A new therapeutic option for chronic hepatitis B: Reduced dose and shorter duration of a combination therapy with pegylated interferon and entecavir

  • Mamun Al Mahtab Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Shahabagh, Dhaka, 1000, Bangladesh http://orcid.org/0000-0003-3728-3879
  • Shahina Tabassum Department of Virology, Bangabandhu Sheikh Mujib Medical University, Shahabagh, Dhaka, 1000, Bangladesh
  • Afzalun Nesa Department of Virology, Bangabandhu Sheikh Mujib Medical University, Shahabagh, Dhaka, 1000, Bangladesh
  • Munira Jahan Department of Virology, Bangabandhu Sheikh Mujib Medical University, Shahabagh, Dhaka, 1000, Bangladesh
  • Md. Sakirul Islam Khan Department of Anatomy and Embryology, Ehime University Graduate School of Medicine, Toon 791-0295, Ehime, Japan
  • Sheikh Mohammad Fazle Akbar Department of Medical Sciences, Toshiba General Hospital, Shinagawa, Tokyo 140-8522, Japan
Keywords: Chronic hepatitis B, Pegylated interferon, Entecavir, Combination therapy

Abstract

Background: Although several drugs are available for treatment of chronic hepatitis B (CHB), the outcome is still far from being satisfactory. The study was conducted to develop a therapeutic strategy for CHB by a combination therapy with reduced dose and duration of antiviral drugs.

Objectives: Therapeutic effects of reduced dose and shorter duration of combination of pegylated interferon (Peg-IFN) and entecavir were evaluated in patients with CHB with two control groups.

Methods: Fifty-four patients with CHB were treated with reduced dose of Peg-IFN (90 microgram in spite of standard dose of 180 microgram) and standard dose of entecavir (0.5 mg) for reduced duration of 24 weeks (Case of group). There were two control groups that adhered to inclusion and exclusion criteria. Patients of Control group-1 (n=50) received regular doses (180 microgram) of Peg-IFN, once weekly for 48 consecutive weeks. Patients of Control group-2 (n=50) were treated with regular does of entecavir (0.5 mg, daily) for 48 weeks.

Results: The treatment regimens were safe for all patients. At the end of therapy (EOT), hepatitis B virus DNA negativity (HBV DNA <250 copies/mL) was found in 67%, 50% and 80% of patients of Control Group-1, Control group-2, and case group, respectively. HBV DNA negativity was found in more patients in cases (89% from 67%) 24 weeks after EOT. However, it declined in patients of Control group-1 (80% to 56%) and remained almost similar in Control group-2 (50% versus 56%). There was no significant difference in alanine transaminase (ALT) negativity and hepatitis E antigen (HBeAg) seronegativity among 3 groups at EOT and 24 weeks after EOT.

Conclusion: A patient-friendlytherapeutic strategy with reduced dose of Peg-IFN and regular dose of entecavir for shortened duration for CHB patientshave been documented and it would be also cheap for usage of patients with CHB.

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Published
2019-12-30
How to Cite
Mahtab, M., Tabassum, S., Nesa, A., Jahan, M., Khan, M., & Akbar, S. M. (2019). A new therapeutic option for chronic hepatitis B: Reduced dose and shorter duration of a combination therapy with pegylated interferon and entecavir. Bangladesh Medical Research Council Bulletin, 45(3), 143-148. https://doi.org/10.3329/bmrcb.v45i3.44643
Section
Research Papers