Fecal Microbiota Transplantation in Hepatitis B e Antigen-Positive Chronic Hepatitis B Patients: A Pilot Study
- 1 March 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Digestive Diseases and Sciences
- Vol. 66 (3), 873-880
- https://doi.org/10.1007/s10620-020-06246-x
Abstract
Background Intestinal flora plays a critical role in immunity against hepatitis B virus (HBV). Fecal Microbiota Transplantation (FMT) may be a potential immunomodulatory therapy in patients with chronic hepatitis B (CHB). Aim We aimed to study role of FMT in hepatitis B e antigen (HBeAg)-positive CHB patients in terms of its effect on HBeAg, HBsAg, and HBV DNA. Methods HBeAg-positive patients despite being on antiviral treatment for > 1 year were given six cycles of FMT via gastroscope (nasoduodenal route) at 4 weekly intervals along with antiviral therapy. Twelve out of 14 included patients in FMT arm completed six cycles. Another 15 HBeAg-positive patients who were on oral antivirals for > 1 year were taken as control-antiviral therapy (AVT) arm. Per-protocol analysis was done. Results The median (interquartile range) age in the FMT and AVT arm were 29 (25-35) and 29(24-38), respectively (P = 0.794). The median (interquartile range) duration of AVT prior to inclusion in the study was 80 (52-104) and 76 (52-114) months in FMT and AVT arm, respectively (P = 0.884). In the FMT arm, 16.7% (2/12) patients had HBeAg clearance in comparison to none in the AVT arm (P = 0.188). None of the patients in either arm had HBsAg loss. The FMT was tolerated well, 42.8% (6/14) patients reported one or more minor adverse events. Conclusions In this non-randomized pilot study, FMT appears to be safe and potentially effective in terms of viral suppression and HBeAg clearance in patients with HBeAg-positive CHB. Further randomized controlled trials are needed in order to obtain robust conclusions.This publication has 28 references indexed in Scilit:
- Compartmentalized and systemic control of tissue immunity by commensalsNature Immunology, 2013
- Duodenal Infusion of Donor Feces for RecurrentClostridium difficileThe New England Journal of Medicine, 2013
- High-throughput DNA sequence analysis reveals stable engraftment of gut microbiota following transplantation of previously frozen fecal bacteriaGut Microbes, 2013
- Transfer of Intestinal Microbiota From Lean Donors Increases Insulin Sensitivity in Individuals With Metabolic SyndromeGastroenterology, 2012
- Natural history of chronic hepatitis B: what exactly has REVEAL Revealed?Liver International, 2012
- Natural history of chronic hepatitis B REVEALedJournal of Gastroenterology and Hepatology, 2011
- Endpoints of hepatitis B treatmentJournal of Viral Hepatitis, 2010
- Hepatitis B surface antigen (HBsAg) levels in the natural history of hepatitis B virus (HBV)-infection: A European perspectiveJournal of Hepatology, 2010
- Hepatitis B surface antigen levels during the natural history of chronic hepatitis B: A perspective on AsiaJournal of Hepatology, 2010
- Tenofovir Disoproxil Fumarate versus Adefovir Dipivoxil for Chronic Hepatitis BThe New England Journal of Medicine, 2008