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Hepatitis BDecember 2024Summary reviewed May 2026

What the Piranga Trial Found — Xalnesiran Combinations for Chronic Hepatitis B

Piranga tested xalnesiran, a small interfering RNA that silences hepatitis B viral genes, alone or with an immune booster in 281 adults with chronic hepatitis B already suppressed on standard pills. The combination with pegylated interferon cleared the surface antigen in roughly 1 in 4.

What the trial was testing

The Piranga enrolled 281 patients with hepatitis b. The study was sponsored by Hoffmann-La Roche and tracked outcomes across the full group of patients who matched the trial's eligibility profile.

It was initial testing (phase 2). Trials at this stage are designed to produce evidence regulators and physicians can act on — not just observations to follow up later.

What the results showed

23% cleared the hepatitis B surface antigen on xalnesiran plus interferon.

New England Journal of Medicine · 2024 · NCT04225715

These findings — that cleared hepatitis B surface antigen 24 weeks after xalnesiran plus pegylated interferon — were published in the New England Journal of Medicine and represent the headline result of the study.

Researchers tracked outcomes across 281 patients enrolled in the trial. The result was consistent enough across the group that the team felt confident reporting it.

What this means for patients

For patients with hepatitis b, this result changes the calculus on what to ask their care team about. Whether it changes day-to-day care depends on factors like disease subtype, prior treatments, and where the patient is in their care journey.

What you can do now

Xalnesiran is still in development and not yet FDA-approved. Standard chronic hepatitis B suppression with daily entecavir or tenofovir remains the FDA-approved cornerstone of treatment. Ask a liver specialist about whether you qualify for ongoing clinical trials.

Eligibility for the treatments mentioned above depends on specific test results and clinical history. Bring this summary, the trial name, and your most recent labs or pathology report to your next visit.

Open hepatitis b trials

RecruitingTesting effectiveness

VIR-2218 and Peginterferon Alfa-2a for Chronic Hepatitis B

Background: Chronic hepatitis B virus (HBV) infection affects 292 million people worldwide; 887,000 die each year from cirrhosis, liver cancer, and related issues. Treatment options are limited. Objective: To test 2 drugs (VIR-2218 and peginterferon) in people with mild or inactive HBV infection. Eligibility: People aged 18 to 65 years with mild or inactive HBV infection. Design: Participants will be screened. They will have blood tests and an eye exam. They will have imaging scans of the liver to check the health of the liver. Participants will be in the study for over 2 years. VIR-2218 is an injection given under the skin of the stomach, upper arm, or thigh. Participants will come to the clinic to receive this injection once a month for 6 months. Peginterferon is also injected under the skin. Participants will have this shot once a week for 6 months. They may either inject themselves at home or come to the clinic to get the injections. Participants will get just the VIR-2218 for 3 months, then both shots for 3 months, then just the peginterferon for 3 months. Participants will have two 3-day stays in the hospital. Tests will include: Liver biopsy. A sample of tissue will be taken from their liver. After the procedure, participants will lie on their right side for 2 hours and then on their back for 4 hours. Fine needle aspiration. A small needle will be used to collect cells from the liver. After the last injection of peginterferon, follow-up visits will continue in the outpatient clinic every 4 to 12 weeks.

Bethesda, Maryland, United States
RecruitingInterventional study

The Immune Responses After Hepatitis B Revaccination Doses in a Young Cohort

This prospective cohort study aims to provide the evidence-based clinical guide to help decide the revaccination doses of hepatitis B vaccine that the high-risk young adults without hepatitis B seroprotective antibodies (anti-HBs titer\<10 mIU/mL) need to take.

Taipei, Taiwan