Infection

, Volume 22, Issue 5, pp 330–332 | Cite as

Treatment of chronic replicative hepatitis B virus infection with short-term continuous infusion of foscarnet

  • R. Schvarcz
  • Ola Weiland
  • B. G. Hansson
  • J. -O. Lernestedt
Originalia

Summary

Three patients with chronic replicative hepatitis B virus infection were treated for 7 days with a continuous intravenous infusion of foscarnet (trisodium phosphonoformate) after an initial bolus dose of 20 mg/kg body weight. Although the dose was calculated from a nomogram, approximately only half the intended plasma concentration (500 µM/l=150 µg/l) was achieved. The levels of s-ALAT, HBV-DNA and DNA-polymerase changed only marginally during the treatment and 24-week follow-up period. All three patients remained HBsAg and HBeAg positive during treatment and follow-up. There were no severe side-effects. We conclude that foscarnet treatment with the dose regimen given in this study had no or only a minor antiviral effect in patients with chronic replicative HBV infection. It remains to be explored if higher doses, longer treatment periods or the use of foscarnet in combination regimen are more effective.

Keywords

Foscarnet Initial Bolus Dose Phosphonoformate Intended Plasma Foscarnet Treatment 

Foscarnet in Kurzzeit-Dauertropfinfusion zur Behandlung der chronischen Hepatitis B mit aktiver Virusreplikation

Zusammenfassung

Foscarnet (Trisodium-Fosfonoformat) wurde sieben Tage lang als intravenöse Dauertropfinfusion nach initialem Bolus von 20 mg/kg KG bei drei Patienten mit chronischer Hepatitis B und aktiver Virusreplikation eingesetzt. Obwohl die Dosis nach einem Nomogramm berechnet wurde, lagen die erreichten Plasmakonzentrationen (500 µM/l=150 µg/l) um etwa die Hälfte unter den angestrebten Werten. Während der Behandlung und einer Beobachtungszeit von 24 Monaten traten nur marginale Änderungen der s-ALAT, HBV-DNA und DNA-Polymerase-Spiegel ein. Alle Patienten blieben während der Behandlung und Beobachtungszeit HBsAg und HBeAg positiv. Wir schließen aus diesen Beobachtungen, daß Foscarnet in der in dieser Studie verabreichten Dosis keinen oder nur einen geringen antiviralen Effekt bei Patienten mit chronischer, replizierender HBV-Infektion hatte. Es bleibt zu prüfen, ob höhere Dosen, längere Behandlungsphasen oder die Anwendung von Foscarnet in Kombinationstherapie wirksamer sind.

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Copyright information

© MMV Medizin Verlag GmbH München 1994

Authors and Affiliations

  • R. Schvarcz
    • 1
  • Ola Weiland
    • 1
  • B. G. Hansson
    • 2
  • J. -O. Lernestedt
    • 3
  1. 1.Dept. of Infectious Diseases, Karolinska Institute I 73Huddinge HospitalHuddinge
  2. 2.Dept. of Medical Microbiology, Section of Clinical VirologyUniversity of Lund, Malmö General HospitalSweden
  3. 3.Astra Arcus ABSödertäljeSweden

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