Combination Therapy for Chronic Hepatitis B Using Capsid Recycling Inhibitor

In this paper, we investigate the dynamics of hepatitis B virus infection taking into account the implementation of combination therapy through mathematical modeling. This model is established considering the interplay between uninfected cells, infected cells, capsids, and viruses. Three drugs are considered for specific roles (i) pegylated interferon (PEG IFN) for immune modulation, (ii) lamivudine (LMV) as a reverse-transcriptase inhibitor, and (iii) entecavir (ETV) to block capsid recycling. Using these drugs, three combination therapies are introduced, specifically CT PEG IFN plus LMV, CT PEG IFN plus ETV, and CT PEG IFN plus LMV plus ETV. As a result, when LMV is used in combination therapy with PEG IFN and ETV, the impacts of ETV become insignificant. In conclusion, if the appropriate drug effectively inhibits reverse transcription, there is no need for an additional inhibitor to block capsid recycling.