Nearly 300 million people in the world are chronically infected with hepatitis B virus. This virus can cause serious liver disease that may progress to cirrhosis or liver cancer.
Currently there are antiviral drugs (entecavir, tenofovir) that inhibit the replication of the B virus and can also normalize transaminase levels, so the long-term prognosis is more favorable. However, the drawback of these drugs is that they only eliminate the virus from the body in 10% of patients, so they must be administered indefinitely.
This year (2024), at the Annual Congress of the American Association for the Study of Liver Diseases, a study of a new drug for the treatment of chronic hepatitis B with very promising results has been presented. This new treatment consists of using an antisense probe that blocks the production of hepatitis B virus proteins. The study included 55 patients who were receiving treatment with antivirals (entecavir, tenofovir) but who were not cured, that is, they remained positive for the surface antigen of the hepatitis B virus (HBsAg). Patients received a weekly subcutaneous injection of the antisense probe at doses of 300 mg or 225 mg for 24 weeks. Then, they remained only on the antivirals (entecavir, tenofovir) for another 24 weeks and finally were followed for another 24 weeks without any treatment.
At week 12 of treatment with the antisense probe, 62% of the patients treated with 300 mg and 43% of those who received 225 mg lost HBsAg (that is, they were theoretically cured). The loss of HBsAg occurred mainly in the first 8 weeks of treatment. The side effects of the antisense probe injection were very mild (reactions at the injection site, fever, and laboratory abnormalities).
In Dr. Carreño’s opinion, treatment with this antisense probe is effective and offers many possibilities for a complete cure of hepatitis B with mild side effects. However, many more studies including a large number of patients are needed for this treatment to become available.
