Preliminary studies of acyclovir in chronic hepatitis B

Area of Science:

• Hepatology
• Virology
• Pharmacology

Background:

• Chronic hepatitis B virus (HBV) infection is a significant global health concern.
• Hepatitis B surface antigen (HBsAg)-positive and DNA polymerase-positive chronic hepatitis indicates active viral replication.
• Effective antiviral therapies are crucial for managing chronic HBV infection.

Purpose of the Study:

• To evaluate the efficacy and safety of intravenous acyclovir in treating chronic hepatitis B virus infection.
• To assess the impact of increasing acyclovir dosages on viral DNA polymerase activity.
• To determine the potential role of acyclovir in chronic HBV treatment.

Main Methods:

• Three patients with HBsAg-positive and DNA polymerase-positive chronic hepatitis were enrolled.
• Intravenous acyclovir was administered at increasing dosages.
• Hepatitis B virus DNA polymerase activity was monitored throughout the treatment courses.

Main Results:

• A decrease in DNA polymerase activity was observed with all acyclovir treatment courses.
• No clear dose-response relationship was established for acyclovir's effect on DNA polymerase.
• One patient achieved a sustained undetectable level of DNA polymerase for five months.
• Two out of ten treatment courses were associated with significant, reversible side effects at higher dosages.

Conclusions:

• Acyclovir demonstrated a partial and transient inhibitory effect on HBV DNA polymerase.
• The lack of a dose-response relationship and significant side effects at higher doses limit its utility.
• Acyclovir is unlikely to be an effective therapeutic agent for chronic hepatitis B virus infection.