Chronic HBV infection. Immunomodulation with levamisole in viremic HBeAg minus and anti HBe positive patients

Abstract

We evaluated the effect of immunomodulatory treatment with levamisole in 9 HBeAg minus and anti-HBe positive patients (5 males and 4 females) with chronic HBV infection and ongoing viral replication. All of them were anti-HDV and anti HCV negative. The dose of levamisole was nearly 2,5 mg/kg/day in 3 consecutive days of week for 12 months or until negative serum I-IBV DNA occurred for at least three months. Viral replication and aminotransferase activity were controlled at the end of 3, 6, 9 and 12 months. The baseline serum HBV DNA level and ALT activity were 548 pg/ml and 2.6 times above upper limit of normal (ULN), respectively. HBV-DNA fell below the detection limit of our assay at the 3, 6, 9 and 12 months in 5, 6, 7 and 7 of the patients, respectively. In one of the patients a significant decrease of serum HBV DNA was noted (from 2500 pg/ml to 75 pg/ml). The rest patient was without effect from the therapy. At the end of treatment 7 of patients were with ALT activity below ULN. An abrupt elevation of aminotransferases with following normalization was observed in 3 patients. Imrnunomodulation with levamisole could benefit some anti-HBe positive patients with chronic HBV infection and ongoing viral replication. This treatment could be used as alternative therapeutic schedule in patients contraindicated for IFN as well as in aspect of lower treatment cost.