AEs due to a non-Gilead concomitant 
medication, the AE should be reported on the AE form. 
Any inappropriate use of concomitant medications prohibited by this protocol should not be 
reported as “misuse,” but may be more appropriately documented as a protocol deviation.
All clinical sequelae in relation to these SSRs will be reported as AEs or SAEs at the same time 
using the AE eCRF and/or the SAE report form. Details of the symptoms and signs, clinical 
management, and outcome will be reported, when available.
7.4.
Reporting Process for Serious Adverse Events and Special Situation Reports
7.4.1.
Serious Adverse Event Reporting Process
•
For fatal or life-threatening events, copies of hospital case reports, autopsy reports, and other 
documents are also to be transmitted by email or fax when requested and applicable. 
Transmission of such documents should occur without personal participant identification, 
maintaining the traceability of a document to the participant identifiers.
•
Additional information may be requested to ensure the timely completion of accurate safety 
reports.
•
Any medications necessary for treatment of the SAE must be recorded onto the concomitant 
medication section of the participant’s eCRF and the SAE narrative section of the Safety 
Report Form eCRF.
7.4.1.1.
Electronic Serious Adverse Event Reporting Process 
•
Site personnel will record all SAE data on the applicable eCRFs and from there transmit the 
SAE information to Gilead PS within 24 hours of the investigator’s knowledge of the event 
from ICF signature throughout the duration of the study, including the protocol-required 
posttreatment FU period. Detailed instructions can be found in the eCRF completion 
guidelines.

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 83
12 April 2023
•
If for any reason it is not possible to record and transmit the SAE information electronically, 
record the SAE on the paper SAE reporting form and transmit within 24 hours to:
Gilead PS
Email: Safety_fc@gilead.com 
or
Fax: 1-650-522-5477
•
As soon as it is possible to do so, any SAE reported via paper must be transcribed on the 
applicable eCRFs according to instructions and within the timelines outlined in the eCRF 
completion guidelines.
•
If an SAE has been reported via a paper form because the eCRF database has been locked, no 
further action is necessary. If the database is not locked, any SAE reported via paper must be 
transcribed as soon as possible on the applicable eCRFs and transmitted to PS.
•
For fatal or life-threatening events, copies of hospital case reports, autopsy reports, and other 
documents are also to be submitted by email or fax when requested and applicable. 
Transmission of such documents should occur without personal participant identification, 
maintaining the traceability of a document to the participant identifiers.
•
Additional information may be requested to ensure the timely completion of accurate safety 
reports.
•
Any medications necessary for treatment of the SAE must be recorded onto the concomitant 
medication section of the participant’s eCRF and the SAE narrative section of the Safety 
Report Form eCRF.
7.4.2.
Special Situations Reporting Process 
7.4.2.1.
Paper Special Situations Reporting Process for Study Drug
•
All SSRs will be recorded on the SSR form and transmitted by emailing or faxing the report 
form within 24 hours of the investigator’s knowledge of the event to the attention of Gilead 
PS from study drug initiation throughout the duration of the study, including the 
protocol-required posttreatment FU period.
Gilead PS
Email: Safety_fc@gilead.com 
or
Fax: 1-650-522-5477

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 84
12 April 2023
7.4.2.2.
Reporting Process for Gilead Concomitant Medications
•
Special situations that involve Gilead concomitant medications that are not considered study 
drug must be reported within 24 hours of the investigator’s knowledge of the event to Gilead 
PS utilizing the paper SSR form to:
Gilead PS
Email: Safety_fc@gilead.com 
or
Fax: 1-650-522-5477
•
Any inappropriate use of concomitant medications prohibited by this protocol should not be 
reported as “misuse,” but may be more appropriately documented as a protocol deviation.
•
Special situations involving non-Gilead concomitant medications do not need to be reported 
on the SSR form; however, special situations that result in AEs due to a non-Gilead 
concomitant medication, must be reported as an AE.
7.4.2.3.
Pregnancy Reporting Process
•
The investigator should report pregnancies in female study participants and/or female 
partners of male participants who are identified after initiation of study drug and throughout 
the study, including the posttreatment FU period, to Gilead PS using the pregnancy report 
form within 24 hours of becoming aware of the pregnancy. Contact details for transmitting 
the pregnancy report form are as follows:
Gilead PS
Email: Safety_fc@gilead.com 
or
Fax: 1-650-522-5477
•
The pregnancy itself is not considered an AE, nor is an induced elective abortion to terminate 
a pregnancy without medical reasons.
•
All other premature terminations of pregnancy (eg, a spontaneous abortion, an induced 
therapeutic abortion due to complications or other medical reasons) must be reported within 
24 hours as an SAE, as described in Section 7.4.1. The underlying medical reason for this 
procedure should be recorded as the AE term.
•
A spontaneous abortion is always considered to be an SAE and will be reported as described 
in Section 7.4.1. Furthermore, any SAE occurring as an adverse pregnancy outcome after 
study completion must be reported to the Gilead PS.
•
The participant should receive appropriate monitoring and care until the conclusion of the 
pregnancy. The outcome of the pregnancy/partner pregnancy should be reported to Gilead PS 
using the pregnancy outcome report form. If the end of the pregnancy/partner pregnancy 

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 85
12 April 2023
occurs after the study has been completed, the outcome should be reported directly to Gilead 
PS. Gilead PS contact information is as follows: email: Safety_FC@gilead.com and 
fax: +1 (650) 522-5477.
•
Refer to Appendix 11.4 for Pregnancy Precautions, Definition for Female of Childbearing 
Potential, and Contraceptive Requirements.
7.5.
Gilead Reporting Requirements
Depending on relevant local legislation or regulations, including the applicable US FDA CFR, 
the EU Clinical Trials Directive (2001/20/EC) and relevant updates, and other country-specific 
legislation or regulations, Gilead may be required to expedite to worldwide regulatory agencies 
reports of SAEs, which may be in the form of line listings, serious adverse drug reactions 
(SADRs), or suspected unexpected serious adverse reactions (SUSARs). In accordance with the 
EU Clinical Trials Directive (2001/20/EC), Gilead or a specified designee will notify worldwide 
regulatory agencies and the relevant IEC in concerned Member States of applicable SUSARs as 
outlined in current regulations.
Assessment of expectedness for SAEs will be determined by Gilead using reference safety 
information specified in the IB or relevant local label as applicable. 
All investigators will receive either a safety letter or quarterly SUSAR line listing (applicable for 
United Kingdom and European Economic Area sites) notifying them of relevant SUSAR reports 
associated with any study drug. The investigator should notify the IRB or IEC of SUSAR reports 
as soon as is practical, where this is required by local regulatory agencies, and in accordance 
with the local institutional policy. 
7.6.
Clinical Laboratory Abnormalities and Other Abnormal Assessments as 
Adverse Events or Serious Adverse Events
Laboratory abnormalities without clinical significance are not to be recorded as AEs or SAEs. 
However, laboratory abnormalities (eg, clinical chemistry, hematology, urinalysis) that require 
medical or surgical intervention or lead to study drug interruption, modification, or 
discontinuation must be recorded as an AE, as well as an SAE, if applicable. In addition, 
laboratory or other abnormal assessments (eg, ECG, x-rays, vital signs) that are associated with 
signs and/or symptoms must be recorded as an AE or SAE if they meet the definition of an AE 
or SAE as described in Sections 7.1.1 and 7.1.2. If the laboratory abnormality is part of a 
syndrome, record the syndrome or diagnosis (eg, anemia), not the laboratory result (ie, decreased 
hemoglobin).
Severity should be recorded and graded according to the GSI Grading Scale (see reference table 
in Appendix 11.5: Toxicity Grading Scale, Version 01 April 2015). For AEs associated with 
laboratory abnormalities, the event should be graded on the basis of the clinical severity in the 
context of the underlying conditions; this may or may not be in agreement with the grading of 
the laboratory abnormality.

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 86
12 April 2023
7.7.
Toxicity Management 
All clinical and clinically significant laboratory toxicities will be managed according to uniform 
guidelines detailed in Appendix 11.6.
•
Grade 3 and 4 clinically significant laboratory abnormalities should be confirmed by repeat 
testing within 3 calendar days of receipt of results and before study drug discontinuation, 
unless such a delay is not consistent with good medical practice
•
Clinical events and clinically significant laboratory abnormalities will be graded according to 
the Table for GSI Grading Scale for Severity of Adverse Events and Laboratory 
Abnormalities (Appendix 11.5)
•
When restarting study drug following resolution of the AE, the study drug should be restarted 
at full dose or modified dose that is dependent upon discussion with the medical monitor
•
Any recurrence of the study drug–related Grade 3 or 4 clinical or clinically significant 
laboratory AE following dose interruption mandates permanent discontinuation of study drug
•
Administration of study drug(s) may be discontinued due to a clinical or laboratory event. 
The medical monitor should be consulted prior to dose discontinuation of study drug(s) 
unless the investigator believes that immediate action is warranted to ensure the continued 
safety of the participant
•
Any questions regarding toxicity management should be directed to the medical monitor.
7.7.1.
Grades 1 and 2 Laboratory Abnormality or Clinical Event
Continue study drug at the discretion of the investigator.
7.7.2.
Grade 3 Laboratory Abnormality or Clinical Event
•
For Grade 3 laboratory abnormality or clinical event, study drug may be continued if the 
event is considered to be unrelated to study drug
•
For any study drug–related, Grade 3 AE, study drug should be held
•
For any study drug–related ≥ Grade 3 AE not able to be medically managed (eg, nausea with 
antiemetics), study drug should be permanently discontinued
•
For a confirmed laboratory abnormality, study drug–related Grade 3, study drug would be 
held until toxicity returns to ≤ Grade 2. If a laboratory abnormality recurs to ≥ Grade 3 
following rechallenge, study drug should be permanently discontinued, and the participant 
managed according to local practice. Recurrence of laboratory abnormalities considered 
unrelated to study drug may not require permanent discontinuation.

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 87
12 April 2023
•
For a Grade 3 clinical event, or clinically significant laboratory abnormality confirmed by 
repeat testing within 3 calendar days that is considered to be related to study drug, study drug 
should be withheld until the toxicity returns to  Grade 2
7.7.3.
Grade 4 Laboratory Abnormality or Clinical Event
•
For a Grade 4 clinical event or clinically significant Grade 4 laboratory abnormality 
confirmed by repeat testing within 3 calendar days, the study drug should be permanently 
discontinued, and the participant managed according to local practice. The participant should 
be followed as clinically indicated until the laboratory abnormality returns to Day 1 of 
treatment or is otherwise explained, whichever occurs first. A clinically significant Grade 4 
laboratory abnormality that is not confirmed by repeat testing should be managed according 
to the algorithm for the new toxicity grade.
•
A Grade 4 laboratory abnormality or clinical event that is not considered clinically 
significant by the investigator may also be tested for confirmation and study drug continued 
at the discretion of the investigator.
•
The study drug may be continued without dose interruption for a clinically nonsignificant 
Grade 4 laboratory abnormality (eg, Grade 4 CK after strenuous exercise or triglyceride 
elevation that is nonfasting or that can be medically managed).
7.7.4.
Toxicity Management of Immune-Related Adverse Events Observed With 
Nivolumab
Adverse events related to the use of immunomodulatory therapies such as nivolumab are 
immunologic in etiology. They may occur at any time from shortly after first dose to many 
months after the last dose and can affect multiple organs simultaneously. Most irAEs observed 
with anti-PD-1/programmed cell death ligand 1 (PD-L1) mAbs are reversible with early 
detection and treatment discontinuation or treatment with immunomodulating agents such as 
corticosteroids. Investigators should exercise clinical judgment regarding best clinical 
management, based on the symptoms and condition of the individual participant. 
General instructions:
•
Monitor all participants closely for signs and symptoms of irAEs, including signs related to 
gastrointestinal, endocrine, hepatic, ophthalmologic, or cardiac irAEs.
•
Early evaluations with radiographic imaging, relevant laboratory testing, procedures and 
speciality consultation should be considered.
•
Initiate high dose steroid (prednisone 1-2 mg/kg) when indicated for appropriate Grade 3-4 
irAEs.
•
The investigator must notify the Gilead medical monitor in a timely manner upon 
identification of any potential irAE regardless of grade or seriousness.

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 88
12 April 2023
•
Report all irAEs that meet serious criteria in accordance with Sections 7.3.3 and 7.4.
According to the approved product label for nivolumab, patients should be monitored 
continuously (at least up to 5 months after the last dose) as an ADR with nivolumab may occur at 
any time during or after discontinuation of therapy. 
For more detailed management guidance, refer to the current approved product label for 
nivolumab {OPDIVO 2022}.
7.7.5.
ALT Elevation or Flare Management on Treatment and Treatment-Free 
Follow-up
On-Treatment ALT Management
Participants with on-treatment serum ALT elevation > 2 × nadir or > 2 × baseline value and 
≥ 5 × ULN, with or without associated symptoms should be managed according to the guidance 
below. 
All elevated serum ALT should be confirmed as soon as possible and ideally within 3 days of 
receipt of results. During the visit, a clinical assessment of the participant should be performed. 
The assessment should include a physical examination, evaluation of the participant’s mental 
status, and the following laboratory tests: 
•
Laboratory parameters: serum ALT and AST, total bilirubin, GGT, INR, and serum albumin, 
alcohol screening
•
If the ALT elevation is confirmed, the central clinical laboratory will conduct reflex testing 
for plasma HBV DNA, serology for HBV (HBsAg, HBsAb, HBeAg and HBeAb), HDV, 
hepatitis A virus (HAV) IgM, HCV, and HEV
•
Liver biopsy may be collected for participants meeting Hy’s law (ALT > 3  ULN and Total 
Bilirubin > 2  ULN; AST > 3  ULN and Total Bilirubin > 2  ULN) with suspected DILI
Additional confirmatory tests such as HDV RNA, HDV IgM, and HEV RNA may be performed 
locally as per local regulations after further discussion with the Gilead’s Medical Monitor.
Based on the results of the confirmatory tests, the following study treatment modifications are 
recommended (Table 6). 

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 89
12 April 2023
Table 6.
Dose Modification and Monitoring
Liver Toxicity Parameters 
Action
Confirmed, ALT ≥ 10 × ULN without evidence of 
hepatic toxicity as defined below
Cohort 1: Hold VIR-2218 and SLGN treatment. 
Participant should be monitored weekly or more 
frequently if clinically indicated until ALT < 5 × ULN. 
Restarting VIR-2218 and/or SLGN treatment may be 
considered when ALT < 5  ULN in discussion with 
the medical monitor. Study treatment should be 
restarted in line with the original assigned 
administration schedule. 
Cohort 2: Initiate TAF 25 mg once daily and hold 
VIR-2218 and SLGN dose. Participant should be 
monitored weekly or more frequently if clinically 
indicated until ALT < 5 × ULN. Restarting VIR-2218 
and/or SLGN treatment may be considered when 
ALT < 5  ULN in discussion with the medical 
monitor. Study treatment should be restarted in line 
with the original assigned administration schedule.
Persistent ALT > 2 × baseline and ≥ 5 × ULN without 
evidence of hepatic toxicity, as defined below
Continue study treatment(s), ALT should be evaluated 
every 2 weeks or more frequently as clinically needed, 
until ALT < 5 × ULN
Confirmed ALT > 2 × nadir, with evidence of hepatic 
toxicity, defined as any one of the following confirmed 
laboratory abnormalities:
•
Total bilirubin > 2 × ULN
•
Elevated INR > 0.5 above baseline AND > ULN 
•
Abnormal serum albumin > 1 g/dL decrease from 
baseline 
Cohort 1: Permanently discontinue study treatment(s) 
except TAF 25 mg once daily. Participant should be 
monitored weekly until ALT < 5 × ULN, and total 
bilirubin, INR, and albumin values return to normal or 
baseline levels. 
Cohort 2: Initiate commercially approved NUC 
treatment once daily and permanently discontinue 
study treatment(s). Participant should be monitored 
weekly until ALT < 5 × ULN, and total bilirubin, 
albumin, and/or INR values return to normal or 
baseline levels 
ALT = alanine aminotransferase; INR = international normalized ratio; NUC = nucleos(t)ide(s); SLGN = selgantolimod; 
TAF = tenofovir alafenamide; ULN = upper limit of normal
Treatment-Free Follow-up ALT Management 
All participants not on NUC treatment will enter TFFU period after completion of study 
treatment, in which they will undergo close safety monitoring. The proportion of participants 
who achieve HBsAg loss or are able to remain off NUC therapy during TFFU period will be 
assessed. Table 7 provides guidance for initiating commercially approved NUC treatment, in 
participants who experience rebound of HBV DNA and ALT levels. Any deviation from the 
table should be discussed in advance with medical monitor. 
If unscheduled visits are required for ALT monitoring, a clinical assessment of the participant 
should be performed. The assessment should include a physical examination, evaluation of the 
participant’s mental status and the following laboratory tests: 

