— Christine M. Kukka, Project Manager, HBV Advocate
Adding pegylated interferon to ongoing antiviral treatment produced
remarkable rates of hepatitis B "e" antigen (HBeAg) loss and even
hepatitis B surface antigen (HBsAg) loss, according to a study
presented at the International Liver Congress held in London in April.
Eighty-three HBeAg-positive patients in China,
who had been on antivirals for more than two years, had 48 weeks of
interferon treatment added to their treatment regimen. A control group
continued on only antivirals:
- 60% of the group treated with add-on interferon
lost HBeAg and their viral loads dropped below 2,000 IU/mL. In
contrast, only 13.8% of patients treated with only antivirals achieved
those benchmarks.
- 27.7% of patients in the combination treatment group lost HBsAg. No one in the antiviral group lost HBsAg.
- All patients who had low HBsAg levels (less than
1,000 IU/mL) at the start of interferon treatment achieved HBeAg loss
and 91% cleared HBsAg.
" Sequential combination
therapy of (antivirals) and pegylated interferon effectively resulted
in high rates of complete response and HBsAg loss in patients with
prior long-term exposure to (antivirals)," researchers wrote. (Abstract
0117)
Another study exploring the benefits of
sequential antiviral and interferon treatment found that HBeAg-positive
patients who had been on antivirals for three years or longer also
experienced high rates of HBeAg loss and development of "e" antibodies
(HBeAg seroconversion) when their antivirals were replaced with
pegylated interferon.
At week 48, the HBeAg seroconversion rate in the
interferon-treated group was 66.67% compared to 2.5% in the antiviral
group. (Abstract P1071)
A third study from India also found notable
improvements when pegylated interferon was added to ongoing tenofovir
treatment. Sixty patients were treated with tenofovir for 12 weeks (300
mg daily), then:
- One group had pegylated interferon added to the
ongoing tenofovir regimen for 24 weeks, and then were followed for
another 28 weeks.
- The other half continued their tenofovir treatment for 52 weeks.
Sixty percent of the interferon-plus-tenofovir
group achieved healthy liver health, with normal alanine
aminotransferase (ALT) levels, compared to 30% in the tenofovir-only
group. The combination-treatment group also experienced greater viral
load (HBV DNA) declines and HBeAg seroconversion (53.3% vs. 23.3% in the
antiviral-only group).
"Sequential therapy using tenofovir and pegylated
interferon may provide rapid and high biochemical and virological
response in selected HBeAg-positive patients," researchers noted.
"Long-term clinical trials are needed to assess (the) sustained durable
response." (Abstract P1092)
Source: www.hbvadvocate.org/EASL_2014_Abstracts.pdf
HBV Journal Review
May 1, 2014, Vol 11, no 5
http://www.hbvadvocate.org/news/HBJ11.5.htm
Labels: interferon plus tenofovir
