My VIR-2218 + Peginterferon Experience — An HBV Functional Cure Trial
I wanted to share my experience with VIR-2218 (elebsiran) and pegylated interferon as part of an NIH clinical trial in Bethesda, Maryland.
One thing that made this particular trial interesting and unique to me was that it was studying a functional-cure approach in people with chronic hepatitis B who had low-level/inactive disease and were not already taking antiviral treatment. Most HBV patients who participate in treatment studies are already on nucleos(t)ide analogues such as tenofovir or entecavir, so this was a very different approach.
My starting point
Middle age, male, HBeAg-negative/anti-HBe positive, and had been considered an inactive HBV carrier for many years.
Before entering the trial:
- HBV DNA was generally around 250–300 IU/mL
- Baseline quantitative HBsAg was approximately 0.60 IU/mL
- FibroScan showed F0/no significant fibrosis
- Liver biopsy was also reassuring with no significant fibrosis
- I was not taking HBV antiviral medication
Because my viral load was so low and I had no significant liver damage, I had never required treatment before.
VIR-2218
I started VIR-2218 (elebsiran) in January 2026.
The trial involved 6 doses, with the final dose in June.
The initial response was honestly remarkable.
My HBV DNA dropped to <10 IU/mL, and my HBsAg became undetectable. It remained negative for several months.
That was the first time in my life that I had seen an HBsAg-negative result.
Adding peginterferon
Pegylated interferon alfa-2a (180 mcg weekly) was added in April 2026.
I ultimately completed 24 weeks of peginterferon.
The side effects were manageable for me overall, but I definitely noticed them. I experienced fatigue, headaches/aches, dry mouth/thirst, injection-site reactions and hair shedding. My white blood cells/neutrophils also dropped during treatment, with my ANC reaching a low of approximately 0.92 ×10⁹/L before later recovering.
My ALT also increased during treatment, reaching the 60–70 range at times.
The unexpected part
After the VIR-2218 course was completed, HBsAg eventually became detectable again.
That was obviously disappointing after having achieved HBsAg negativity.
However, my HBV DNA remained suppressed. It has continued to be <10 IU/mL.
The NIH team felt that one possible explanation was that the effect of the siRNA was wearing off. They also wanted to confirm the HBsAg result before considering it a true breakthrough because the HBV DNA remained suppressed.
My most recent results
My latest results have actually become quite interesting.
On 9/28/2026, from the same blood draw:
- HBV DNA: <10 IU/mL, detected but below quantification
- Quantitative HBsAg: <0.05 IU/mL
- Qualitative HBsAg with confirmation: positive
The quantitative HBsAg was repeated two days later, on 9/30, and was again <0.05 IU/mL.
So I currently have a confirmed qualitative HBsAg-positive result while the quantitative HBsAg is below the assay’s reporting limit on two separate measurements.
My ALT and AST have also improved, most recently ALT 39 and AST 27.
Thyroid and stopping interferon
One of the complications during the interferon course was my thyroid. My TSH eventually dropped to <0.01.
After discussing this with the NIH team, we decided that continuing interferon was no longer recommended because of the thyroid abnormality.
So my 24-week peginterferon course has now ended.
Looking back
This has been a very unusual HBV treatment journey.
I started as someone with very low-level/inactive HBV, no significant fibrosis, low HBsAg and no prior antiviral treatment.
Then:
VIR-2218 → HBsAg became undetectable → peginterferon → continued HBV DNA suppression → HBsAg later became detectable → quantitative HBsAg now <0.05 IU/mL twice
I don’t know yet what the long-term outcome will be, but I wanted to document the experience because there aren’t many people sharing what it’s like to go through an HBV functional-cure trial when you start as an untreated inactive carrier.
I’m grateful to the NIH team and everyone involved in the trial for giving me the opportunity to participate. Whatever the eventual outcome, it’s been an interesting experience and hopefully my journey will be useful to other people living with hepatitis B.