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 90
12 April 2023
•
Laboratory parameters: serum ALT and AST, total and direct bilirubin, GGT, INR, serum 
albumin, plasma HBV DNA, quantitative HBsAg, PBMC for immune profiling, and alcohol 
screen.
•
At the initial confirmatory visit, collect serology for HDV, HAV IgM, HCV, and HEV.
Participants with HBV DNA ≤ LLOQ and ALT elevation/flare meeting any of the below table 
criteria should be evaluated for alternative liver disease etiologies by the investigator and in 
discussion with the medical monitor. Liver biopsy may be collected at the investigator’s 
discretion.
Participants with HBV DNA > LLOQ and ALT elevation/flare should be managed according to 
the table below: 
Table 7.
Starting Commercial NUC Treatment Criteria
Liver Toxicity Parameters
Action
Confirmed ALT ≥ 10 × ULN with no evidence of 
hepatic toxicity, as defined below.
Initiate NUC treatment and monitor weekly until ALT 
< 5 × ULN, and every 2 weeks until ALT < 2  ULN, 
or more frequently if clinically indicated.
ALT ≥ 5  ULN without evidence of hepatic toxicity, 
as defined below
ALT should be evaluated every 2 weeks or more 
frequently as clinically needed, until ALT < 2 × ULN. 
Confirmed ALT > ULN with evidence of hepatic 
toxicity, defined as any one of the following confirmed 
laboratory abnormalities: 
•
Total bilirubin > 2  nadir AND > 2.5 mg/dL in 
the absence of Gilbert’s disease
•
Elevated INR > 0.5 above nadir AND > ULN 
•
Abnormal serum albumin > 1 g/dL decrease from 
baseline
Initiate NUC treatment and monitor weekly or more 
frequently if clinically indicated until return to baseline 
levels or within normal reference range. Liver biopsy 
may be considered if appropriate for participant 
management.
Confirmed, HBV DNA > 20,000 IU/mL (HBeAg 
positive) or > 2,000 IU/mL (HBeAg negative) and
persistent ALT > ULN without evidence of hepatic 
toxicity, as defined above, for > 8 weeks
Initiating NUC treatment may be considered in 
discussion with the medical monitor. 
ALT = alanine aminotransferase; DNA = deoxyribonucleic acid; HBeAg = hepatitis B e antigen; HBV = hepatitis B virus; 
NUC = nucleos(t)ide(s); ULN = upper limit of normal

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 91
12 April 2023
8.
STATISTICAL CONSIDERATIONS
8.1.
Analysis Objectives and Endpoints
8.1.1.
Analysis Objectives
The primary objectives of this study are as follows:
•
To evaluate the safety and tolerability of study treatment(s)
•
To evaluate the efficacy of study treatment(s) as measured by the proportion of participants 
who achieve functional cure, defined as HBsAg loss and HBV DNA < LLOQ at FU Week 24
The secondary objectives of this study are as follows: 
•
To evaluate the proportion of participants with HBsAg loss with and without anti-HBsAg 
seroconversion during the study
•
To evaluate in participants with CHB who are HBeAg positive at baseline, the proportion of 
participants who achieve HBeAg loss with and without anti-HBeAg seroconversion during 
the study
•
To evaluate the proportion of participants who remain off NUC treatment during FU
•
To evaluate the proportion of participants experiencing HBV virologic breakthrough during 
study treatment(s)
CCI

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 92
12 April 2023
8.1.2.
Primary Endpoint
The primary efficacy endpoint is the proportion of participants who achieve functional cure, 
defined as HBsAg loss and HBV DNA < LLOQ at FU Week 24.
8.1.3.
Secondary Endpoint
Secondary efficacy endpoints of this study are as follows:
•
The proportion of participants with HBsAg loss with and without anti-HBsAg 
seroconversion during the study
•
The proportion of participants with HBeAg loss with and without anti-HBeAg 
seroconversion during the study in participants with CHB who are HBeAg positive at 
baseline
•
The proportion of participants who remain off NUC treatment during FU
•
The proportion of participants experiencing HBV virologic breakthrough during study 
treatment(s)
8.2.
Planned Analyses
8.2.1.
Primary Analysis
The primary analysis will be conducted after all participants within each cohort have completed 
FU Week 24 or early terminated from the study prior to FU Week 24.
8.2.2.
Final Analysis
The final analysis will be performed at the end of the study, after all participants have completed 
the study or early terminated from the study, outstanding data queries have been resolved or 
adjudicated as unresolvable, and the data have been cleaned and finalized. 
8.3.
Analysis Conventions
8.3.1.
Analysis Sets
8.3.1.1.
Efficacy
The primary analysis set for efficacy analysis is the Full Analysis Set (FAS), defined as all 
participants who are enrolled and have received at least 1 dose of study drug. Participants will be 
analyzed according to the treatment(s) to which they were assigned.
CCI

Selgantolimod 
Protocol GS-US-465-4439 
Gilead Sciences, Inc. 
8.3.1.2. 
Safety 
Final 
Amendment2 
The prirmuy analysis set for safety analyses is the Safety Analysis Set, defined as all paiiicipants 
who have received at least 1 dose of study drng. Paiticipants will be analyzed according to the 
treatment( s) they actually received. 
8.3.1.3. 
Phaimacokinetics 
The PK Analysis Set will include all enrolled paiiicipants who took at least 1 dose of study chug 
and have at least 1 nonmissing concentration value repo1ied by the PK laborato1y. 
8.3.1.4. 
Biomai·kers 
The Biomai·ker Analysis Set will include all enrolled paiiicipants who took at least 1 dose of the 
study chug and have at least 1 nonmissing biomai·ker value for each respective biomarker. 
8.3.1.5. 
Data Handling Conventions 
For the primaiy efficacy endpoint and the categorical seconda1y efficacy endpoints, missing data 
will be handled using a missing= failure approach. For continuous secondaiy endpoints, a 
missing = excluded approach will be employed. 
For selected analyses, HBsAg and HBV DNA data (IU/mL) will be transfonned to the 
logarithmic (base 10) scale (log10 IU/mL). 
For summaiy statistics, PK concentration values below the limit of quantitation will be treated as 
zero at predose and one-half of the LLOQ for postdose time points. 
8.4. 
Demographic and Baseline Characteristics Analysis 
Demographic and baseline measurements will be summarized by coho1i using standai·d 
descriptive methods. 
Demographic sUllllllai·ies will include sex, race/ethnicity, randomization stratification group (if 
applicable), and age. 
Baseline data will include a summaiy of body weight, height, body mass index, HBsAg 
(log10 IU/mL), HBV DNA (log10 IU/mL), HBeAg/HBeAb status, HBV genotype, ALT, and 
additional endpoints as necessaiy. 
CONFIDENTIAL 
Page 93 
12 April 2023 

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 94
12 April 2023
8.5.
Efficacy Analysis
8.5.1.
Primary Analysis
The primary analysis will be performed separately for each cohort when the last participant in 
each cohort reaches FU Week 24.
The proportion of participants who achieve functional cure at FU Week 24 will be analyzed for 
each treatment cohort. A point estimate with a 2-sided 95% exact CI will be constructed for the 
proportion using the binomial distribution (Clopper-Pearson method).
8.5.2.
Secondary Analyses
The secondary efficacy endpoints will be summarized by treatment cohort.
Continuous secondary endpoints will be summarized using conventional descriptive statistics 
(n, mean, SD, median, first quartile [Q1], third quartile [Q3], minimum, and maximum) by 
treatment cohort.
Categorical secondary endpoints will be summarized by number and percentage of participants 
who meet the endpoint by treatment cohort.
8.5.3.
Analysis of Other Endpoints of Interest
Continuous endpoints will be summarized using conventional descriptive statistics (n, mean, SD, 
median, Q1, Q3, minimum, and maximum) by treatment cohort.
Categorical endpoints will be summarized by number and percentage of participants who meet 
the endpoint by treatment cohort.
8.6.
Safety Analysis
Safety will be evaluated by assessment of clinical laboratory tests and AEs. The primary safety 
analysis will be evaluated through 30 days posttreatment. 
Posttreatment is defined as the following:
•
For VIR-2218 and nivolumab, posttreatment will start 4 weeks after last dose. 
•
For SLGN, posttreatment will start 1 week after last dose.
Posttreatment for each cohort will be based on the last study drug(s) end of the treatment window 
duration that is the longest.
The safety analysis will also be conducted through FU Week 24 as a secondary safety analysis.
All safety data collected during the study will be included in data listings.

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 95
12 April 2023
8.6.1.
Extent of Exposure
A participant’s extent of exposure to study drug data will be generated from the study drug 
administration data. Exposure data will be summarized by treatment cohort. 
8.6.2.
Adverse Events
Clinical and laboratory AEs will be coded using the MedDRA. System organ class, high-level 
group term (HLGT), high-level term (HLT), preferred term (PT), and lower-level term (LLT) 
will be attached to the clinical database.
Events will be summarized on the basis of the date of onset for the event. A treatment-emergent 
AE (TEAE) will be defined as:
•
Any AE that begins on or after the date of first dose of any study drug and no later than 
30 days posttreatment of SLGN + nivolumab ± VIR-2218 
•
Any AE leading to premature discontinuation of any study drug
Summaries (number and percentage of participants) of TEAEs (by SOC and PT) will be 
provided by treatment group:
•
All TEAEs
•
TEAEs of Grade 3 or higher
•
All TE treatment-related AEs
•
TE treatment-related AEs of Grade 3 or higher
•
All TE SAEs
•
All TE treatment-related SAEs
•
All TEAEs leading to premature discontinuation of any study drug
•
All TEAEs leading to temporary interruption of any study drug
•
AEs of special interest (eg, uveitis)
Summaries (number and percentage of participants) of all on-treatment and posttreatment 
potential irAEs (by SOC and PT), as defined by relevant MedDRA Standardised MedDRA 
Queries (SMQs), will be provided by treatment group. 
All AEs collected during the study will be presented in the data listings.

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 96
12 April 2023
8.6.3.
Laboratory Evaluations
Selected laboratory data (using units) will be summarized using only observed data. Data and 
change from baseline at all scheduled time points will be summarized.
Graded laboratory abnormalities will be defined using the grading scheme in Appendix 11.5.
Incidence of TE laboratory abnormalities, defined as values that increase at least one toxicity 
grade from baseline at any time postbaseline up to 30 days posttreatment of 
SLGN + nivolumab ± VIR-2218, will be summarized by treatment group. If baseline data are 
missing, then any graded abnormality (ie, at least a Grade 1) will be considered TE. 
This analysis will also be provided through FU Week 24.
All laboratory abnormalities will be included in the listings of laboratory data.
8.6.4.
Other Safety Evaluations
Individual data for ECG and vital signs measurements will be listed by participant and 
summarized for each treatment group by visit by incidence of events/abnormalities or descriptive 
statistical summaries (n, mean, SD, median, Q1, Q3, minimum, and maximum), as appropriate.
8.7.
Pharmacokinetic Analysis 
Plasma concentrations of SLGN and VIR-2218 may be analyzed. Serum concentrations of 
nivolumab may be analyzed (as applicable, from existing samples).
Concentration data from all sparse and intensive blood PK samples may be pooled with data 
from other studies and may be used for estimation of population PK parameters.
CCI
CCI
CCI

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 97
12 April 2023
CCI
CCI

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 98
12 April 2023
9.
RESPONSIBILITIES
9.1.
Investigator Responsibilities
9.1.1.
Good Clinical Practice
The investigator will ensure that this study is conducted in accordance with International Council 
for Harmonisation (of Technical Requirements for Pharmaceuticals for Human Use) (ICH) 
E6(R2) addendum to its guideline for GCP and applicable laws and regulations.
9.1.2.
Financial Disclosure
The investigator and subinvestigators will provide prompt and accurate documentation of their 
financial interest or arrangements with Gilead or proprietary interests in the study drug during 
the course of a clinical study. This documentation must be provided prior to the investigator’s 
(and any subinvestigator’s) participation in the study. The investigator and subinvestigator agree 
to notify Gilead of any change in reportable interests during the study and for 1 year following 
completion of the study. Study completion is defined as the date when the last participant 
completes the protocol-defined activities.
9.1.3.
Institutional Review Board/Independent Ethics Committee Review and 
Approval
The investigator (or Gilead as appropriate according to local regulations) will submit this 
protocol, ICF, and any accompanying material to be provided to the participant (such as 
advertisements, participant information sheets, or descriptions of the study used to obtain 
informed consent) to an IRB/IEC. The investigator will not begin any study participant activities 
until approval from the IRB/IEC has been documented and provided as a letter to the 
investigator.
Before implementation, the investigator will submit to and receive documented approval from 
the IRB/IEC any modifications made to the protocol or any accompanying material to be 
provided to the participant after initial IRB/IEC approval, with the exception of those necessary 
to reduce immediate risk to study participants.
9.1.4.
Informed Consent
The investigator is responsible for obtaining written informed consent from each individual 
participating in this study after adequate explanation of the aims, methods, objectives, and 
potential hazards of the study before undertaking any study-related procedures. The investigator 
must use the most current IRB- or IEC-approved ICF for documenting written informed consent. 
Each ICF (or assent as applicable) will be appropriately signed and dated by the participant or 
the participant’s legally authorized representative, the person conducting the consent discussion, 
and an impartial witness (if required by IRB or IEC or local requirements). 

Selgantolimod 
Protocol GS-US-465-4439 
Gilead Sciences, Inc. 
9.1.5. 
Confidentiality 
Final 
Amendment2 
The investigator must ensure that paiiicipants' anonymity will be strictly maintained and that 
their identities ai·e protected from unauthorized paiiies. Only an identification code and any other 
unique identifier(s) as allowed by local law (such as year of bi1ih) will be recorded on any fo1m 
or biological sample submitted to Gilead or the laborato1y. Laborato1y specimens must be 
labeled in such a way as to protect paiiicipant identity while allowing the results to be recorded 
to the proper pa1iicipant. Refer to specific laborato1y instructions. 
NOTE: The investigator must keep a screening log with details for all participants screened and 
emolled in the study, in accordance with the site procedures and regulations. Paiiicipant data will 
be processed in accordance with all applicable regulations. 
The investigator agrees that all info1mation received from Gilead, including but not limited to the 
IB, this protocol, case repo1i fonns (CRFs)/eCRFs, study diug info1mation, and any other study 
info1mation, remain the sole and exclusive prope1iy of Gilead during the conduct of the study 
and thereafter. This info1mation is not to be disclosed to any third pa1iy (except employees or 
agents directly involved in the conduct of the study or as required by law) without prior written 
consent from Gilead. The investigator fmi her agrees to take all reasonable precautions to prevent 
the disclosure by any employee or agent of the study site to any third paiiy or othe1wise into the 
public domain. 
9.1.6. 
Study Files and Retention of Records 
The investigator must maintain adequate and accurate records to enable the conduct of the study 
to be fully documented and the study data to be subsequently verified. These documents should 
be classified into at least the following 2 categories: (1) investigator's study file and 
(2) paiiicipant clinical source documents. 
The investigator's study file will contain the protocol/amendments, CRFs/eCRFs, governmental 
approval with conespondence, the ICF(s), dmg records, staff cmTiculum vitae and authorization 
fo1ms, and other appropriate documents and con espondence. 
The required source data should include sequential notes containing at least the following 
info1mation for each paiiicipant: 
CONFIDENTIAL 
Page 99 
12 April 2023 

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 100
12 April 2023
•
Participant identification
•
Documentation that participant meets eligibility criteria, ie, medical history, physical 
examination, and confirmation of diagnosis (to support inclusion and exclusion criteria)
•
Documentation of the reason(s) a consented participant is not enrolled
•
Participation in study (including study number)
•
Study discussed and date of informed consent
•
Dates of all visits
•
Documentation that protocol-specific procedures were performed
•
Results of efficacy parameters, as required by the protocol
•
Start and end date (including dose regimen) of study drug, including dates of dispensing and 
return
•
Record of all AEs and other safety parameters (start and end date; causality and severity) and 
documentation that adequate medical care has been provided for any AE
•
Concomitant medication (start and end date; dose if relevant; dose changes)
•
Date of study completion and reason for ED, if it occurs
All clinical study documents must be retained by the investigator for at least 2 years or according 
to local laws, whichever is longer, after the last approval of a marketing application in an ICH 
region (ie, US, Europe, or Japan) and until there are no pending or planned marketing 
applications in an ICH region; or, if no application is filed or if the application is not approved 
for such indication, for 2 years after the investigation is discontinued and regulatory authorities 
have been notified. Investigators may be required to retain documents longer if specified by 
regulatory requirements, by local regulations, or by an agreement with Gilead. The investigator 
must notify Gilead before destroying any clinical study records.
Should the investigator wish to assign the study records to another party or move them to another 
location, Gilead must be notified in advance.
If the investigator cannot provide for this archiving requirement at the study site for any or all of 
the documents, special arrangements must be made between the investigator and Gilead to store 
these records securely away from the site so that they can be returned sealed to the investigator 
in case of an inspection. When source documents are required for the continued care of the 
participant, appropriate copies should be made for storage away from the site.

