AEGiS-CATIE: Combination therapy for Hepatitis B

Combination therapy for Hepatitis B

TreatmentUpdate80 - Vol. 8, No. 0; August 1997
Sean Hosein

Background

Hepatitis B virus (HBV) can be passed from one person to another during sex. The virus infects the liver and unless the infection is brought under control, severe liver damage and liver cancer can eventually develop.

Therapy

Currently, the only licensed treatment is interferon-alpha, but this drug is not effective in as many as 60% of infected people. As well, the anti-HIV drug 3TC and Famvir (famciclovir), a new anti-herpes treatment, have been reported to help reduce levels of HBV in the blood. Unfortunately early results from clinical trials suggest that in most treated persons, HBV levels rise once therapy stops, showing that HBV has not been wiped out. Moreover, use of these anti-HBV drugs by themselves can cause the virus to develop resistance against them.

For a therapy to be effective it :

* must be active in cells of the immune system that carry the virus out of the liver into the lymph nodes

* must not allow HBV to quickly develop resistance

There are trials underway outside of Canada testing combinations of 3TC with interferon alpha. Some researchers are suggesting use of IL-2 (interleukin-2) together with anti-HBV drugs to help the immune system better control HBV infection. Just as in HIV/AIDS it is clear that combination therapy is the best treatment, combination therapy against HBV seems to be the next step. Protease inhibitor therapy has been reported useful in one case of infection with both HIV and HBV.

REFERENCES:

1. Honkoop P, Niesters HGM, de Man RAM, et al. Lamivudine resistance in immunocompetent chronic hepatitis B. Journal of Hepatology 1997;26:1393-1395.

2. Locarini SA and Newbold JE. Chronic Hepatitis B: the therapeutic challenges. Journal of Antimicrobial Chemotherapy 1997;39:559-565.

3. Carr A and Cooper DA. Restoration of immunity to chronic hepatitis B infection in HIV-infected patient on protease inhibitor. Lancet 1997;349:995-996.

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Copyright © 1997 - TreatmentUpdate. Reproduced with permission. Reproduction of this article (other than one copy for personal reference) must be cleared through the Editor, The Canadian AIDS Treatment Information Exchange, 555 Richmond St. West, Suite 505, Box 1104, Toronto, ON, M5V 3B1 • Phone: 416-203-7122 • Toll Free: 1-800-263-1638 • Fax: 416-203-8284 http://www.catie.ca

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