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Adding interferon to nucleoside antivirals may improve response for people with chronic hepatitis B
Liz Highleyman, 2014-04-16 10:20:00

Adding pegylated interferon to entecavir (Baraclude) led to greater hepatitis B virus (HBV) viral load decline and higher likelihood of serological response in people with HBeAg-positive chronic hepatitis B, as did added interferon after long-term nucleoside therapy, but adding interferon after only a short course of antivirals did not improve response, according to a set of studies presented at the 49th Annual Meeting of the European Association for the Study of the Liver (EASL) last week in London.

Antiviral therapy for hepatitis B generally does a good job of suppressing HBV DNA or viral load, but serological response – including hepatitis B 'e' antigen (HBeAg) and surface antigen (HBsAg) loss or seroconversion – is less common. Hepatitis B surface antibody seroconversion, considered closest to a cure, is rare in people with chronic HBV infection. Some past research indicates that adding interferon increases the likelihood of antigen loss or seroconversion, but data have been inconsistent.

"Nucleoside analogue antivirals, which interfere with the HBV lifecycle, are standard treatment for chronic hepatitis B," explained EASL Education Councilor Cihan Yurdaydin of the University of Ankara at a press conference summarising the study findings. "Because only a minority of chronic hepatitis B patients achieve HBsAg loss with entecavir, treatment is indefinite for the majority of these patients. Interferon, which has long been the mainstay of hepatitis C treatment, is known to stimulate the natural immune response against viral infections. This synergistic effect should theoretically contribute to improved outcomes for hepatitis B as well."