Intentional superinfection of decompensated chronic viral hepatitis by avian Infectious Bursal Disease Virus shows promise

T. Bakács, MD ^ab, J. N. Mehrishi, PhD ^b

AIM: Worldwide, ~350 million people are chronic hepatitis B carriers and ~200 people million C virus (HBV/HCV) carriers. Despite an effective vaccine, HBV infection remains a significant cause of liver cirrhosis and hepatocellular carcinoma (HCC) with a poor prognosis. The majority of HCV-infected patients develop chronic hepatitis evolving to cirrhosis or HCC in about 20% of cases. Prospects of an HCV vaccine are remote. Chronic hepatitis infections nonresponsive to interferon or combination therapy require better options. METHOD: The Birnaviridae family avian Infectious Bursal Disease Virus (IBDV), despite worldwide distribution in domestic fowl, is not a known hazard in transmitting to other species, although Zoonotic diseases are of concern. RESULTS: A Phase II clinical trial suggested the efficacy of intentional superinfection therapy by an apathogenic IBDV given to 42 acute hepatitis patients (HBV and HCV). Significantly, it was also effective in decompensated chronic hepatitis patients, who went into long-lasting remission or those with significant clinical improvement and stabilization without considerable side effects. We discuss a case of a decompensated chronic HCV patient with a twenty years history. Conventional interferon, ribavirin and thymosin treatment was unsuccessful. He received disabled status. IBDV therapy proved effective enabling him to work and enjoy life. CONCLUSIONS: This case challenges the current assumption that decompensated chronic hepatitis patients are untreatable. We discuss intentional superinfection strategy in view of the improved survival of HIV infected patients natural superinfection with the GB virus

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Paper presented at the International Symposium on Predictive Oncology and Intervention Strategies; Paris, France; February 9 - 12, 2002; in the section on Viral Oncogenesis.

http://www.cancerprev.org/Journal/Issues/26/101/996/4338