Combination therapy with famciclovir and interferon-alpha for the treatment of chronic hepatitis B.
Interferon-alpha (IFN-alpha) treatment results in long-term remissions in only 25%-40% of patients with chronic hepatitis B virus (HBV) infection. Famciclovir, the oral prodrug of penciclovir, inhibits HBV DNA replication. Five adults with chronic HBV infection in whom previous IFN-alpha therapy had failed were treated in a pilot study of overlapping IFN-alpha and famciclovir therapy totaling 20 weeks. HBV DNA levels decreased by 0.9 log units during the initial 4-week period of famciclovir alone, followed by a further decrease of 1.8 logs during the middle 12-week period of combination therapy. HBV DNA rose by 0.9 log during the final 4-week period of IFN-alpha alone. Two patients cleared HBV DNA, and their liver disease improved by clinical and histologic criteria. The combination of famciclovir and IFN-alpha appeared to be at least additive in suppressing HBV DNA. Efficacy trials of combination therapy with famciclovir and IFN-alpha are warranted.
Laboratory of Clinical Investigation, National Institute of Allergy andInfectious disease, National Institutes of Health, Bethesda, MD, USA. amarques@atlas.niaid.nih.gov
A R
AR
Marques
D T
DT
Lau
R
R
McKenzie
S E
SE
Straus
J H
JH
Hoofnagle
D015075:2-Aminopurine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use*; D001219:Aspartate Aminotransferases / Q000097:blood; D004279:DNA, Viral / Q000032:analysis; D004359:Drug Therapy, Combination; D000077595:Famciclovir; D006515:Hepatitis B virus / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000188:drug therapy*; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male
D000998:Antiviral Agents; D004279:DNA, Viral; D016898:Interferon-alpha; D015075:2-Aminopurine; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000077595:Famciclovir