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 101
12 April 2023
9.1.7.
Case Report Forms
An eCRF casebook will be completed by an authorized study personnel member whose training 
for this function is completed in the EDC system unless otherwise directed. The eCRF casebook 
will only capture the data required per the protocol schedule of events and procedures unless 
collected by a nonelectronic data capture vendor system (eg, central laboratory). The 
Inclusion/Exclusion Criteria and Enrollment eCRFs should be completed only after all data 
related to eligibility are available. Data entry should be performed in accordance with the CRF 
Completion Guidelines provided by Gilead. Subsequent to data entry, a study monitor may 
perform source data verification (SDV). System-generated or manual queries will be issued in 
the EDC system as data discrepancies are identified by the study monitor or Gilead personnel 
who routinely review the data for completeness, correctness, and consistency. The site 
investigator, site coordinator, or other designee is responsible for responding to the queries in a 
timely manner, within the system, either by confirming the data as correct or updating the 
original entry, and providing the reason for the update (eg, data entry error). Original entries as 
well as any changes to data fields will be stored in the audit trail of the system. Regular oversight 
by the principal investigator of the data entered into the EDC system is expected to occur on an 
ongoing basis throughout the study to ensure quality and completeness. At a minimum, before 
any interim, final, or other time points (as instructed by Gilead), the investigator will apply 
his/her electronic signature to confirm that the forms have been reviewed and that the entries 
accurately reflect the information in the source documents. At the conclusion of the study, Gilead 
will provide the site investigator with a read-only archive copy of the data entered. This archive 
must be stored in accordance with the records retention requirements outlined in Section 9.1.6.
9.1.8.
Investigator Inspections
The investigator will make available all source documents and other records for this study to 
Gilead’s appointed study monitors, to IRBs/IECs, or to regulatory authority or health authority 
inspectors.
9.1.9.
Protocol Compliance
The investigator is responsible for ensuring the study is conducted in accordance with the 
procedures and evaluations described in this protocol.
9.2.
Sponsor Responsibilities
9.2.1.
Protocol Modifications
Protocol modifications, except those intended to reduce immediate risk to study participants, 
may be made only by Gilead. The investigator must submit all protocol modifications to 
IRB/IEC and regulatory authorities in accordance with local requirements and receive 
documented IRB/IEC and regulatory authority approvals before modifications may be 
implemented.

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 102
12 April 2023
9.2.2.
Study Reports and Publications
A clinical study report (CSR) will be prepared and provided to the regulatory agency(ies) when 
applicable and in accordance with local regulatory requirements. Gilead will ensure that the 
report meets the standards set out in the ICH Guideline for Structure and Content of Clinical 
Study Reports (ICH E3). Note that an abbreviated report may be prepared in certain cases. For 
studies with sites in countries following the EU Regulation No. 536/2014, a CSR will be 
submitted within 1 year (6 months for pediatric studies, in accordance with Regulation [EC] 
No. 1901/2006) after the global end of study (as defined in Section 3.7).
Investigators in this study may communicate, orally present, or publish study data in scientific 
journals or other scholarly media in accordance with the Gilead clinical trial agreement.
9.3.
Joint Investigator/Sponsor Responsibilities
9.3.1.
Payment Reporting
Investigators and their study staff may be asked to provide services performed under this 
protocol (eg, attendance at investigator meetings). If required under the applicable statutory and 
regulatory requirements, Gilead will capture and disclose to federal and state agencies any 
expenses paid or reimbursed for such services, including any clinical study payments, meal, 
travel expenses or reimbursements, consulting fees, and any other transfer of value.
9.3.2.
Access to Information for Monitoring
The monitor is responsible for routine review of the CRF/eCRF at regular intervals throughout 
the study to verify adherence to the protocol and the completeness, consistency, and accuracy of 
the data being entered on them. The monitor should have access to any participant records 
needed to verify the entries in the CRF/eCRF. The investigator agrees to cooperate with the 
monitor to ensure that any problems detected through any type of monitoring (central, on-site) 
are resolved.
9.3.3.
Access to Information for Auditing or Inspections
Representatives of regulatory authorities or Gilead may conduct inspections or audits of the 
clinical study. If the investigator is notified of an inspection by a regulatory authority the 
investigator agrees to notify the medical monitor immediately. The investigator agrees to provide 
to representatives of a regulatory agency or Gilead access to records, facilities, and personnel for 
the effective conduct of any inspection or audit.
9.3.4.
Premature Study Termination
Both Gilead and the investigator reserve the right to terminate the study at any time. Should this 
be necessary, both parties will arrange discontinuation procedures and notify the participants, 
appropriate regulatory authority, and IRB/IEC. In terminating the study, Gilead and the 
investigator will ensure that adequate consideration is given to the protection of the participants’ 
interests.

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 103
12 April 2023
10.
REFERENCES
Attarwala H, Goel V, Madigan K, Akinc A, Robbie GJ. Development of a 
Pharmacokinetic-Pharmacodynamic (PK-PD) Model of Fitusiran, an 
Investigational RNAi Therapeutic Targeting Antithrombin for the Treatment of 
Hemophilia in Patients With and Without Inhibitors [Presentation]. International 
Society on Thrombosis and Haemostasis (ISTH) Congress; 2017 08-13 July; 
Berlin, Germany. 
Benias P, Min A. Goals of Antiviral Therapy for Hepatitis B: HBeAg Seroconversion, HBsAg 
Seroconversion, Histologic Improvement, and Possible Impact on Risk of 
Hepatocellular Carcinoma. Curr Hepatitis Rep 2011;10.
Bjornsson ES. Hepatotoxicity by Drugs: The Most Common Implicated Agents. International 
journal of molecular sciences 2016;17:224.
Buti M, Berg T, Chan H, Suri V, Wang H, Gaggar A, et al. Evaluation of HBV Outcomes After 
Treatment Discontinuation From 4 Phase 3 Studies [Poster THU-205]. EASL: 
The International Liver Congress; 2019 10-14 April; Vienna, Austria. 
Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron 
1976;16:31-41.
Cohen C., Block J., Ibrahim Y. The Voice of the Patient: Living with Chronic Hepatitis B. 
Hepatitis B Foundation: 2020:55. 
Dienstag JL, Goldin RD, Heathcote EJ, Hann HWL, Woessner M, Stephenson SL, et al. 
Histological outcome during long-term lamivudine therapy. Gastroenterology 
2003;124 (1):105-17.
El-Khoueiry AB, Sangro B, Yau T, Crocenzi TS, Kudo M, Hsu C, et al. Nivolumab in patients 
with advanced hepatocellular carcinoma (CheckMate 040): an open-label, 
non-comparative, phase 1/2 dose escalation and expansion trial. Lancet 2017;389 
(10088):2492-502.
European Association for the Study of the Liver (EASL). EASL Clinical Practice Guidelines: 
Management of chronic hepatitis B virus infection [published version]. 
J Hepatology 2012;57:167-85.
European Association for the Study of the Liver (EASL). EASL 2017 Clinical Practice 
Guidelines on the management of hepatitis B virus infection. [Article In Press]. 
J Hepatol 2017:1-29.

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 104
12 April 2023
Evans A, Riva A, Cooksley H, Phillips S, Puranik S, Nathwani A, et al. Programmed death 1 
expression during antiviral treatment of chronic hepatitis B: Impact of hepatitis B 
e-antigen seroconversion. Hepatology 2008;48 (3):759-69.
Fattovich G, Giustina G, Sanchez-Tapias J, Quero C, Mas A, Olivotto PG, et al. Delayed 
clearance of serum HBsAg in compensated cirrhosis B: relation to interferon 
alpha therapy and disease prognosis. Am J Gastroenterol 1998;93 (6):896-900.
Friedman CF, Proverbs-Singh TA, Postow MA. Treatment of the Immune-Related Adverse 
Effects of Immune Checkpoint Inhibitors: A Review. JAMA oncology 
2016;2 (10):1346-53.
G. B. D. Mortality Causes of Death Collaborators. Global, Regional, and National Life 
Expectancy, All-Cause Mortality, and Cause-Specific Mortality for 249 Causes of 
Death, 1980-2015: A Systematic Analysis for the Global Burden of Disease Study 
2015. Lancet 2016;388:1459-544.
Gane E, Dubar PR, Brooks AE, Zhao Y, Tan SK, Lau AH, et al. Efficacy and Safety of 24 
Weeks Treatment with Oral TLR8 Agonist Selgantolimod (GS-9688, SLGN) in 
Virally Suppressed Adult Patients with Chronic Hepatitis B: A Phase 2 Study 
[Abstract 71]. The Digital International Liver Congress (ILC); 2020 27-29 
August. 
Gane E, Verdon DJ, Brooks AE, Gaggar A, Nguyen AH, Subramanian GM, et al. Anti-PD-1 
blockade with nivolumab with and without therapeutic vaccination for virally 
suppressed chronic hepatitis B: A pilot study. J Hepatol 2019;71 (5):900-7.
Gane EJ, Dunbar PR, Brooks AE, Zhang F, Chen D, Wallin JJ, et al. Safety and efficacy of the 
oral TLR8 agonist selgantolimod in individuals with chronic hepatitis B under 
viral suppression. J Hepatol 2023;78:513-23.
Gardiner D, Lalezari J, Lawitz E, DiMicco M, Ghalib R, Reddy KR, et al. A randomized, 
double-blind, placebo-controlled assessment of BMS-936558, a fully human 
monoclonal antibody to programmed death-1 (PD-1), in patients with chronic 
hepatitis C virus infection. PLoS ONE 2013;8 (5):e63818.
Global Burden of Disease Cancer Collaboration, Fitzmaurice C, Dicker D, Pain A, Hamavid H, 
Moradi-Lakeh M, et al. The Global Burden of Cancer 2013. JAMA oncology 
2015;1 (4):505-27.
Gubser C, Chiu C, Lewin SR, Rasmussen TA. Immune checkpoint blockade in HIV. 
EBioMedicine 2022;76:103840.

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 105
12 April 2023
Idilman R, Cinar K, Seven G, Bozkus Y, Elhan A, Bozdayi M, et al. Hepatitis B surface antigen 
seroconversion is associated with favourable long-term clinical outcomes during 
lamivudine treatment in HBeAg-negative chronic hepatitis B patients. J Viral 
Hepat 2012;19 (3):220-6.
Janas MM, Harbison CE, Perry VK, Carito B, Sutherland JE, Vaishnaw AK, et al. The 
Nonclinical Safety Profile of GalNAc-conjugated RNAi Therapeutics in Subacute 
Studies. Toxicol Pathol 2018;46 (7):735-45.
Janssen H, Lim Y, Kim H, Tseng CH, Coffin C, Elkashab M, et al. Safety and Efficacy of Oral 
TLR8 Agonist Selgantolimod in Viremic Adult Patients With Chronic Hepatitis B 
[Poster 2429]. International Liver Congress 2021 23–26 June. 
Kim GA, Lim YS, An J, Lee D, Shim JH, Kim KM, et al. HBsAg seroclearance after nucleoside 
analogue therapy in patients with chronic hepatitis B: clinical outcomes and 
durability. Gut 2013;63:1325-32.
Kwon H, Lok AS. Hepatitis B therapy. Nature reviews. Gastroenterology & hepatology 2011;8 
(5):275-84.
Liaw Y-F, Kao J-H, Piratvisuth T, Chan HLY, Chien R-N, Liu C-J, et al. Asian-Pacific 
consensus statement on the management of chronic hepatitis B: a 2012 update. 
Hepatol International 2012;6:531-61.
Liaw YF. Impact of hepatitis B therapy on the long-term outcome of liver disease. Liver Int 
2011;31 Suppl 1:117-21.
Lok AS. Evolution of nucleoside/tide analogues for hepatitis B: is the ideal drug here yet? J 
Hepatol 2009;51 (2):416-8.
Lok AS. Hepatitis: Long-term therapy of chronic hepatitis B reverses cirrhosis. Nature reviews. 
Gastroenterology & hepatology 2013;10 (4):199-200.
Mizukoshi E, Sidney J, Livingston B, Ghany M, Hoofnagle JH, Sette A, et al. Cellular immune 
responses to the hepatitis B virus polymerase. J Immunol 2004;173 (9):5863-71.
Moucari R, Korevaar A, Lada O, Martinot-Peignoux M, Boyer N, Mackiewicz V, et al. High 
rates of HBsAg seroconversion in HBeAg-positive chronic hepatitis B patients 
responding to interferon: a long-term follow-up study. J Hepatol 2009;50 
(6):1084-92.
Nair JK, Attarwala H, Sehgal A, Wang Q, Aluri K, Zhang X, et al. Impact of enhanced metabolic 
stability on pharmacokinetics and pharmacodynamics of GalNAc-siRNA 
conjugates. Nucleic Acids Res 2017;45 (19):10969-77.
OPDIVO, Bristol-Myers Squibb. OPDIVO (nivolumab) injection, for intravenous use. U.S. 
Prescribing Information. Princeton, NJ. Revised March. 2022:

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 106
12 April 2023
Peppa D, Micco L, Javaid A, Kennedy PT, Schurich A, Dunn C, et al. Blockade of 
immunosuppressive cytokines restores NK cell antiviral function in chronic 
hepatitis B virus infection. PLoS pathogens 2010;6 (12):e1001227.
Ratnam I, Chiu C, Kandala NB, Easterbrook PJ. Incidence and risk factors for immune 
reconstitution inflammatory syndrome in an ethnically diverse HIV type 
1-infected cohort. Clin Infect Dis 2006;42 (3):418-27.
Rehermann B, Nascimbeni M. Immunology of hepatitis B virus and hepatitis C virus infection. 
Nature reviews 2005;5 (3):215-29.
Sarin SK, Kumar M, Lau GK, Abbas Z, Chan HL, Chen CJ, et al. Asian-Pacific clinical practice 
guidelines on the management of hepatitis B: a 2015 update. Hepatol Int 2015.
Schweitzer A, Horn J, Mikolajczyk RT, Krause G, Ott JJ. Estimations of worldwide prevalence 
of chronic hepatitis B virus infection: a systematic review of data published 
between 1965 and 2013. Lancet 2015;386:1546-55.
Sherman AC, Trehanpati N, Daucher M, Davey RT, Masur H, Sarin SK, et al. Augmentation of 
hepatitis B virus-specific cellular immunity with programmed death 
receptor-1/programmed death receptor-L1 blockade in hepatitis B virus and 
HIV/hepatitis B virus coinfected patients treated with adefovir. AIDS Res Hum 
Retroviruses 2013;29 (4):665-72.
Simonetti J, Bulkow L, McMahon BJ, Homan C, Snowball M, Negus S, et al. Clearance of 
hepatitis B surface antigen and risk of hepatocellular carcinoma in a cohort 
chronically infected with hepatitis B virus. Hepatology 2010;51 (5):1531-7.
Terrault NA, Bzowej NH, Chang KM, Hwang JP, Jonas MM, Murad MH. AASLD guidelines 
for treatment of chronic hepatitis B. Hepatology 2016;63 (1):261-83.
Topalian SL, Hodi FS, Brahmer JR, Gettinger SN, Smith DC, McDermott DF, et al. Safety, 
activity, and immune correlates of anti-PD-1 antibody in cancer. N Engl J Med 
2012;366 (26):2443-54.
VEMLIDY, Gilead Sciences Inc. VEMLIDY® (tenofovir alafenamide) tablets, for oral use. U.S. 
Prescribing Information. Foster City, CA. Revised August. 2020:
World Health Organization (WHO). Hepatitis B. Fact sheet N°204. Available at:. Accessed: 
29 October 2015. Updated: July 2015a.
World Health Organization (WHO). Hepatitis B. Introduction. Available at: 
http://www.who.int/csr/disease/hepatitis/whocdscsrlyo20022/en/index1.html. 
Accessed: 03 August 2015b.

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 107
12 April 2023
World Health Organization (WHO). Hepatitis C Fact sheet N° 164. Available at: 
http://www.who.int/mediacentre/factsheets/fs164/en/. Updated July 2015. 
Accessed: 03 November 2015c.
Zuckerman AJ. Progress towards the comprehensive control of hepatitis B. Gut 1996;38 (2):S1.

