Foscarnet therapy in chronic hepatitis B virus e antigen carriers

✍ Scribed by V. G. Bain; H. M. Daniels; A. Chanas; G. J. M. Alexander; Dr. Roger Williams

• Publisher: John Wiley and Sons
• Year: 1989
• Tongue: English
• Weight: 343 KB
• Volume: 29
• Category: Article
• ISSN: 0146-6615
• DOI: 10.1002/jmv.1890290214

✦ Synopsis

Foscarnet (trisodium phosphonoformate) is a novel antiviral agent that inhibits viral-specific DNA polymerase. In the present study, eight males with chronic HBV carriage (HBeAg and HBV-DNA seropositivity >I2 months) showing chronic persistent hepatitis (CPH) or chronic active hepatitis (CAH) on liver biopsy received either a continuous infusion of foscarnet at 0.15 mgikgimin for 7 days or 180 mgikgiday divided into three daily boluses for 2 weeks. In all eight, HBV-DNA levels fell during therapy (median, 401 pgi40 pl serum; range, 4-3,100) vs. pretreatment levels (median, 533 pgi40 +I; range, 30-4.1751, but in none was HBV-DNA undetectable at any stage. Within 1 month, the HBV-DNA had risen to pretreatment levels in all but one patient (with the lowest pretreatment level), who cleared HBeAg and developed anti-HBe within 3 months. Two further patients were anti-HBe positive at 6 months, but their pretreatment serum HBV-DNA levels were already low, suggesting a high probability of spontaneous seroconversion. Toxicity was not evident with the continuous infusion, but for those receiving IV bolus therapy, serum creatinine and phosphate levels rose in three of four patients, necessitating a 25% dose reduction. There was no difference i n the effect on serum HBV-DNA between the two regimes. We conclude that foscarnet has only modest antiviral activity in chronic HBV carriers.