Safety and Efficacy of Nucleic Acid Polymers in Monotherapy and Combined with Immunotherapy in Treatment-Naive Bangladeshi Patients with HBeAg Positive Chronic Hepatitis B Infection

The studies evaluated the use of nucleic acid polymers (NAPs) in treating HBeAg positive chronic hepatitis B infection in Bangladeshi patients. The REP 101 study involved 8 patients receiving REP 2055 monotherapy, while the REP 102 study involved 12 patients receiving REP 2139-Ca monotherapy, with 9 transitioning to combined treatment with pegylated interferon alpha 2a or thymosin alpha 1. NAP monotherapy resulted in significant reductions in serum HBsAg and HBV DNA levels, and the appearance of anti-HBsAg antibodies. In the REP 102 study, 8 out of 9 patients experienced HBsAg loss with combined therapy. After therapy withdrawal, 8 patients achieved low HBV DNA levels, with viral rebound occurring in 7 patients over 12 to 123 weeks, but absent in 2 patients at 135 and 137 weeks. REP 2139-Ca therapy was associated with hair loss, dysphagia, and dysgeusia, likely due to heavy metal exposure. These findings suggested that NAPs could enhance antiviral responses and improve immunotherapy outcomes, indicating their potential role in future combination therapies for chronic hepatitis B.