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eMediNexus 08 July 2020
Intestinal flora is crucial for immunity against hepatitis B virus (HBV). Fecal microbiota transplantation (FMT) seems to be a promising immunomodulatory therapy for patients with chronic hepatitis B (CHB).
The present pilot study by researchers at AIIMS, New Delhi and AIIMS, Patna, explored the role of FMT in hepatitis B e antigen (HBeAg)-positive CHB patients for its effect on HBeAg, HBsAg, and HBV DNA.
Despite undergoing antiviral treatment for > 1 year, HBeAg-positive patients were subjected to six cycles of FMT via gastroscope (nasoduodenal route) at 4 weekly intervals in addition to antiviral therapy. Twelve of the 14 patients in FMT arm completed six cycles. Another 15 HBeAg-positive patients on oral antivirals for > 1 year constituted the control-antiviral therapy (AVT) group.
The median (interquartile range) age in the FMT and AVT arms were 29 (25-35) and 29 (24-38), respectively. The median (interquartile range) duration of AVT before being included in the study was 80 (52-104) and 76 (52-114) months in FMT and AVT arm, respectively. In the FMT arm, 16.7% (2/12) patients were shown to have HBeAg clearance compared to none in the AVT arm. Additionally, none of the patients in either arm had HBsAg loss. FMT was tolerated well.
FMT was shown to be a safe and potentially effective option pertaining to viral suppression and HBeAg clearance in patients with HBeAg-positive CHB. Additional randomized controlled trials may help obtain robust conclusions.
Source: Chauhan A, Kumar R, Sharma S, et al. Fecal Microbiota Transplantation in Hepatitis B E Antigen-Positive Chronic Hepatitis B Patients: A Pilot Study. Dig Dis Sci. 2020 Apr 11.
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