very good report of all hbv therapies

[stef2011]

http://regist2.virology-education.com/2011/9eu/docs/24_Levrero.pdf

too bad i can t find a single study with hbsag graphics and cccdna decline on tenofovir hbeag -

it is like all other less potent nucs are advertised but little indepth data on tdf

[stef2011]

we also have to be very careful with mutations, ultradeep sequence studies just made an abservation that mutations are already present in the cccdna and that nucs/immune system pressure just select these mutations over the long term

another observation from researchers in pisa about nuc was:
nucs make hbvdna und and some immune system response towards hbv is rescued but if hbvdn becomes totally undetactable the immune system is also less stimulated for a bg response, this is why sometimes when stoping nucs we observe hbsag seroconversion

the biggest problem is we miss marker of immune response, maybe those patients reached low hbsag and cccdna so stopping nucs they could seroconvert hbsag negative

another good observation from researchers/doctors in my home town, they run many courses of interferon especially on those with decreasing hbsag.they make 1 year then stop for some years if hbsag keeps decreasing and then run another course when hbsag starts to rise
i guess they are now running trials of interferon+tenofovir, they have reached a very good number of serconversions over the years

[4est]

in one of the links posted yesterday (i think was one with adv + inf) it was mentioned that 2 or 3 patients that achieve s seroconversion (beside |hbv dna und) lost the antibody after stoping the treatment - so the cccdna pool was not completely block.

[StephenCastlecrag]

I read one of the slides that said: antivirals block the "replenishment of the cccDNA pool". I wonder whether this is true? If it is true, I wonder how mutations can occur. Can it be that antivirals cannot completely block replication, some small number of new virions and replenishment do occur???

Very good slides. Thanks.

[stef2011]

i really do like and share this sentence after data of interferon+adv study:

some liver damage and regrowth is needed to get cccdna unstable and reduce it, the perfect scenario of interferon+potent nuc (tdf best) or maybe interferon+adv where incomplete hbvdna suppression lead to some low level but continuous liver damage/regrowth