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 108
12 April 2023
11.
APPENDICES

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 109
12 April 2023
11.1.
Investigator Signature Page
GILEAD SCIENCES, INC.
333 LAKESIDE DRIVE
FOSTER CITY, CA 94404
STUDY ACKNOWLEDGMENT
A Phase 2a, Open-Label Study to Evaluate the Safety and Efficacy of Selgantolimod 
(SLGN)-Containing Combination Therapies for the Treatment of Chronic Hepatitis B (CHB)
GS-US-465-4439, Amendment 2 12 April 2023
This protocol has been approved by Gilead Sciences, Inc. The following signature documents 
this approval.
[See appended electronic signature]
Medical Monitor
Signature
[See appended electronic signature]
Date
INVESTIGATOR STATEMENT
I have read the protocol, including all appendices, and I agree that it contains all necessary 
details for me and my staff to conduct this study as described. I will conduct this study as 
outlined herein and will make a reasonable effort to complete the study within the time 
designated.
I will provide all study personnel under my supervision copies of the protocol and access to all 
information provided by Gilead Sciences, Inc. I will discuss this material with them to ensure 
that they are fully informed about the drugs and the study.
Principal Investigator Name (Printed)
Signature
Date
Site Number
PPD

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 110
12 April 2023
11.2.
Pandemic Risk Assessment and Mitigation Plan
During an ongoing pandemic, potential risks associated with participants being unable to attend 
study visits have been identified for this study. 
These risks can be summarized as follows:
1) Study drug supplies to participants and sites:
a) Participants may be unable to return to the site for a number of visits to get the study 
drug, or the site may be unable to accept any participant visits. Without study drugs, the 
participant would not be able to stay on the study drug as planned per protocol.
Mitigation plan: Study drug supplies may be provided to the participant from the site without a 
clinic visit, once it is confirmed that the participant may safely continue on study drug as 
determined by the principal investigator (PI). A virtual study visit, via phone or video 
conferencing, must be performed prior to remote study drug resupply. At the earliest opportunity, 
the site will schedule in-person participant visits and return to the protocol’s regular schedule of 
assessments. A qualified courier may be utilized to ship the study drug from sites to study 
participants if permitted by local ethic committee (EC)/institutional review boards 
(IRB)/Regulatory Authority as applicable and with sponsor's approval.
b) Shipments of study drug could be delayed because of transportation issues. Without study 
drug participant would not be able to stay on the study drug as planned per protocol.
Mitigation plan: The sites' study drug inventory should be closely monitored. Site staff should 
notify the sponsor or delegate if they foresee shortage in study drug inventory or if there is any 
interruption in local shipping service. The sponsor will continue to monitor inventory at the 
study drug depot and study sites. Manual shipments will be triggered as necessary.
2) Participant safety monitoring and FU:
c) Participants may be unable or unwilling to come to the study site for their scheduled 
study visits as required per protocol.
Mitigation plan: For participants who may be unable or unwilling to visit the study site for their 
scheduled study visits as required per protocol, the PI or qualified delegate will conduct a virtual 
study visit, via phone or video conferencing, to assess the participant within target visit window 
date whenever possible. During the virtual study visit, the following information at minimum 
will be reviewed: 
i)
Confirm if participant has experienced any adverse events (AEs)/serious adverse 
events (SAEs)/special situations (including pregnancy) and FU on any unresolved 
AE/SAEs.
ii) Review current list of concomitant medications and document any new concomitant 
medications.

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 111
12 April 2023
iii) If applicable, confirm participants study drug supply is sufficient to last until the next 
planned visit date. If study drug resupply is needed it will be provided as described 
above in (1).
iv) If applicable, remind participant to maintain current dosing and to keep all dispensed 
study drug kits for return at the next on-site visit.
d) Participants may be unable or unwilling to travel to the site for planned assessments (eg, 
safety blood draws); hence samples may not be sent for central lab analyses.
Mitigation plan: Local labs may be utilized as appropriate to monitor participant safety until the 
participant can return to the site for their regular FU per protocol. Any laboratory assessments 
conducted at a local lab due to the pandemic will be documented accordingly. Pregnancy testing 
may be performed using a home urine pregnancy test if local lab pregnancy testing is not 
feasible.
e) Participants may be unable or unwilling to attend the study visit to sign an updated 
informed consent form (ICF) version.
Mitigation plan: The site staff will follow their approved consent process and remain in 
compliance with local EC/IRB and national laws and regulations. Remote consent will be 
allowed if has been approved by the local EC/IRB. The consent process will be documented and 
confirmed by normal consent procedure at the earliest opportunity.
3) Protocol and monitoring compliance:
f)
Protocol deviations may occur, in case scheduled visits cannot occur as planned per 
protocol.
Mitigation plan: If it is not possible to complete a required procedure, an unscheduled visit 
should be conducted as soon as possible when conditions allow. The situation should be recorded 
and explained as a protocol deviation. Any missed participant visits or deviation to the protocol 
due to the pandemic must be reported in the eCRF and described in the clinical study report. Any 
virtual study visits that are conducted in lieu of clinic visits due to the pandemic will be 
documented as a protocol deviation related to the pandemic.
g) Monitors may be unable to carry out source data review (SDR) or (SDV), or study drug 
accountability or assess protocol and Good Clinical Practice (GCP) compliance. This 
may lead to delays in SDV, an increase in protocol deviations, or under reporting of AEs.
Mitigation plan: The study monitor is to remain in close communication with the site to ensure 
data entry and query resolution. In compliance with Gilead policy, a remote SDV should not be 
arranged). The study monitor is to reference the Study Monitoring Plan for guidance on how to 
conduct a remote monitoring visit. The study staff is to save and document all relevant 
communication in the study files. The status of sites that cannot accept monitoring visits and/or 
participants on site, must be tracked centrally and updated on a regular basis.

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc.
Amendment 2
CONFIDENTIAL
Page 112
12 April 2023
4) Missing data and data integrity:
h) There may be an increased amount of missing data due to participants missing 
visits/assessments. This could have an impact on the analysis and the interpretation of 
clinical study data. 
Mitigation plan: Implications of a pandemic on methodological aspects for the study will be 
thoroughly assessed and documented, and relevant actions will be taken as appropriate (ie, 
modification of the statistical analysis plan) and in compliance with Regulatory Authorities’ 
guidance. Overall, the clinical study report will describe the impact of the pandemic on the 
interpretability of study data.
Risks will be assessed continuously, and temporary measures will be implemented to mitigate 
these risks as part of a mitigation plan, as described above. These measures will be 
communicated to the relevant stakeholders as appropriate and are intended to provide alternate 
methods that will ensure the evaluation and assessment of the safety of participants who are 
enrolled in this study. 
Since these potential risks are considered mitigated with the implementation of these measures, 
the expected benefit-risk assessment of selgantolimod (SLGN), VIR-2218, and TAF in study 
participants remains unchanged.

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 113
12 April 2023
11.3.
Study Procedures Tables
Appendix Table 1.
Study Procedures Table for NUC-Suppressed Cohort 1
Treatment Cycles
Week (± 2 days)a
EOT 
(−5 days)
Follow-up Weeksb
Screening 
(45 days)
Baseline 
Day 1
4
8
12
13c
14
16
20
24
28
32
36/EOT
EDd
1c
4
8c
12
16c
24
36
48
Written Informed 
Consente
X
Review of 
Inclusion/Exclusion 
Criteria
X
Medical History
X
AEs & Concomitant 
Medicationsf
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Complete Physical 
Examination
X
X
X
X
X
Symptom-directed 
physical examination
X
X
X
X
X
X
X
X
X
X
X
X
X
Vital signs
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Height
X
Body weight 
X
X
X
X
X
X
X
X
X
X
X
12-lead ECGg
X
X
X
X
X
X
Chest x-ray
X
Xh
Ophthalmologic 
examinationi
X
X
X
Xh
Symptom-directed 
ophthalmologic 
examination
X
X
X
X
X
X
X
X
X
X
X
X
X
Safety laboratory 
tests (hematology & 
chemistry; 
coagulation)
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
APRI
X
X
X
X
X
X
X
FibroTest 
X
X
X
X
X
X
X

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 114
12 April 2023
Treatment Cycles
Week (± 2 days)a
EOT 
(−5 days)
Follow-up Weeksb
Screening 
(45 days)
Baseline 
Day 1
4
8
12
13c
14
16
20
24
28
32
36/EOT
EDd
1c
4
8c
12
16c
24
36
48
FibroScanj
X
α-fetoprotein (HCC 
imaging [eg, CT 
scan] is required for 
participants with 
α-fetoprotein 
≥ 50 ng/mL at 
screening)
X
Serology testing to 
exclude HCV, HDV, 
and HIV infectionk
X
Quantitative plasma 
HBV DNA
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Serum sample for 
HBV viral 
sequencing 
(resistance 
surveillance) and 
ddPCR
X
Serum sample for 
HBV viral 
sequencing 
(resistance 
surveillance) and 
genotyping sample
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Quantitative HBV 
Serum HBsAg, 
HBcrAg, HBeAg, 
and HBV RNA
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Qualitative HBV 
serology HBeAg, 
HBeAb, and HBsAg, 
HBsAb
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 115
12 April 2023
Treatment Cycles
Week (± 2 days)a
EOT 
(−5 days)
Follow-up Weeksb
Screening 
(45 days)
Baseline 
Day 1
4
8
12
13c
14
16
20
24
28
32
36/EOT
EDd
1c
4
8c
12
16c
24
36
48
Biomarker Samples: 
Collection of PBMC, 
whole blood, serum, 
and plasma samples 
for biomarker 
analysisl, m
X
Xl
X
Xm
X
Sparse PK for 
VIR-2218n
X
X
X
Sparse PK for SLGNn
X
X
X
Estimated creatinine 
clearance (using the 
Cockcroft-Gault 
method)
X
X
X
X
X
X
Urinalysis
X
X
X
X
X
X
X
X
X
X
X
X
Urine Drug and 
Alcohol Screen
X
Autoantibodies 
X
TSH
X
X
X
X
FSHo
X
Serum Pregnancy 
Testp
X
X
Urine Pregnancy 
Testp
X
X
X
X
X
X
X
X
X
X
X
Xp
X
Xp
X
X
X
Enrollment
X
Dispense and 
Administer TAF as 
appropriate
Tenofovir alafenamide (TAF) 25-mg tablet administered orally daily for up to 84 weeks
Dispense & 
Administer VIR-2218 
SC as appropriate
X
X
X
X
X
X
Dispense & 
Administer SLGNq as 
appropriate
X
X
X
X
X
X
X
X

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 116
12 April 2023
Treatment Cycles
Week (± 2 days)a
EOT 
(−5 days)
Follow-up Weeksb
Screening 
(45 days)
Baseline 
Day 1
4
8
12
13c
14
16
20
24
28
32
36/EOT
EDd
1c
4
8c
12
16c
24
36
48
Study Drug 
Accountability
X
X
X
X
X
X
X
X
X
X
AE = adverse event; APRI = AST to Platelet Ratio Index; CT = computed tomography; ddPCR = digital droplet polymerase chain reaction; ECG = electrocardiogram; ED = early discontinuation; 
EOT = end of treatment; FSH = follicle-stimulating hormone; FU = follow-up; HBcrAg = hepatitis B core-related antigen; HBeAb = hepatitis B e antibody; HBeAg = hepatitis B e antigen; 
HBsAb = hepatitis B surface antibody; HBsAg = hepatitis B surface antigen; HBV = hepatitis B virus; HCC = hepatocellular carcinoma; HCV = hepatitis C virus; HDV = hepatitis D virus; 
IV = intravenous; PBMC = peripheral blood mononuclear cells; PK = pharmacokinetic; SAE = serious adverse event; SC = subcutaneous; SLGN = selgantolimod; TAF = tenofovir alafenamide; 
TSH = thyroid-stimulating hormone
a
All study visits except for Weeks 13 and 14.
b
FU Week 1 will have a visit window of + 3 days, FU Weeks 4 through FU Week 16 will have a visit window of ± 5 days, and FU Weeks 24 through FU Week 48 will have a visit window of ± 14 
days.
c
Week 13, FU Week 1, FU Week 8, and FU Week 16 will be conducted as a virtual/telephonic visit to review AEs, concomitant medications, and overall health of the participant by investigator.
d
The ED visit should be performed within 14 days from notification of study discontinuation. If ED is done in FU period, all of these procedures should be performed.
f
Record any SAEs and all AEs related to protocol-mandated procedures occurring after signing of the informed consent form. After drug administration, report all AEs and SAEs.
g
Participants must rest quietly in the supine position for a minimum of 5 minutes prior to the recording.
h
At ED visit, these procedures are optional and to be done as needed.
i
Ophthalmologic examination at screening should be performed during the screening window, ie, within 45 days of randomization. Ophthalmologic examinations post-Day 1 should occur within −4 
to +10 days of visit.
j
FibroScan testing where applicable for liver disease staging.
k
In the event of a positive result for serology and/or antigen testing for HIV, HDV, or HCV, reflex tests will be performed as necessary.
l
Collect pre-SLGN dose administration on Week 12, 4 hours and 24-72 hours postdose.
m
Collect pre-SLGN dose administration on Week 32, 4 hours, and 24-72 hours postdose. 
n
The sparse PK collection for VIR-2218 at baseline/Day 1 should occur predose and postdose. Postdose sparse PK collection should occur any time between 1 and 5 hours postdose relative to 
VIR-2218, and/or SLGN administration. 
o
FSH test is required for female participants who are < 54 years old who are not on hormonal contraception and who have stopped menstruating for ≥ 12 months but do not have documentation of 
ovarian hormonal failure.
p
For female participants of childbearing potential, the serum pregnancy test will be performed at screening. Urine pregnancy test will be performed at all other visits as indicated. Positive urine 
pregnancy test will be confirmed with serum pregnancy test. Pregnancy testing should include prevention counseling. FU Week 8 and Week 16 urine pregnancy test will be a virtual/telephonic 
visit for females participants of childbearing potential.
q
SLGN tablets will be administered while fasting once a week, on the same day.
CCI
CCI
CCI
CCI
------
--------------------------------

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 117
12 April 2023
s
Intensive PK sample to be drawn at any one visit at Week 20, 24, 28 or 32 relative to SLGN dosing in clinic on the morning of the intensive PK visit. Collection will occur at predose, 0.25, 0.5, 1, 
1.5, 2, 3, 4, 5, 8, 10, 12 and 24 hours postdose (8, 10, 12 hour collections are optional).
t
Intensive PK sample to be drawn on Baseline/Day 1 and at Week 20 relative to VIR-2218 dosing in clinic on the morning of the intensive PK visit. Collection will occur at predose, 0.25, 0.5, 1, 
1.5, 2, 3, 4, 5, 8, 10, 12 and 24 hours postdose (8, 10, 12 hour collections are optional).
CCI

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 118
12 April 2023
Appendix Table 2.
Study Procedures Table for Viremic Cohort 2 
Screenin
g
(45 days)
BL 
Day 1
Treatment Cycles
Week (± 2 days)a
EOT 
(−5 days)
Follow-up Weeks b
Cohort 2 
Group B 
only
Cohort 2 
Group A only
1
c
2d
4
8
12
13
c
14
16
20
24
28
32
24
(Cohort 2 
Group B)
/ 36 
(Cohort 2 
Group A)
ED
e
1b,c
4
8c
12
1
6
24
36
48
Written Informed 
consentf
X
Review of 
Inclusion/
Exclusion 
Criteria
X
Medical History
X
AEs & 
Concomitant 
Medicationsg
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Complete 
Physical 
Examination
X
X
X
X
X
Symptom-
directed physical 
examination
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Vital signs
X
X
X
(Cohort 
2 
Group B
)
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Height
X
Body weight
X
X
X
(Cohort 
2 
Group B
)
X
(Cohort 
2 
Group B
)
X
X
X
X
X
X
X
X
X
12-lead ECGh
X
X
X
X
X
X
Chest x-ray
X
Xi

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 119
12 April 2023
Screenin
g
(45 days)
BL 
Day 1
Treatment Cycles
Week (± 2 days)a
EOT 
(−5 days)
Follow-up Weeks b
Cohort 2 
Group B 
only
Cohort 2 
Group A only
1
c
2d
4
8
12
13
c
14
16
20
24
28
32
24
(Cohort 2 
Group B)
/ 36 
(Cohort 2 
Group A)
ED
e
1b,c
4
8c
12
1
6
24
36
48
Ophthalmologic 
examinationj
X
X
(Cohort 
2 
Group B
)
X
X
Xi
Symptom-
directed 
ophthalmologic 
examination
X
X
X
X
X
X
X
X
X
X
X
X
X
Safety laboratory 
tests (hematology 
& chemistry; 
coagulation)
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
APRI
X
X
X
X
X
X
X
FibroTest 
X
X
X
X
X
X
X
FibroScank
X
α-fetoprotein 
(HCC imaging 
[eg, CT scan] is 
required for 
participants with 
α-fetoprotein ≥ 50 
ng/mL at 
screening)
X
Serology testing 
to exclude HCV, 
HDV, and HIV 
infectionl
X
Quantitative 
plasma HBV 
DNA
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 120
12 April 2023
Screenin
g
(45 days)
BL 
Day 1
Treatment Cycles
Week (± 2 days)a
EOT 
(−5 days)
Follow-up Weeks b
Cohort 2 
Group B 
only
Cohort 2 
Group A only
1
c
2d
4
8
12
13
c
14
16
20
24
28
32
24
(Cohort 2 
Group B)
/ 36 
(Cohort 2 
Group A)
ED
e
1b,c
4
8c
12
1
6
24
36
48
Serum sample for 
HBV viral 
sequencing 
(resistance 
surveillance) and 
ddPCR
X
Serum sample for 
HBV viral 
sequencing 
(resistance 
surveillance) and 
genotyping 
sample
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Quantitative 
HBV Serum 
HBsAg, HBcrAg, 
HBeAg, and 
HBV RNA
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Qualitative HBV 
serology HBeAg, 
HBeAb, and 
HBsAg, HBsAb 
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Biomarker 
Samples: 
Collection of 
PBMC, whole 
blood, serum and 
plasma samples 
for biomarker 
analysism,n
X 
m,n
Xn
Xm
X
m
Xn
X
m
X
Sparse PK for 
VIR-2218o
X
X
X
Sparse PK for 
SLGNp
Xp
X
X
Xp

