— Christine M. Kukka, Project Manager, HBV Advocate
Chinese researchers found that hepatitis B "e" antigen
(HBeAg)-positive patients who were treated first with the antiviral
entecavir (Baraclude) and then with pegylated interferon achieve a
higher rate of HBeAg seroconversion (loss of HBeAg and development of
"e" antibodies) than patients treated with only entecavir.
To date, patients treated with only antivirals,
such as entecavir, rarely achieve a permanent HBeAg seroconversion once
antiviral treatment stops. A simultaneous combination of antivirals
plus interferon has also proven relatively unsuccessful.
However, recently doctors are finding that a
sequential approach to using antivirals and interferon may yield better
results. In this study, published in the June issue of the Journal of Hepatology,
doctors first knocked down patients' viral loads (HBV DNA) to less
than 1,000 copies per milliliter by treating them first with entecavir
for between nine and 36 months.
They continued with just the entecavir treatment
in 98 patients who served as the control group. However in a second
group of 94 patients, they replaced the entecavir with pegylated
interferon (180 μg/week) for 48 weeks.
After 48 weeks, 14.9 % of patients who switched
to interferon experienced HBeAg seroconversion, compared to just 6.1%
in the entecavir-treated control group.
Additionally, 8.5% of interferon-treated patients
lost hepatitis B surface antigen (HBsAg), indicating a vastly improved
health outlook in clearing the infection. None of the entecavir-only
patients cleared HBsAg.
Patients who experienced early declines in HBeAg
and HBsAg during interferon treatment were the most likely to
experience HBeAg seroconversion.
Researchers concluded that patients who achieved
low viral loads from entecavir can improve their chances of HBeAg
seroconversion by switching to a finite course of interferon.
Source: www.ncbi.nlm.nih.gov/pubmed/24915612
Labels: antivirals and HCC, HBeAg seroconversion
