Immunotherapy for hepatitis B in the direct acting antiviral era: Reevaluating the thymosin α1 efficacy trials in the light of a combination therapy approach.

Autor: Naylor PH; Department of Internal Medicine/Gastroenterology, Wayne State University School of Medicine, Harper University Hospital, Detroit, MI, USA., Mutchnick MG; Department of Internal Medicine/Gastroenterology, Wayne State University School of Medicine, Harper University Hospital, Detroit, MI, USA.
Jazyk: angličtina
Zdroj: Journal of viral hepatitis [J Viral Hepat] 2018 Jan; Vol. 25 (1), pp. 4-9. Date of Electronic Publication: 2017 Nov 20.
DOI: 10.1111/jvh.12807
Abstrakt: Hepatitis B virus (HBV) causes both acute and chronic hepatitis and infects large numbers of individuals worldwide. Unfortunately, prediction of typical clinical outcome is problematic and there is considerable variability in the frequency, duration and severity of disease progression. The mainstay of HBV treatment is directed towards the suppression of HBV replication by nucleos(t)ide analogs (NUCs). The use of immunomodulators such as α-Interferon and thymosin α1 can, in select patients, results in elimination of both HBsAg and HBeAg. Given the observation that viral clearance is most effective in the presence of a strong immune response, this review summarizes data suggesting that the use of a combination of an immune modulator such as Tα1 with a highly effective NUC may result in a more successful therapeutic approach in patients with chronic hepatitis B (CHB). Results from small studies using combination Tα1 and NUCs are encouraging, and ongoing clinical trials combining entecavir with Tα1 are anticipated to provide important data assessing the use of a combination of Tα1 with a NUC to achieve resolution of CHB.
(© 2017 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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