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 121
12 April 2023
Screenin
g
(45 days)
BL 
Day 1
Treatment Cycles
Week (± 2 days)a
EOT 
(−5 days)
Follow-up Weeks b
Cohort 2 
Group B 
only
Cohort 2 
Group A only
1
c
2d
4
8
12
13
c
14
16
20
24
28
32
24
(Cohort 2 
Group B)
/ 36 
(Cohort 2 
Group A)
ED
e
1b,c
4
8c
12
1
6
24
36
48
Estimated 
creatinine 
clearance (using 
the Cockcroft-
Gault method)
X
X
X
X
X
X
Urinalysis
X
X
X
X
X
X
X
X
X
X
X
X
Urine Drug and 
Alcohol Screen
X
Autoantibodies 
X
TSH
X
X 
(Cohort 
2 
Group B
)
X
X
X
FSHq
X
Serum Pregnancy 
Testr
X
X
Urine Pregnancy 
Testr
X
X
X
X
X
X
X
X
X
X
X
X
r
X
Xr
X
X
X
Enrollment
X
Dispense & 
Administer VIR-
2218 SC as 
appropriate 
(Group A only)
X
X
X
X
X
X
Dispense & 
Administer 
SLGNs as 
appropriate
(Group A only)
X
X
X
X
X
X
X
X

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 122
12 April 2023
Screenin
g
(45 days)
BL 
Day 1
Treatment Cycles
Week (± 2 days)a
EOT 
(−5 days)
Follow-up Weeks b
Cohort 2 
Group B 
only
Cohort 2 
Group A only
1
c
2d
4
8
12
13
c
14
16
20
24
28
32
24
(Cohort 2 
Group B)
/ 36 
(Cohort 2 
Group A)
ED
e
1b,c
4
8c
12
1
6
24
36
48
Dispense & 
Administer 
SLGNs as 
appropriate
(Group B only)
X
X
X
X
X
X
X
X
X
X
Study Drug 
Accountability
X
X
X
X
X
X
X
X
X
X
X
AE = adverse event; APRI = AST to Platelet Ratio Index; BL = baseline; CT = computed tomography; ddPCR = digital droplet polymerase chain reaction; 
ECG = electrocardiogram; ED = early discontinuation; EOT = end of treatment; FSH = follicle-stimulating hormone; FU = follow-up; HBcrAg = hepatitis B core-related antigen; 
HBeAb = hepatitis B e antibody; HBeAg = hepatitis B e antigen; HBsAb = hepatitis B surface antibody; HBsAg = hepatitis B surface antigen; HBV = hepatitis B virus; 
HCC = hepatocellular carcinoma; HCV = hepatitis C virus; HDV = hepatitis D virus; IV = intravenous; PBMC = peripheral blood mononuclear cells; PK = pharmacokinetic; SAE 
= serious adverse event; SC = subcutaneous; SLGN = selgantolimod; TAF = tenofovir alafenamide; TSH = thyroid-stimulating hormone
a
All study visits (± 2 days), except for Weeks 1, 2, 13, and 14.
b
FU Week 1 will have a visit window of ± 2 days, FU Weeks 4 through FU Week 16 will have a visit window of ± 5 days, and FU Weeks 24 through FU Week 48 will have a 
visit window of ± 14 days. 
c
Week 1 (Cohort 2 Group B only), Week 13 (Cohort 2 Group A only), and FU Week 1, Week 8, and Week 16 will be conducted as a virtual/telephonic visit to review AEs, 
concomitant medications, and overall health of the participant by investigator. 
d
Week 2 visit is only applicable for Cohort 2 Group B. 
e
The ED visit should be performed within 14 days from notification of study discontinuation.
g
Record any SAEs and all AEs related to protocol mandated procedures occurring after signing of the consent form. After drug administration, report all AEs and SAEs.
CCI
CCI
CCI
CCI

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 123
12 April 2023
h
Participants must rest quietly in the supine position for a minimum of 5 minutes prior to the recording.
i
At ED visit, these procedures are optional and to be done as needed.
j
Ophthalmologic examination at screening should be performed during the screening window, ie, within 45 days of randomization. Ophthalmologic examinations post-Day 1 
should occur within −4 to +10 days of visit.
k
FibroScan testing where applicable for liver disease staging.
l
In the event of a positive result for serology and/or antigen testing for HIV, HDV, or HCV, reflex tests will be performed as necessary.
m
Cohort 2 Group A biomarker collection. Collect pre-SLGN dose administration at Baseline/Day 1, Week 12, 4 hours and 24-72 hours postdose. Collect at Week 14, predose. 
Collect pre-SLGN dose administration at Week 32, 4 hours and 24-72 hours postdose.
n
Cohort 2 Group B biomarker collection. Collect pre-SLGN dose administration on Baseline/Day 1, 4 hours and 24-72 hours postdose. Collect at Week 2, pre-dose. Collect 
pre-SLGN dose administration at Week 20, 4 hours and 24-72 hours postdose. 
o
The sparse PK collection for VIR-2218 at baseline/Day 1 should occur predose and postdose. Postdose sparse PK collection for VIR-2218 should occur any time between 1 
and 5 hours postdose relative to VIR-2218 administration.
p
Sparse PK collection for SLGN should occur any time between 1 and 5 hours postdose relative to SLGN administration. The collection at Baseline/Day 1 is only applicable to 
Cohort 2 Group B. The collection at Week 32 is only applicable to Cohort 2 Group A. 
q
FSH test is required for female participants who are < 54 years old who are not on hormonal contraception and who have stopped menstruating for ≥ 12 months but do not 
have documentation of ovarian hormonal failure.
r
For female participants of childbearing potential, the serum pregnancy test will be performed at screening. Urine test will be performed at all other visits as indicated. Positive 
urine test will be confirmed with serum test. Pregnancy testing should include prevention counseling. FU Week 8 and Week 16 urine pregnancy test will be a 
virtual/telephonic visit for female participants of childbearing potential.
s
SLGN tablets will be administered while fasting once a week on the same day.
u
For Group A, intensive PK sample to be drawn at any one visit at Week 20, 24, 28 or 32 relative to SLGN dosing in clinic on the morning of the intensive PK visit. For 
Group B, sample will be collected Week 12 or later relative to SLGN dosing in clinic on the morning of the intensive PK visit.
v
Group A and B: Collection will occur at Predose, 0.25, 0.5, 1, 1.5, 2, 3, 4, 5, 8, 10, 12 and 24 hours postdose (8, 10 and 12 hour collections are optional).
w
For Group A only, intensive PK sample to be drawn on Baseline/Day 1 and at Week 20 relative to VIR-2218 dosing in clinic on the morning of the intensive PK visit. 
CCI

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 124
12 April 2023
11.4.
Pregnancy Precautions, Definition for Female of Childbearing Potential, and 
Contraceptive Requirements
1)
Definitions
a.
Definition of Childbearing Potential
For the purposes of this study, a female born participant is considered of childbearing potential 
following the initiation of puberty (Tanner stage 2) until becoming postmenopausal unless the 
participant is permanently sterile or has medically documented ovarian failure.
Women are considered to be in a postmenopausal state when they are > 54 years of age with 
cessation of previously occurring menses for > 12 months without an alternative cause. In 
addition, women < 54 years of age with amenorrhea of ≥ 12 months may also be considered 
postmenopausal if their follicle-stimulating hormone (FSH) level is in the postmenopausal range 
and they are not using hormonal contraception or hormonal replacement therapy. 
Permanent sterilization includes hysterectomy, bilateral oophorectomy, or bilateral 
salpingectomy in a female participant of any age.
b.
Definition of Male Fertility
For the purposes of this study, a male born participant is considered fertile after the initiation of 
puberty unless the participant is permanently sterile by bilateral orchidectomy or medical 
documentation.
2)
Contraception Requirements for Female Participants
a.
Study Drug Effects on Pregnancy and Hormonal Contraception
Tenofovir alafenamide (TAF)
Data from clinical pharmacokinetic interaction studies of TAF have demonstrated that there is no 
reduction in the clinical efficacy of hormonal contraception. Nonclinical toxicity studies in 
animals (rats and rabbits) of TAF have demonstrated no adverse effect on fertility or 
embryo-fetal development. However, there are no clinical studies of TAF in pregnant women. 
Please refer to the latest version of the IB for additional information.
Nivolumab
There are no data on the use of nivolumab in pregnant women. Studies in animals have shown 
embryofetal toxicity. Nivolumab is not recommended during pregnancy. Women of childbearing 
potential should use effective contraception for at least 5 months following the last dose of 
nivolumab. It is unknown whether nivolumab is secreted in human milk. Because many 
medicinal products, including antibodies, can be secreted in human milk, a risk to the 
newborns/infants cannot be excluded. Please refer to the latest version of nivolumab product 
information for additional information.

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 125
12 April 2023
Selgantolimod
There is no clinical data available on SLGN treatment in pregnant women. Nonclinical studies in 
rabbits showed no adverse effect on fertility but did show a possible risk of 
teratogenicity/fetotoxicity during embryo-fetal development. Therefore, the use of highly 
effective contraception will be required for participation in this study. Nonclinical studies 
showed no genotoxicity.
Nonclinical studies demonstrate low induction potential with once weekly dosing of SLGN. 
Based on this data, no reduction in the exposure of hormonal contraception is expected.
Please refer to the latest version of the IB for additional information.
VIR-2218
There are no available data on the use of VIR-2218 in pregnant women to evaluate a 
drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. 
No adverse effects on pregnancy or embryo-fetal development related to VIR-2218 were 
observed in rats and in rabbits. No studies have been conducted in animals on the effect of 
VIR-2218 on fertility and pre/postnatal development. Nonclinical studies showed no 
genotoxicity. 
Women of childbearing potential are required to have a negative pregnancy test, cannot be breast 
feeding, must use highly effective contraception during the study, should continue using 
contraception for a least 1 month following the last dose of VIR-2218, and meet any other 
contraception requirements specified in the protocol. Male participants with female partners of 
childbearing potential must agree to meet the contraception requirements specified in the 
protocol.
Please refer to the latest version of the VIR-2218 IB for additional information.
There is no metabolic enzyme (or transporter) induction effect that is expected from either 
nivolumab or VIR-2218. Therefore, because SLGN is not an inducer, none of the drugs used in 
this trial either alone or in combination are expected to yield a reduction of exposure of hormonal 
contraception.
Because many medicinal products can be secreted in human milk, a risk to newborns/infants 
cannot be excluded.
b.
Contraception Requirements for Female Participants of Childbearing 
Potential 
The inclusion of female participants of childbearing potential requires the use of highly effective 
contraceptive measures with a failure rate of < 1% per year. They must have a negative serum 
pregnancy test at screening and a negative pregnancy test at the screening visit prior to 
randomization. Pregnancy tests will be performed at monthly intervals thereafter until the end of 
contraception requirement. 

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 126
12 April 2023
Duration of required contraception for female participants in this clinical trial should start from 
screening visit until 30 days after the last dose of TAF, SLGN, or VIR-2218 or for 5 months after 
the last dose of nivolumab whichever contraception ending date is latest. If a participant requires 
a commercially approved nucleos(t)ide analog treatment, the investigator will provide 
contraception requirements according to the local label for the specific marketed product and 
again taking into consideration whichever contraception ending date is latest. 
Female participants must agree to one of the following contraceptive methods: 
Complete abstinence from intercourse of reproductive potential. Abstinence is an acceptable 
method of contraception only when it is in line with the participant’s preferred and usual 
lifestyle. 
Or 
Consistent and correct use of 1 of the following methods of birth control listed below: 
•
Hormonal or nonhormonal intrauterine device (IUD)
•
Subdermal contraceptive implant
•
 Bilateral tubal occlusion (upon medical assessment of surgical success) 
•
Vasectomy in the male partner (upon medical assessment of surgical success) 
Or 
Female participants who wish to use a hormonally-based method must use it in conjunction with 
a barrier method, preferably a male condom. Hormonal methods are restricted to those associated 
with the inhibition of ovulation. Hormonally-based contraceptives and barrier methods permitted 
for use in this protocol are as follows: 
•
Hormonal methods (each method must be used with a barrier method, preferably male 
condom) 
Oral contraceptives (either combined or progesterone only) 
Injectable progesterone 
Transdermal contraceptive patch 
Contraceptive vaginal ring 
•
Barrier methods (each method must be used with a hormonal method) 
Male condom (with or without spermicide) 

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 127
12 April 2023
Female condom (with or without spermicide) 
Diaphragm with spermicide 
Cervical cap with spermicide 
Sponge with spermicide
Inclusion of methods of contraception in this list of permitted methods does not imply that the 
method is approved in any country or region. Methods should only be used if locally approved. 
Female participants must also refrain from egg donation and in vitro fertilization during 
treatment and until the end of contraception requirement.
3)
Contraception Requirements for Male Participants
It is theoretically possible that a relevant systemic concentration of study drug may be achieved 
in a female partner from exposure of the male participant’s seminal fluid and poses a potential 
risk to an embryo/fetus. Therefore, male participants with female partners of childbearing 
potential must use condoms during treatment until 30 days after the last dose of TAF, SLGN, or 
VIR-2218 or for 5 months after last dose of nivolumab whichever contraception ending date is 
latest. If a participant requires a commercially approved nucleos(t)ide analog treatment, the 
investigator will provide contraception requirements according to the local label for the specific 
marketed product and again taking into consideration whichever contraception ending date is 
latest. If the female partner of childbearing potential is not pregnant, additional contraception 
recommendations should also be considered. 
Male participants must also refrain from sperm donation during treatment and until the end of 
contraception requirement.
4)
Unacceptable Birth Control Methods
Birth control methods that are unacceptable include periodic abstinence (eg, calendar, ovulation, 
symptothermal, postovulation methods), withdrawal (coitus interruptus), spermicides only, and 
lactational amenorrhea method. A female condom and a male condom should not be used 
together.
5) 
Procedures to be Followed in the Event of Pregnancy
Female participants will be instructed to notify the investigator if they become pregnant or 
suspect they are pregnant at any time from start of the study to the end of the study. Nivolumab, 
SLGN and VIR-2218 must be discontinued immediately. Interruption of other drugs should be 
considered upon discussion with the medical monitor.
Male participants whose partner has become pregnant or suspects she is pregnant from start of 
study to the end of the contraception requirement must also report the information to the 
investigator. Instructions for reporting pregnancy, partner pregnancy, and pregnancy outcome are 
outlined in Section 7.4.2.3.

