Pharmacokinetics and pharmacodynamics of pegylated interferon for the treatment of hepatitis B

Abstract

Introduction: Interferon (IFN) had both antiviral and immunomodulatory effects, and was one of the approved treatments for hepatitis B virus (HBV). Herein, we reviewed the pharmacokinetics and pharmacodynamics of pegylated IFN-? (PegIFN-?) for the treatment of HBV. Areas covered: The steady-state serum levels of PegIFN-? were reached within 5 to 8?weeks, and the week 48 mean trough concentrations were approximately 2-fold higher than week 1. There was also no difference of the pharmacokinetics in male or female, healthy volunteers or patients with hepatitis B or C infection. PegIFN-? did not affect the metabolism of the cytochrome P450 (CYP) isozymes, except inhibition of CYP1A2. There was also no pharmacokinetic interaction between PegIFN-? and HBV nucleot(s)ide analogues (NUCs). Forty-eight weeks of PegIFN-? achieved 32% of HBeAg seroconversion, 32-43% of HBV DNA suppression, 41-59% of ALT normalization, and 3% of HBsAg seroconversion rate with a post-treatment durable response up to 80% in the initial responders. Expert opinion: On-treatment HBsAg titer guided the treatment of HBV with PegIFN-?. The recommendation of PegIFN-? and NUC combination or switch remained controversial. New immunotherapeutic agents are now in development. Although, PegIFN-? should continue to play a role in the treatment of HBV.