Inosine Pranobex (Isoprinosine) – a Potential Adjuvant in the Management of Chronic HBV Infection

Abstract

After achieving a durable on-treatment virological response with NUC (nucleos(t)ide analogues), adding an immunomodulating agent seems to have beneficial effect on the course of chronic HBV disease. Methods: Nine patients were investigated (5 -HBeAg(-) and 4 -HBeAg(+). All patients achieved durable on-treatment virological response with NA and then Isoprinosine was added for a period of 21 to 27 months. Serum HBsAg and HBV DNA levels were evaluated at a 3-month interval. Aim: The aim of the present study was to evaluate the effect of adjuvant immunomodulation with Isoprinosine in patients with chronic HBV infection who achieved durable suppression of HBV DNA on-treatment with NUC. Results: In HBeAg-negative patients an initial increase of qHBsAg was observed in 4/5 of patients after the adding of Isoprinosine. On month 15 of combined therapy a reduction of more than 50% from the baseline HBsAg level was found in 4/5 of patients (P=0.043). In HBeAg-positive patients there was no significant reduction of HBsAg during the follow-up. A reduction of HBsAg levels (about 30%) from the baseline was established in 3/4 patients at month 18. In the remaining one patient a reduction of 70% was established at month 27. There was an initial increase of HBsAg in 3/4 patients. In 3/4 of the patients there was a negativation of HBeAg. Conclusion: After adding Isoprinosine to NA, HBeAg-loss was achieved in 3/4 of HBeAg positive patients. HBsAg decline was more pronounced in HBeAg-negative subjects, which was not observed in NUC monotherapy. Isoprinosine in combination with NUC is safe and well tolerated. .

Biochemical study on immunomodulation and safety margin of inosine acedoben dimepranol before and after vaccination

“…Our findings of survival or protection could be explained on the basis of the significant decrements of NDV titer in IAD only, Vaccine only and IAD + Vaccine groups comparing with control group indicated by PCR. Despite absence of similar findings in chickens, yet decreasing other virus titers by Isoprinosine may be supportive findings of the present study; for instance, [15] and [16] found that treatment with Isoprinosine decreased HB and HC virus titers, respectively.…”