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 128
12 April 2023
11.5.
GSI Grading Scale for Severity of Adverse Events and Laboratory 
Abnormalities
Antiviral Toxicity Grading Scale Version 01 April 2015 will be used to grade all adverse events 
(AEs), with the exception of infusion-related reactions (IRRs).
For grading of IRRs, the Common Terminology Criteria for Adverse Events (CTCAE) Version 
5.0 found on the NCI website will be used:
https://ctep.cancer.gov/protocoldevelopment/electronic_applications/docs/CTCAE_v5_Quick_R
eference_5x7.pdf

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 129
12 April 2023
HEMATOLOGY
Grade 1
Grade 2
Grade 3
Grade 4
Hemoglobin
HIV POSITIVE
Adult and Pediatric  57 Days
8.5 to 10.0 g/dL 
85 to 100 g/L
7.5 to  8.5 g/dL 
75 to  85 g/L
6.5 to  7.5 g/dL 
65 to  75 g/L
 6.5 g/dL
 65 g/L
HIV NEGATIVE
Adult and Pediatric  57 Days 
10.0 to 10.9 g/dL
100 to 109 g/L
OR
Any decrease 
from Baseline
2.5 to  3.5 g/dL
25 to  35 g/L
9.0 to  10.0 g/dL
90 to  100 g/L
OR
Any decrease 
from Baseline
3.5 to  4.5 g/dL
35 to  45 g/L
7.0 to  9.0 g/dL
70 to  90 g/L
OR
Any decrease from Baseline
 4.5 g/dL
 45 g/L
 7.0 g/dL
 70 g/L
Infant, 36–56 Days
(HIV POSITIVE OR NEGATIVE)
8.5 to 9.4 g/dL
85 to 94 g/L
7.0 to  8.5 g/dL
70 to  85 g/L
6.0 to  7.0 g/dL
60 to < 70 g/L
 6.0 g/dL
< 60 g/L
Infant, 22–35 Days
(HIV POSITIVE OR NEGATIVE)
9.5 to 10.5 g/dL
95 to 105 g/L
8.0 to  9.5 g/dL
80 to  95 g/L
7.0 to  8.0 g/dL
70 to  80 g/L
 7.0 g/dL
 70 g/L
Infant, 1–21 Days
(HIV POSITIVE OR NEGATIVE)
12.0 to 13.0 g/dL
120 to 130 g/L
10.0 to 
 12.0 g/dL
100 to  120 g/L
9.0 to  10.0 g/dL
90 to  100 g/L
 9.0 g/dL
 90 g/L
1000 to 1300/mm3
750 to  
1000/mm3
500 to  750/mm3
 500/mm3
Absolute Neutrophil Count (ANC)
Adult and Pediatric, 
≥ 7 Months# 
1.00 to 1.30 GI/L
0.75 to  1.00 
GI/L
0.50 to  0.75 GI/L
 0.50 GI/L
Absolute CD4+ Count
HIV NEGATIVE ONLY
Adult and Pediatric > 13 Years
300 to 400/mm3
300 to 400/μL
200 to  300/mm3
200 to  300/μL
100 to  200/mm3
100 to  200/μL
 100/mm3
 100/μL

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 130
12 April 2023
HEMATOLOGY
Grade 1
Grade 2
Grade 3
Grade 4
Absolute Lymphocyte Count
HIV NEGATIVE ONLY
Adult and Pediatric  13 Years
600 to 650/mm3
0.60 to 0.65 GI/L
500 to  600/mm3
0.50 to  0.60 GI/L
350 to  500/mm3
0.35 to  0.50 GI/L
 350/mm3
 0.35 GI/L
Platelets 
100,000 to 
< 125,000/mm3
100 to  125 GI/L
50,000 to 
 100,000/mm3
50 to  100 GI/L
25,000 to  50,000/mm3
25 to  50 GI/L
 25,000/mm3
 25 GI/L
2000/mm3 to 
2500/mm3
1,500 to 
 2,000/mm3
1000 to  1,500/mm3
 1000/mm3
WBCs 
2.00 GI/L to 
2.50 GI/L
1.50 to  2.00 GI/L
1.00 to  1.50 GI/L
 1.00 GI/L
100 to 200 mg/dL
75 to  100 mg/dL
50 to  75 mg/dL
 50 mg/dL
Hypofibrinogenemia
1.00 to 2.00 g/L
0.75 to  1.00 g/L
0.50 to  0.75 g/L
 0.50 g/L
 ULN to 
600 mg/dL
 600 mg/dL
—
—
Hyperfibrinogenemia
 ULN to 6.0 g/L
 6.0 g/L
—
—
20 to 40 μg/mL
 40 to 50 μg/mL
 50 to 60 μg/mL
 60 μg/mL
Fibrin Split Product 
20 to 40 mg/L
 40 to 50 mg/L
 50 to 60 mg/L
 60 mg/L
Prothrombin Time
 1.00 to 1.25  
ULN
 1.25 to 1.50  
ULN 
 1.50 to 3.00  ULN 
 3.00  ULN 
International Normalized Ratio of prothrombin time 
(INR)
1.1 to 1.5  ULN
>1.5 to 2.0  ULN
>2.0 to 3.0  ULN
> 3.0  ULN
Activated Partial
Thromboplastin Time
 1.00 to 1.66  
ULN
 1.66 to 2.33  
ULN
 2.33 to 3.00  ULN
 3.00  ULN
Methemoglobin 
5.0 to 10.0%
 10.0 to 15.0%
 15.0 to 20.0%
 20.0% 

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 131
12 April 2023
CHEMISTRY
Grade 1
Grade 2
Grade 3
Grade 4
130 to <LLN 
mEq/L
125 to  130 mEq/L
121 to  125 mEq/L
 121 mEq/L
Hyponatremia 
130 to <LLN 
mmol/L
125 to  130 mmol/L
121 to  125 mmol/L
 121 mmol/L
>ULN to 150 
mEq/L
 150 to 154 mEq/L
 154 to 159 mEq/L
 159 mEq/L
Hypernatremia 
>ULN to 150 
mmol/L
 150 to 154 mmol/L
 154 to 159 mmol/L
 159 mmol/L
3.0 to <LLN 
mEq/L
2.5 to  3.0 mEq/L
2.0 to  2.5 mEq/L
 2.0 mEq/L
Hypokalemia 
Adult and Pediatric
 1 Year
3.0 to <LLN 
mmol/L
2.5 to  3.0 mmol/L
2.0 to  2.5 mmol/L
 2.0 mmol/L
Infant <1 Year 
3.0 to 3.4 mEq/L
3.0 to 3.4 
mmol/L
2.5 to  3.0 mEq/L
2.5 to <3.0 mmol/L
2.0 to  2.5 mEq/L
2.0 to <2.5 mmol/L
 2.0 mEq/L
<2.0 mmol/L
Hyperkalemia 
Adult and Pediatric
 1 Year
5.6 to 6.0 mEq/L
5.6 to 6.0 
mmol/L
 6.0 to 6.5 mEq/L
 6.0 to 6.5 mmol/L
 6.5 to 7.0 mEq/L
 6.5 to 7.0 mmol/L
 7.0 mEq/L
 7.0 mmol/L
Infant <1 Year
>ULN to 6.0 
mEq/L
>ULN to 6.0 
mmol/L
> 6.0 to 6.5 mEq/L
> 6.0 to 6.5 mmol/L
 6.5 to 7.0 mEq/L
 6.5 to 7.0 mmol/L
 7.0 mEq/L
 7.0 mmol/L
Hypoglycemia
Adult and Pediatric
 1 Month
55 to 64 mg/dL
3.03 to 
3.58 mmol/L
40 to  55 mg/dL
2.20 to  3.03 mmol/L
30 to  40 mg/dL
1.64 to  2.20 mmol/L
 30 mg/dL
 1.64 mmol/L

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 132
12 April 2023
CHEMISTRY
Grade 1
Grade 2
Grade 3
Grade 4
Infant,  1 Month
50 to 54 mg/dL
2.8 to 
3.0 mmol/L
40 to  50 mg/dL
2.2 to  2.8 mmol/L
30 to  40 mg/dL
1.7 to  2.2 mmol/L
 30 mg/dL
 1.7 mmol/L
116 to 
160 mg/dL
 160 to 250 mg/dL
 250 to 500 mg/dL
 500 mg/dL
Hyperglycemia, Nonfasting 
6.42 to 
8.91 mmol/L
 8.91 to 13.90 mmol/L
 13.90 to 
27.79 mmol/L
 27.79 
mmol/L
Hyperglycemia, Fasting
110 to 
125 mg/dL
6.08 to 6.96 
mmol/L
>125 to 250 mg/dL
>6.96 to 13.90 mmol/L
>250 to 500 mg/dL
>13.90 to 27.79 
mmol/L
>500 mg/dL
>27.79 
mmol/L
Hypocalcemia 
(corrected for albumin if appropriate*)
Adult and Pediatric
2 Years
7.8 
<LLN mg/dL
1.94 to <LLN 
mmol/L
7.0 to  7.8 mg/dL
1.74 to  1.94 mmol/L
6.1 to  7.0 mg/dL
1.51 to  1.74 mmol/L
 6.1 mg/dL
 1.51 mmol/L
Pediatric ≥7 days -2 Years
7.8 to 8.4 mg/dL
1.94 to 2.10 
mmol/L
7.0 to <7.8 mg/dL
1.74 to <1.94 mmol/L
6.1 to <7.0 mg/dL
1.51 to < 1.74 mmol/L
< 6.1 mg/dL
< 1.51 
mmol/L
Infant,  7 Days
6.5 to 7.5 mg/dL
1.61 to 1.88 
mmol/L
6.0 to  6.5 mg/dL
1.49 to < 1.61 mmol/L
5.5 to  6.0 mg/dL
1.36 to < 1.49 mmol/L 
 5.5 mg/dL
< 1.36 
mmol/L
>ULN to 
11.5 mg/dL
 11.5 to 12.5 mg/dL
 12.5 to 13.5 mg/dL
 13.5 mg/dL
Hypercalcemia (corrected for albumin if 
appropriate*) Adult and Pediatric  7 Days
>ULN to 2.88 
mmol/L
 2.88 to 3.13 mmol/L
 3.13 to 3.38 mmol/L
 3.38 mmol/L

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 133
12 April 2023
CHEMISTRY
Grade 1
Grade 2
Grade 3
Grade 4
Infant,  7 Days
11.5 to 
12.4 mg/dL
2.86 to 3.10 
mmol/L
 12.4 to 12.9 mg/dL
> 3.10 to 3.23 mmol/L
 12.9 to 13.5 mg/dL
> 3.23 to 3.38 mmol/L
 13.5 mg/dL
> 3.38 
mmol/L
3.0 mg/dL to  
LLN
2.5 to < 3.0 mg/dL
2.0 to  2.5 mg/dL
 2.0 mg/dL
Hypocalcemia (ionized)
0.74 mmol/L to 
 LLN
0.62 to  0.74 mmol/L
0.49 to  0.62 mmol/L
 0.49 mmol/L
 ULN to 
6.0 mg/dL
 6.0 to 6.5 mg/dL
 6.5 to 7.0 mg/dL
 7.0 mg/dL
Hypercalcemia (ionized)
 ULN to 1.50 
mmol/L
 1.50 to 1.63 mmol/L
 1.63 to 1.75 mmol/L
 1.75 mmol/L
1.40 to 
<LLN mg/dL
1.2 to <LLN 
mEq/L
1.04 to  1.40 mg/dL
0.9 to  1.2 mEq/L
0.67 to  1.04 mg/dL
0.6 to  0.9 mEq/L
 0.67 mg/dL
 0.6 mEq/L
Hypomagnesemia
0.58 to <LLN 
mmol/L
0.43 to  0.58 mmol/L
0.28 to  0.43 mmol/L
 0.28 mmol/L
Hypophosphatemia
Adult and Pediatric
 14 Years
2.0 to < 
LLN mg/dL
0.63 to  LLN 
mmol/L
1.5 to  2.0 mg/dL
0.47 to  0.63 mmol/L
1.0 to  1.5 mg/dL
0.31 to  0.47 mmol/L
 1.0 mg/dL
 0.31 mmol/L

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 134
12 April 2023
CHEMISTRY
Grade 1
Grade 2
Grade 3
Grade 4
Pediatric 1 Year–14 Years 
3.0 to 
<LLN mg/dL
0.96 to <LLN 
mmol/L
2.5 to  3.0 mg/dL
0.80 to < 0.96 mmol/L
1.5 to  2.5 mg/dL
0.47 to < 0.80 mmol/L
 1.5 mg/dL
< 0.47 
mmol/L
Pediatric  1 Year
3.5 to 
<LLN mg/dL
1.12 to <LLN 
mmol/L
2.5 to  3.5 mg/dL
0.80 to < 1.12 mmol/L
1.5 to  2.5 mg/dL
0.47 to < 0.80 mmol/L
 1.5 mg/dL
< 0.47 
mmol/L
Hyperbilirubinemia 
Adult and Pediatric > 14 Days
 1.0 to 1.5  
ULN 
 1.5 to 2.5  ULN
 2.5 to 5.0  ULN 
 5.0  ULN 
Infant,  14 Days
(non-hemolytic)
NA
20.0 to 25.0 mg/dL
342 to 428 μmol/L
 25.0 to 30.0 mg/dL
> 428 to 513 μmol/L
 30.0 mg/dL
> 513 μmol/L
Infant,  14 Days
(hemolytic)
NA
NA
20.0 to 25.0 mg/dL
342 to 428 μmol/L
 25.0 mg/dL
> 428 μmol/L
Blood Urea Nitrogen
1.25 to 2.50  
ULN 
 2.50 to 5.00  ULN 
 5.00 to 10.00  ULN 
 10.00  
ULN
>ULN to 
10.0 mg/dL 
 10.0 to 12.0 mg/dL 
 12.0 to 15.0 mg/dL 
 15.0 mg/dL
Hyperuricemia
>ULN to 597 
μmol/L
 597 to 716 μmol/L
 716 to 895 μmol/L
 895 μmol/L
1.5 mg/dL to  
LLN
87 μmol/L to  
LLN
1.0 to  1.5 mg/dL
57 to  87 μmol/L
0.5 to  1.0 mg/dL
27 to  57 μmol/L
 0.5 mg/dL
 27 μmol/L
Hypouricemia
Adult and Pediatric
≥ 1 year
Infant < 1 Year
N/A
1.0 mg/dl to <LLN-
57 μmol to <LLN
0.5 to  1.0 mg/dL
27 to  57 μmol/L
 0.5 mg/dL
 27 μmol/L

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 135
12 April 2023
CHEMISTRY
Grade 1
Grade 2
Grade 3
Grade 4
Creatinine** 
 1.50 to 
2.00 mg/dL
 133 to 177 
μmol/L
 2.00 to 3.00 mg/dL
 177 to 265 μmol/L
 3.00 to 6.00 mg/dL 
 265 to 530 μmol/L
 6.00 mg/dL
 530 μmol/L
16.0 mEq/L to 
 LLN 
11.0 to  16.0 mEq/L
8.0 to  11.0 mEq/L
 8.0 mEq/L
Bicarbonate
Adult and Pediatric 
≥ 4 Years
16.0 mmol/L to 
 LLN
11.0 to  16.0 mmol/L
8.0 to  11.0 mmol/L
 8.0 mmol/L
Pediatric < 4 Years
NA
11.0 mEq/L to <LLN
8.0 to  11.0 mEq/L
 8.0 mEq/L
11.0 mmol/L to <LLN
8.0 to  11.0 mmol/L
 8.0 mmol/L
Triglycerides
(Fasting)
NA
500 to 750 mg/dL
5.64–8.47 mmol/L
 750 to 1200 mg/dL
 8.47–13.55 mmol/L
 1200 mg/dL
 13.55 
mmol/L
130 to 
160 mg/dL
>160 to 190 mg/dL
> 190 mg/dL
NA
LDL (Fasting)
Adult
3.35 to 4.15 
mmol/L
>4.15 to 4.92 mmol/L
>4.92 mmol/L
110 to 
130 mg/dL
>130 to 190 mg/dL
> 190 mg/dL
NA
LDL (Fasting)
Pediatric >2 to <18 years
2.84 to 3.37 
mmol/L
>3.37 to 4.92 mmol/L
>4.92 mmol/L
200 to 
239 mg/dL
 239 to 300 mg/dL
 300 mg/dL
NA
Hypercholesterolemia
(Fasting)
5.16 to 6.19 
mmol/L
 6.19 to 7.77 mmol/L
 7.77 mmol/L

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 136
12 April 2023
CHEMISTRY
Grade 1
Grade 2
Grade 3
Grade 4
Pediatric  18 Years
170 to 
199 mg/dL
4.39 to 5.15 
mmol/L
 199 to 300 mg/dL
 5.15 to 7.77 mmol/L
 300 mg/dL
 7.77 mmol/L
NA
Creatine Kinase
3.0 to  6.0  
ULN
6.0 to  10.0  ULN
10.0 to  20.0  ULN
 20.0  ULN
*
Calcium should be corrected for albumin if albumin is < 4.0 g/dL.
**
An overlap between the Grade 1 scale and the Lab’s normal range for creatinine may result for male participants > 70 years. Please follow the Gilead convention of grading 
any result within the LLN and ULN a 0. 
ENZYMES
Grade 1
Grade 2
Grade 3
Grade 4
AST (SGOT) 
1.25 to 2.50  ULN
 2.50 to 5.00  ULN
 5.00 to 10.00  ULN
 10.00  ULN
ALT (SGPT) 
1.25 to 2.50  ULN
 2.50 to 5.00  ULN
 5.00 to 10.00  ULN
 10.00  ULN
GGT
1.25 to 2.50  ULN
 2.50 to 5.00  ULN
 5.00 to 10.00  ULN
 10.00  ULN
Alkaline Phosphatase 
1.25 to 2.50  ULN
 2.50 to 5.00  ULN
 5.00 to 10.00  ULN
 10.00  ULN
Total Amylase
 1.0 to 1.5  ULN
 1.5 to 2.0  ULN
 2.0 to 5.0  ULN
 5.0  ULN
Pancreatic Amylase
 1.0 to 1.5  ULN
 1.5 to 2.0  ULN
 2.0 to 5.0  ULN
 5.0  ULN
Lipase 
 1.0 to 1.5  ULN
 1.5 to 3.0  ULN
 3.0 to 5.0  ULN
 5.0  ULN
-
2.0 to  LLN g/dL
20 to  LLN g/L
 2.0 g/dL
 20 g/L
NA
Albumin
Pediatrics <16 years 
≥ 16 years
3.0 g/dL to  LLN
30 g/L to  LLN
2.0 to  3.0 g/dL
20 to  30 g/L
 2.0 g/dL
 20 g/L
NA

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 137
12 April 2023
URINALYSIS
Grade 1
Grade 2
Grade 3
Grade 4
Hematuria (Dipstick) 
1
2
3-4+
NA
Hematuria (Quantitative) 
See Note below
Females
> ULN - 10 RBC/HPF
 10-75 RBC/HPF
> 75 RBC/HPF
NA
Males
6-10 RBC/HPF
 10-75 RBC/HPF
> 75 RBC/HPF
NA
Proteinuria (Dipstick)
1
2–3
4
NA
Proteinuria, 24 Hour Collection
Adult and Pediatric 
 10 Years
200 to 999 mg/24 h
> 999 to 1999 mg/24 h
> 1999 to 3500 mg/24 h
 3500 mg/24 h
Pediatric  3 Mo to 
< 10 Years
201 to 499 mg/m2/24 h
> 499 to 799 mg/m2/24 h
> 799 to 1000 mg/m2/24 h
 1000 mg/ m2/24 h
Glycosuria (Dipstick)
1+
2-3
4
NA
Notes: 
•
Toxicity grades for Quantitative and Dipstick Hematuria will be assigned by Covance Laboratory, however for other laboratory tests, toxicity grades will only be assigned to 
Dipstick Hematuria.
•
With the exception of lipid tests, any graded laboratory test with a result that is between the LLN and ULN should be assigned Grade 0.
•
If the severity of a clinical AE could fall under either one of two grades (eg, the severity of an AE could be either Grade 2 or Grade 3), select the higher of the two grades for 
the AE.

