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Foscarnet therapy in chronic hepatitis B virus e antigen carriers
Author(s) -
Bain V. G.,
Daniels H. M.,
Chanas A.,
Alexander G. J. M.,
Williams Roger
Publication year - 1989
Publication title -
journal of medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.782
H-Index - 121
eISSN - 1096-9071
pISSN - 0146-6615
DOI - 10.1002/jmv.1890290214
Subject(s) - hbeag , medicine , foscarnet , seroconversion , hepatitis b virus , gastroenterology , virology , hepatitis b , nucleoside analogue , immunology , hbsag , virus , viral disease , nucleoside , biology , herpesviridae , biochemistry
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 > 12 months) showing chronic persistent hepatitis (CPH) or chronic active hepatitis (CAH) on liver biopsy received either a continuous infusion of foscarnet at 0.15 mg/kg/min for 7 days or 180 mg/kg/day divided into three daily boluses for 2 weeks. In all eight, HBV‐DNA levels fell during therapy (median, 401 pg/40 μl serum; range, 4–3, 100) vs. pretreatment levels (median, 533 pg/40 μl; range, 30–4, 175), 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 in the effect on serum HBV‐DNA between the two regimes. We conclude that foscarnet has only modest antiviral activity in chronic HBV carriers.