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 138
12 April 2023
CARDIOVASCULAR
Grade 1
Grade 2
Grade 3
Grade 4
Cardiac Arrhythmia (general)
(By ECG or physical exam)
Asymptomatic AND No 
intervention indicated
Asymptomatic AND 
Non-urgent medical 
intervention indicated
Symptomatic, 
non-life-threatening AND 
Non-urgent medical 
intervention indicated 
Life-threatening arrhythmia 
OR Urgent intervention 
indicated
Cardiac-ischemia/Infarction
NA
NA
Symptomatic ischemia 
(stable angina) OR Testing 
consistent with ischemia 
Unstable angina OR Acute 
myocardial infarction
Hemorrhage (significant 
acute blood loss)
NA
Symptomatic AND No 
transfusion indicated
Symptomatic AND 
Transfusion of  2 units 
packed RBCs (for children 
 10 cc/kg) indicated 
Life-threatening hypotension 
OR Transfusion of  2 units 
packed RBCs indicated (for 
children  10 cc/kg) indicated
Hypertension (with repeat 
testing at same visit)
140–159 mmHg systolic 
OR 
90–99 mmHg diastolic
 159–179 mmHg systolic 
OR 
 99–109 mmHg diastolic
 179 mmHg systolic 
OR 
 109 mmHg diastolic
Life-threatening 
consequences (eg, malignant 
hypertension) OR 
Hospitalization (other than 
ER visit) indicated
Pediatric  17 Years (with 
repeat testing at same visit)
NA
91st–94th percentile adjusted 
for age, height, and gender 
(systolic and/or diastolic)
≥ 95th percentile adjusted 
for age, height, and gender 
(systolic and/or diastolic)
Life-threatening 
consequences (eg, malignant 
hypertension) OR 
Hospitalization indicated 
(other than ER visit)
Hypotension
NA
Symptomatic, corrected with 
oral fluid replacement
Symptomatic, IV fluids 
indicated
Shock requiring use of 
vasopressors or mechanical 
assistance to maintain blood 
pressure
Pericardial Effusion
Asymptomatic, small 
effusion requiring no 
intervention
Asymptomatic, moderate or 
larger effusion requiring no 
intervention
Effusion with 
non-life-threatening 
physiologic consequences 
OR Effusion with 
nonurgent intervention 
indicated
Life-threatening 
consequences 
(eg, tamponade) OR Urgent 
intervention indicated

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 139
12 April 2023
CARDIOVASCULAR
Grade 1
Grade 2
Grade 3
Grade 4
Prolonged PR Interval
PR interval 
0.21 to 0.25 sec
PR interval
 0.25 sec
Type II 2nd degree AV 
block OR Ventricular pause 
 3.0 sec
Complete AV block 
Pediatric  16 Years
1st degree AV block
(PR > normal for age and 
rate)
Type I 2nd degree AV block 
Type II 2nd degree AV 
block 
Complete AV block
Prolonged QTc
Asymptomatic, QTc interval 
0.45 to 0.47 sec OR Increase 
interval  0.03 sec above 
baseline
Asymptomatic, QTc interval 
0.48 to 0.49 sec OR Increase 
in interval 0.03 to 0.05 sec 
above baseline
Asymptomatic, QTc 
interval  0.50 sec OR 
Increase in interval 
 0.06 sec above baseline
Life-threatening 
consequences, eg, Torsade de 
pointes or other associated 
serious ventricular 
dysrhythmia
Pediatric  16 Years
Asymptomatic, QTc interval 
0.450 to 0.464 sec 
Asymptomatic, QTc interval 
0.465 to 0.479 sec 
Asymptomatic, QTc 
interval  0.480 sec 
Life-threatening 
consequences, eg, Torsade de 
pointes or other associated 
serious ventricular 
dysrhythmia
Thrombosis/Embolism
NA
Deep vein thrombosis AND 
No intervention indicated 
(eg, anticoagulation, lysis 
filter, invasive procedure) 
Deep vein thrombosis AND 
Intervention indicated 
(eg, anticoagulation, lysis 
filter, invasive procedure) 
Embolic event (eg, pulmonary 
embolism, life-threatening 
thrombus) 
Vasovagal Episode 
(associated with a procedure 
of any kind)
Present without loss of 
consciousness 
Present with transient loss of 
consciousness
NA 
NA
Ventricular Dysfunction 
(congestive heart failure, 
CHF)
NA
Asymptomatic diagnostic 
finding AND intervention 
indicated
New onset with symptoms 
OR Worsening 
symptomatic CHF
Life-threatening CHF

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 140
12 April 2023
RESPIRATORY
Grade 1
Grade 2
Grade 3
Grade 4
Bronchospasm (acute)
FEV1 or peak flow reduced to 
70% to 80%
FEV1 or peak flow 50% to 69%
FEV1 or peak flow 
25% to 49% 
Cyanosis OR FEV1 or peak 
flow  25% OR Intubation
Dyspnea or Respiratory 
Distress
Dyspnea on exertion with no 
or minimal interference with 
usual social & functional 
activities 
Dyspnea on exertion causing 
greater than minimal 
interference with usual social & 
functional activities 
Dyspnea at rest causing 
inability to perform usual 
social & functional 
activities 
Respiratory failure with 
ventilatory support indicated
Pediatric  14 Years
Wheezing OR minimal 
increase in respiratory rate for 
age
Nasal flaring OR Intercostal 
retractions OR Pulse oximetry 
90% to 95%
Dyspnea at rest causing 
inability to perform usual 
social & functional 
activities OR Pulse 
oximetry  90%
Respiratory failure with 
ventilatory support indicated
OCULAR/VISUAL
Grade 1
Grade 2
Grade 3
Grade 4
Uveitis
Asymptomatic but detectable 
on exam
Symptomatic anterior uveitis 
OR Medical intervention 
indicated
Posterior or pan-uveitis OR 
Operative intervention 
indicated
Disabling visual loss in affected 
eye(s) 
Visual Changes (from 
baseline)
Visual changes causing no or 
minimal interference with 
usual social & functional 
activities
Visual changes causing greater 
than minimal interference with 
usual social & functional 
activities
Visual changes causing 
inability to perform usual 
social & functional 
activities
Disabling visual loss in affected 
eye(s)

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 141
12 April 2023
SKIN
Grade 1
Grade 2
Grade 3
Grade 4
Alopecia
Thinning detectable by 
study participant or 
caregiver (for disabled 
adults)
Thinning or patchy hair loss 
detectable by health care 
provider
Complete hair loss
NA
Cutaneous Reaction – Rash
Localized macular rash 
Diffuse macular, 
maculopapular, or 
morbilliform rash OR Target 
lesions 
Diffuse macular, 
maculopapular, or 
morbilliform rash with vesicles 
or limited number of bullae 
OR Superficial ulcerations of 
mucous membrane limited to 
one site
Extensive or generalized 
bullous lesions OR 
Stevens-Johnson 
syndrome OR Ulceration 
of mucous membrane 
involving two or more 
distinct mucosal sites OR 
Toxic epidermal 
necrolysis (TEN)
Hyperpigmentation
Slight or localized
Marked or generalized
NA
NA
Hypopigmentation
Slight or localized 
Marked or generalized
NA
NA
Pruritis (itching – no skin 
lesions) 
(See also Injection Site 
Reactions: Pruritis associated 
with injection)
Itching causing no or 
minimal interference with 
usual social & functional 
activities
Itching causing greater than 
minimal interference with 
usual social & functional 
activities
Itching causing inability to 
perform usual social & 
functional activities 
NA

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 142
12 April 2023
GASTROINTESTINAL
Grade 1
Grade 2
Grade 3
Grade 4
Anorexia
Loss of appetite without 
decreased oral intake
Loss of appetite associated with 
decreased oral intake without 
significant weight loss 
Loss of appetite associated 
with significant weight loss 
Life-threatening 
consequences OR Aggressive 
intervention indicated 
(eg, tube feeding or total 
parenteral nutrition)
Ascites
Asymptomatic
Symptomatic AND Intervention 
indicated (eg, diuretics or 
therapeutic paracentesis)
Symptomatic despite 
intervention
Life-threatening 
consequences
Cholecystitis
NA
Symptomatic AND Medical 
intervention indicated
Radiologic, endoscopic, or 
operative intervention 
indicated
Life-threatening 
consequences (eg, sepsis or 
perforation) 
Constipation 
NA
Persistent constipation requiring 
regular use of dietary 
modifications, laxatives, or 
enemas 
Obstipation with manual 
evacuation indicated
Life-threatening 
consequences 
(eg, obstruction)
Diarrhea 
Adult and Pediatric 
 1 Year
Transient or intermittent 
episodes of unformed stools 
OR Increase of  3 stools 
over baseline/24 hour
Persistent episodes of unformed 
to watery stools OR Increase of 
4–6 stools over baseline per 
24-hours. 
Bloody diarrhea OR Increase 
of  7 stools per 24-hour 
period OR IV fluid 
replacement indicated
Life-threatening 
consequences 
(eg, hypotensive shock)
Pediatric  1 Year
Liquid stools (more 
unformed than usual) but 
usual number of stools
Liquid stools with increased 
number of stools OR Mild 
dehydration
Liquid stools with moderate 
dehydration
Liquid stools resulting in 
severe dehydration with 
aggressive rehydration 
indicated OR Hypotensive 
shock
Dysphagia-Odynophagia 
Symptomatic but able to eat 
usual diet
Symptoms causing altered 
dietary intake without medical 
intervention indicated
Symptoms causing severely 
altered dietary intake with 
medical intervention 
indicated
Life-threatening reduction in 
oral intake

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 143
12 April 2023
GASTROINTESTINAL
Grade 1
Grade 2
Grade 3
Grade 4
Mucositis/Stomatitis 
(clinical exam)
See also Proctitis, 
Dysphagia-Odynophagia
Erythema of the mucosa
Patchy pseudomembranes or 
ulcerations 
Confluent pseudomembranes 
or ulcerations OR Mucosal 
bleeding with minor trauma
Tissue necrosis OR Diffuse 
spontaneous mucosal 
bleeding OR Life-threatening 
consequences (eg, aspiration, 
choking)
Nausea 
Transient ( 24-hours) or 
intermittent nausea with no 
or minimal interference 
with oral intake
Persistent nausea resulting in 
decreased oral intake for 
24-48-hours
Persistent nausea resulting in 
minimal oral intake for 
 48-hours OR Aggressive 
rehydration indicated 
(eg, IV fluids)
Life-threatening 
consequences 
(eg, hypotensive shock)
Pancreatitis
NA
Symptomatic AND 
Hospitalization not indicated 
(other than ER visit)
Symptomatic AND 
Hospitalization indicated 
(other than ER visit)
Life-threatening 
consequences (eg, sepsis, 
circulatory failure, 
hemorrhage)
Proctitis (functional- 
symptomatic)
Also see Mucositis/ 
Stomatitis for Clinical 
Exam
Rectal discomfort AND No 
intervention indicated
Symptoms causing greater than 
minimal interference with usual 
social & functional activities 
OR Medical intervention 
indicated 
Symptoms causing inability 
to perform usual social/ 
functional activities OR 
Operative intervention 
indicated 
Life-threatening 
consequences 
(eg, perforation)
Vomiting
Transient or intermittent 
vomiting with no or 
minimal interference with 
oral intake
Frequent episodes of vomiting 
with no or mild dehydration
Persistent vomiting resulting 
in orthostatic hypotension OR 
Aggressive rehydration 
indicated
Life-threatening 
consequences 
(eg, hypotensive shock)

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 144
12 April 2023
NEUROLOGICAL
Grade 1
Grade 2
Grade 3
Grade 4
Alteration in 
Personality-Behavior or in 
Mood (eg, agitation, 
anxiety, depression, mania, 
psychosis)
Alteration causing no or 
minimal interference with 
usual social & functional 
activities 
Alteration causing greater 
than minimal interference 
with usual social & functional 
activities 
Alteration causing inability to 
perform usual social & 
functional activities 
Behavior potentially harmful 
to self or others 
(eg, suicidal/homicidal 
ideation or attempt, acute 
psychosis) OR Causing 
inability to perform basic 
self-care functions
Altered Mental Status 
For Dementia, see 
Cognitive and 
Behavioral/Attentional 
Disturbance (including 
dementia and ADD)
Changes causing no or 
minimal interference with 
usual social & functional 
activities
Mild lethargy or somnolence 
causing greater than minimal 
interference with usual social 
& functional activities
Confusion, memory 
impairment, lethargy, or 
somnolence causing inability 
to perform usual social & 
functional activities
Delirium OR obtundation, OR 
coma
Ataxia 
Asymptomatic ataxia 
detectable on exam OR 
Minimal ataxia causing no 
or minimal interference 
with usual social & 
functional activities
Symptomatic ataxia causing 
greater than minimal 
interference with usual social 
& functional activities
Symptomatic ataxia causing 
inability to perform usual 
social & functional activities 
Disabling ataxia causing 
inability to perform basic 
self-care functions
Cognitive and 
Behavioral/Attentional 
Disturbance (including 
dementia and Attention 
Deficit Disorder) 
Disability causing no or 
minimal interference with 
usual social & functional 
activities OR Specialized 
resources not indicated
Disability causing greater 
than minimal interference 
with usual social & functional 
activities OR Specialized 
resources on part-time basis 
indicated
Disability causing inability to 
perform usual social & 
functional activities OR 
Specialized resources on a 
full-time basis indicated
Disability causing inability to 
perform basic self-care 
functions OR 
Institutionalization indicated
CNS Ischemia
(acute)
NA
NA
Transient ischemic attack
Cerebral vascular accident 
(CVA, stroke) with 
neurological deficit 

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 145
12 April 2023
NEUROLOGICAL
Grade 1
Grade 2
Grade 3
Grade 4
Developmental delay – 
Pediatric  16 Years
Mild developmental delay, 
either motor or cognitive, 
as determined by 
comparison with a 
developmental screening 
tool appropriate for the 
setting 
Moderate developmental 
delay, either motor or 
cognitive, as determined by 
comparison with a 
developmental screening tool 
appropriate for the setting 
Severe developmental delay, 
either motor or cognitive, as 
determined by comparison 
with a developmental 
screening tool appropriate for 
the setting 
Developmental regression, 
either motor or cognitive, as 
determined by comparison 
with a developmental 
screening tool appropriate for 
the setting
Headache 
Symptoms causing no or 
minimal interference with 
usual social & functional 
activities
Symptoms causing greater 
than minimal interference 
with usual social & functional 
activities
Symptoms causing inability 
to perform usual social & 
functional activities
Symptoms causing inability 
to perform basic self-care 
functions OR Hospitalization 
indicated (other than ER visit) 
OR Headache with significant 
impairment of alertness or 
other neurologic function 
Insomnia
NA
Difficulty sleeping causing 
greater than minimal 
interference with usual 
social/functional activities
Difficulty sleeping causing 
inability to perform usual 
social & functional activities
Disabling insomnia causing 
inability to perform basic 
self-care functions
Neuromuscular Weakness 
(including myopathy & 
neuropathy) 
Asymptomatic with 
decreased strength on exam 
OR Minimal muscle 
weakness causing no or 
minimal interference with 
usual social & functional 
activities
Muscle weakness causing 
greater than minimal 
interference with usual social 
& functional activities
Muscle weakness causing 
inability to perform usual 
social & functional activities 
Disabling muscle weakness 
causing inability to perform 
basic self-care functions OR 
Respiratory muscle weakness 
impairing ventilation
Neurosensory Alteration 
(including paresthesia and 
painful neuropathy)
Asymptomatic with sensory 
alteration on exam or 
minimal paresthesia 
causing no or minimal 
interference with usual 
social & functional 
activities 
Sensory alteration or 
paresthesia causing greater 
than minimal interference 
with usual social & functional 
activities 
Sensory alteration or 
paresthesia causing inability 
to perform usual social & 
functional activities
Disabling sensory alteration 
or paresthesia causing 
inability to perform basic self-
care functions

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 146
12 April 2023
NEUROLOGICAL
Grade 1
Grade 2
Grade 3
Grade 4
Seizure: (new onset) 
NA
1 seizure 
2–4 seizures 
Seizures of any kind that are 
prolonged, repetitive 
(eg, status epilepticus), or 
difficult to control 
(eg, refractory epilepsy)
Seizure: (preexisting) 
For Worsening of Existing 
Epilepsy the Grades Should 
Be Based on an Increase 
from Previous Level of 
Control to Any of These 
Levels
NA
Increased frequency of 
preexisting seizures 
(nonrepetitive) without 
change in seizure character 
OR infrequent breakthrough 
seizures while on stable meds 
in a previously controlled 
seizure disorder
Change in seizure character 
from baseline either in 
duration or quality 
(eg, severity or focality) 
Seizures of any kind that are 
prolonged, repetitive 
(eg, status epilepticus), or 
difficult to control 
(eg, refractory epilepsy)
Seizure 
– Pediatric  18 Years
Seizure, generalized onset 
with or without secondary 
generalization, lasting 
< 5 minutes with 
< 24-hours post-ictal state
Seizure, generalized onset 
with or without secondary 
generalization, lasting 
5-20 minutes with 
< 24-hours post-ictal state
Seizure, generalized onset 
with or without secondary 
generalization, lasting 
> 20 minutes 
Seizure, generalized onset 
with or without secondary 
generalization, requiring 
intubation and sedation
Syncope (not associated 
with a procedure)
NA
Present
NA
NA
Vertigo
Vertigo causing no or 
minimal interference with 
usual social & functional 
activities
Vertigo causing greater than 
minimal interference with 
usual social & functional 
activities 
Vertigo causing inability to 
perform usual social & 
functional activities
Disabling vertigo causing 
inability to perform basic 
self-care functions

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 147
12 April 2023
MUSCULOSKELETAL
Grade 1
Grade 2
Grade 3
Grade 4
Arthralgia
See also Arthritis
Joint pain causing no or 
minimal interference with 
usual social & functional 
activities
Joint pain causing greater than 
minimal interference with usual 
social & functional activities
Joint pain causing inability 
to perform usual social & 
functional activities
Disabling joint pain causing 
inability to perform basic 
self-care functions
Arthritis
See also Arthralgia
Stiffness or joint swelling 
causing no or minimal 
interference with usual 
social & functional 
activities
Stiffness or joint swelling causing 
greater than minimal interference 
with usual social & functional 
activities
Stiffness or joint swelling 
causing inability to perform 
usual social & functional 
activities
Disabling joint stiffness or 
swelling causing inability to 
perform basic self-care 
functions
Bone Mineral Loss
BMD t-score or z-score
–2.5 to –1.0 
BMD t-score or z-score  –2.5
Pathological fracture 
(including loss of vertebral 
height)
Pathologic fracture causing 
life-threatening consequences 
Pediatric  21 Years
BMD z-score 
–2.5 to –1.0
BMD z-score < –2.5
Pathological fracture 
(including loss of vertebral 
height)
Pathologic fracture causing 
life-threatening consequences 
Myalgia
(noninjection site)
Muscle pain causing no or 
minimal interference with 
usual social & functional 
activities
Muscle pain causing greater than 
minimal interference with usual 
social & functional activities
Muscle pain causing 
inability to perform usual 
social & functional 
activities
Disabling muscle pain 
causing inability to perform 
basic self-care functions
Osteonecrosis
NA
Asymptomatic with radiographic 
findings AND No operative 
intervention indicated
Symptomatic bone pain 
with radiographic findings 
OR Operative intervention 
indicated
Disabling bone pain with 
radiographic findings causing 
inability to perform basic 
self-care functions

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 148
12 April 2023
SYSTEMIC
Grade 1
Grade 2
Grade 3
Grade 4
Acute Systemic Allergic 
Reaction 
Localized urticaria 
(wheals) with no medical 
intervention indicated
Localized urticaria with medical 
intervention indicated OR Mild 
angioedema with no medical 
intervention indicated
Generalized urticaria OR 
Angioedema with medical 
intervention indicated OR 
Symptomatic mild 
bronchospasm
Acute anaphylaxis OR 
Life-threatening 
bronchospasm OR laryngeal 
edema
Chills
Symptoms causing no or 
minimal interference with 
usual social & functional 
activities
Symptoms causing greater than 
minimal interference with usual 
social & functional activities 
Symptoms causing inability 
to perform usual social & 
functional activities
NA
Fatigue
Malaise
Symptoms causing no or 
minimal interference with 
usual social & functional 
activities
Symptoms causing greater than 
minimal interference with usual 
social & functional activities
Symptoms causing inability 
to perform usual social & 
functional activities
Incapacitating fatigue/malaise 
symptoms causing inability to 
perform basic self-care 
functions
Fever (nonaxillary)
37.7C to 38.6C
99.8F to 101.5F
38.7C to 39.3C
101.6F to 102.8F
39.4C to 40.5C
102.9F to 104.9F
 40.5C 
 104.9F
Pain- Indicate Body Site
See also Injection Site 
Pain, Headache, 
Arthralgia, and Myalgia
Pain causing no or 
minimal interference with 
usual social & functional 
activities
Pain causing greater than minimal 
interference with usual social & 
functional activities
Pain causing inability to 
perform usual social & 
functional activities
Disabling pain causing 
inability to perform basic 
self-care functions OR 
Hospitalization (other than 
ER visit) indicated
Unintentional Weight 
Loss
NA
5% to 9% loss in body weight 
from baseline
10% to 19% loss in body 
weight from baseline
 20% loss in body weight 
from baseline OR Aggressive 
intervention indicated 
(eg, tube feeding or total 
parenteral nutrition)

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 149
12 April 2023
INJECTION SITE REACTION
Grade 1
Grade 2
Grade 3
Grade 4
Injection Site Pain 
(pain without touching)
Or Tenderness (pain when 
area is touched) 
Pain/tenderness causing no 
or minimal limitation of use 
of limb
Pain/tenderness limiting use 
of limb OR Pain/tenderness 
causing greater than minimal 
interference with usual social 
& functional activities
Pain/tenderness causing 
inability to perform usual 
social & functional 
activities
Pain/tenderness causing 
inability to perform basic 
self-care function OR 
Hospitalization (other than ER 
visit) indicated for management 
of pain/tenderness
Injection Site Reaction 
(Localized),  15 Years
Erythema OR Induration
of 5  5 cm to 9  9 cm 
(or 2581  cm2)
Erythema OR Induration OR 
Edema  9 cm any diameter 
(or  81 cm2)
Ulceration OR Secondary 
infection OR Phlebitis OR 
Sterile abscess OR 
Drainage
Necrosis (involving dermis and 
deeper tissue)
Pediatric  15 Years
Erythema OR Induration 
OR Edema present but 
 2.5 cm diameter
Erythema OR Induration OR 
Edema > 2.5 cm diameter but 
< 50% surface area of the 
extremity segment (eg, upper 
arm/thigh)
Erythema OR Induration 
OR Edema involving 
 50% surface area of the 
extremity segment 
(eg, upper arm/thigh) OR 
Ulceration OR Secondary 
infection OR Phlebitis OR 
Sterile abscess OR 
Drainage
Necrosis (involving dermis and 
deeper tissue)
Pruritis Associated with 
Injection 
See also Skin: Pruritis 
(itching—no skin lesions)
Itching localized to 
injection site AND 
Relieved spontaneously or 
with  48 h treatment 
Itching beyond the injection 
site but not generalized OR 
Itching localized to injection 
site requiring  48 h treatment 
Generalized itching causing 
inability to perform usual 
social & functional 
activities
NA

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 150
12 April 2023
ENDOCRINE/METABOLIC
Grade 1
Grade 2
Grade 3
Grade 4
Lipodystrophy (eg, back 
of neck, breasts, 
abdomen)
Detectable by study 
participant or caregiver 
(for young children and 
disabled adults)
Detectable on physical exam by 
health care provider
Disfiguring OR Obvious 
changes on casual visual 
inspection
NA
Diabetes Mellitus
NA
New onset without need to initiate 
medication OR Modification of 
current meds to regain glucose 
control
New onset with initiation of 
indicated med OR Diabetes 
uncontrolled despite 
treatment modification
Life-threatening 
consequences 
(eg, ketoacidosis, 
hyperosmolar non-ketotic 
coma) 
Gynecomastia
Detectable by study 
participant or caregiver 
(for young children and 
disabled adults)
Detectable on physical exam by 
health care provider
Disfiguring OR Obvious on 
casual visual inspection
NA
Hyperthyroidism 
Asymptomatic
Symptomatic causing greater than 
minimal interference with usual 
social & functional activities OR 
Thyroid suppression therapy 
indicated
Symptoms causing inability 
to perform usual social & 
functional activities OR 
Uncontrolled despite 
treatment modification 
Life-threatening 
consequences (eg, thyroid 
storm)
Hypothyroidism
Asymptomatic
Symptomatic causing greater than 
minimal interference with usual 
social & functional activities OR 
Thyroid replacement therapy 
indicated
Symptoms causing inability 
to perform usual social & 
functional activities OR 
Uncontrolled despite 
treatment modification 
Life-threatening 
consequences (eg, myxedema 
coma)
Lipoatrophy (eg, fat loss 
from the face, 
extremities, buttocks)
Detectable by study 
participant or caregiver 
(for young children and 
disabled adults)
Detectable on physical exam by 
health care provider
Disfiguring OR Obvious on 
casual visual inspection
NA

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 151
12 April 2023
GENITOURINARY
Grade 1
Grade 2
Grade 3
Grade 4
Intermenstrual 
Bleeding (IMB)
Spotting observed by participant 
OR Minimal blood observed 
during clinical or colposcopic 
exam
Intermenstrual bleeding not 
greater in duration or amount 
than usual menstrual cycle
Intermenstrual bleeding greater 
in duration or amount than usual 
menstrual cycle
Hemorrhage with 
life-threatening 
hypotension OR Operative 
intervention indicated
Urinary Tract 
obstruction (eg, stone)
NA
Signs or symptoms of urinary 
tract obstruction without 
hydronephrosis or renal 
dysfunction
Signs or symptoms of urinary 
tract obstruction with 
hydronephrosis or renal 
dysfunction
Obstruction causing 
life-threatening 
consequences
INFECTION
Grade 1
Grade 2
Grade 3
Grade 4
Infection (any other 
than HIV infection)
Localized, no systemic 
antimicrobial treatment 
indicated AND Symptoms 
causing no or minimal 
interference with usual social & 
functional activities
Systemic antimicrobial 
treatment indicated OR 
Symptoms causing greater 
than minimal interference 
with usual social & functional 
activities
Systemic antimicrobial 
treatment indicated AND 
Symptoms causing inability to 
perform usual social & 
functional activities OR 
Operative intervention (other 
than simple incision and 
drainage) indicated
Life-threatening 
consequences 
(eg, septic shock)
Basic Self-care Functions: Activities such as bathing, dressing, toileting, transfer/movement, continence, and feeding. 
Usual Social & Functional Activities: Adaptive tasks and desirable activities, such as going to work, shopping, cooking, use of transportation, pursuing a hobby, etc.

Selgantolimod 
Protocol GS-US-465-4439 
Gilead Sciences, Inc. 
Final 
Amendment2 
11.6. 
Management of Clinical and Laboratory Adverse Events 
Grade 1 
Grade 2 
Grade3 
JVlay continue 
dosing at the 
discretion of the 
investigator 
R epeat lab to 
conf'n'm toxicity 
grade 
If confirmed and considered related to 
investigational medicinal products: 
1. 'Withhold investigational medicinal 
products until :::: Grade 2 
2. Resta1·t all investigational medicinal 
products at full dose 
Grade4 
Repeat lab to 
confirm toxicity 
grade 
If conf'n'med and considered 
um·elated to investigational 
medicinal products, dosing 
may continue at the 
disc1·etion of the investigator 
If confirmed and 
considered related to 
investigational 
medicinal products, 
discontinue 
investigational 
medicinal products 
dosing permanently 
and follow at 
pe1iodic intervals at 
least weekly until a 
return to baseline or 
is otherwise 
explained 
If Grade 3 or Grade 4 recurrence that is 
confirmed and considered related to 
investigational medicinal products, 
discontinue all investigational medicinal 
products dosing permanently 
If Grade 3 or Grade 4 recurrence that is 
considered unrelated to investigational 
medicinal products, continue all 
investigational medicinal products at the 
same dose at the discretion of the investigator 
If the adverse event is considered related to nivolumab, the investigator must follow the toxicity 
management guidance outlined in the local label for nivolumab. 
11.7. 
Amendment History 
A high-level summaiy of this amendment is provided in tabular fonn in the subsection below, 
with changes listed in order of impo1iance. Minor changes such as the conection of typographic 
enors, grammar, or fonnatting are not detailed. 
Sepai·ate summaiy of change documents for earlier amendments ai·e available upon request. 
A sepai·ate tracked change (red-lined) document compai·ing the Protocol Amendment 1 to this 
amendment will be made available upon the publication of this protocol. 
11.7.1. 
Amendment 2 (12 April 2023) 
Rationale fo1· Key Changes Included in Amendment 2 
References to nivolumab were modified throughout the protocol due to Gilead's 
decision to discontinue nivolumab dosing across study cohorts. 
An ongoing study (GS-US-389-5458) assessing the safety, tolerability and 
efficacy of once-weekly administration of SLGN 3 mg in special populations with 
chronic hepatitis B virus (CHB) was added. 
CONFIDENTIAL 
Page 152 
Affected Sections 
Throughout the protocol, as 
required 
Section 1.2.1.1 
12 April 2023 

Selgantolimod
Protocol GS-US-465-4439
Final
Gilead Sciences, Inc. 
Amendment 2
CONFIDENTIAL
Page 153
12 April 2023
Rationale for Key Changes Included in Amendment 2
Affected Sections
Figure 1 was updated in order to reflect the current changes to study design.
Section 3.2
A new section to describe the rationale for modifications to the study design was 
added following the decision to discontinue nivolumab dosing.
Sections 1.3.1
Benefit/Risk Assessment for nivolumab and Overall Benefit/Risk was updated 
following discontinuation of nivolumab in this study.
Section 1.5
Number of viremic chronic hepatitis B (CHB)-infected participants was reduced 
from 80 to 60 participants to reflect a prior sponsor decision that cohort 3 would 
not be enrolled.
Synopsis, Section 3.2, and 
throughout the protocol, as 
required
A new subsection for changes to the study design was added.
Section 3.2.1
All incidences of ‘Participants who remain on nucleos(t)ide (NUC) treatment into 
follow-up (FU) period are not required to attend FU Weeks 2 and 8 visits’ have 
been removed as all participants in Cohort 1 will remain on NUCs throughout the 
FU period.
Synopsis and Section 6.7
FU period was updated to outline the procedures following the change to study 
design.
Synopsis and Section 3.5
An individual treatment modification criterion (Any on treatment uveitis, 
confirmed by ophthalmologic evaluation) was moved to individual treatment 
discontinuation criteria after confirmation that no rechallenge is required 
following the resolution of the AE.
Synopsis and Section 6.9.1
A new section for toxicity management of irAEs observed with nivolumab was 
added.
Section 11.5
AE of special interest (eg, uveitis) was added to the safety analysis.
Section 8.6.2
FU Week 8 virtual/telephonic visit pregnancy test was changed across all cohorts.
Section 11.3 and throughout 
the protocol, as required.
The visit windows for FU Weeks 24 through FU Week 48 (for Cohorts 1 and 2) 
were extended to ± 14 days.
Sections 11.3 and 6.7
FU Week 2 was removed in order to simplify the FU period for participants.
Section 11.3 and throughout 
the protocol, as required
References to Cohort 3 were removed throughout the protocol due to the decision 
to discontinue this cohort.
Throughout the protocol, as 
required
Incidences of Global Patient Safety have been changed to Patient Safety (PS).
Section 7 and throughout 
the protocol, as required
Minor changes included to correct typographical errors.
Throughout the protocol, as 
required

Prot-GS-US-465-4439-amd-2
ELECTRONIC SIGNATURES
Signed by
Meaning of Signature
Server Date
(dd-MMM-
yyyy hh:mm:ss)
Clinical Development
eSigned
13-Apr-2023
16:49:46
CCI