New Drugs to cure Hep B?

Thanks Thomas for the reply🙏
I forgot to ask about how you felt about this drug it’s coming to the United States soon I hope. it’s called - myrcludex b - bulevirtide - that’s being used already showing promising results.

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Hi Eddie,

Yeah, up until a couple of years ago I was working the lab of Prof Stephan Urban (the inventor of Myrcludex B). For people with Hepatitis D and Hepatitis B co-infections, Myrcludex B/bulevertide/hepcludex is one of the only treatments out there and it works well. For Hepatitis B infection alone, they are still testing it and working out which combinations might be best (this might include the addition of interferon).

TT

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I was reading About it. It seems to do the same thing for hep b. like you said in your speech it Keeps the roots from getting into the cells

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Yep, that’s how it works. But some work from our lab shows that Hep B doesn’t set up new roots very often because the roots already there are very stable. This is part of why it is not as effective against Hep B itself. But there is a thought that with combination with other drugs, it could be part of a cure treatment.

Thomas

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Sorry for the late response—I was traveling for work and had a nasty confluence of deadlines.

Disclosure: I’m an advisor to Antios.

I’m quite supportive of this combination. The Antios drug is a promising new prodrug form of Clevudine that looks like it may have solved the muscle toxicity associated with the earlier version of Clevudine, and Vebicorvir is a first-generation capsid assembly modifier. Their mechanisms of action are complementary and both seem to be performing well so far in the early clinical trials.

John.

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In looking at the responses regarding this I am wondering what the scientists on here think about the initiative that is behind the work on ThervacB. It seems there has been funding allocated specifically for finding a cure and providing ground treatment.
As with many people, the first I ever heard of hepatitis B was in my own diagnosis a few months ago.

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Hi @Bonzai123,

I’ve just moved your post into a more on-topic thread. If you see above (New Drugs to cure Hep B? - #25 by ThomasTu), there is a bit of discussion about ThervacB.

Cheers,
Thomas

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Hi @john.tavis and @ThomasTu
I want to say first and foremost this website is a lucky find amongst the uncertainty of a new diagnosis. Thank you Thomas for creating this community and all the verified scientists that take the time to answer our questions.

I wanted to touch on a continuing subject here which is potential cures that will rid us of this constant worry and bi-annual or annual tests. Being that a cure was found for Hepatitis C and really not that long ago, do we know why pushes for Hep B cures have only been ramped up in the past 5-8 years? This is such a dangerous disease I can’t imagine that the research into a cure for Hep C didn’t overlap with research and cures for Hep B as well? I confess I don’t know much and am hoping for clarity. I am very much hoping and looking forward to the day we can move on from this awful disease and celebrate a cure much like Hep C patients and am hopeful it will be sooner rather than later.

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Dear @Bonzai123,

This is an interesting question with multiple answers.

HBV cure research never really stopped, but it slowed to just a trickle for a long time. The slowdown started in the late 80’s or early 90s after the wonderful vaccine was approved. There became an assumption at the US NIH (and presumably other major funders too) and the biotech/pharmaceutical companies that the disease would just fade away with time, so research funding got very difficult to obtain in many places. About the same time HCV was discovered and a lot of money was poured into understanding it, so many HBV researchers shifted all or part of their focus to HCV (I worked on both HBV and HCV for most of the time between 2000 and 2012). Thankfully, that effort vs. HCV was stunningly successful. So the core of the problem was that shade was thrown on HBV research by the vaccine and the urgency to address HCV. The final issue is that HBV is going to be harder to cure than HCV was due to its replication mechanism (the nuclear “cccDNA” form of the HBV genome needs to be eliminated, but that is a really hard target). The experimental systems for HBV were (and still are) quite limited in some aspects of what we need to study to develop a cure, and that makes everything even harder.

The very good news is that there is a massive, world-wide academic, biotech, and major pharma effort ongoing to develop a cure for HBV. The number of scientists pursuing cure projects is very large, and good progress is being made. Part of the credit for the very rapid scale-up vs. HBV ironically comes from HCV research. Major pharma had developed truly impressive research capacity for hepatic virology, and so they just refocused a large number of talented people and funding towards HBV. The shift in industrial resources towards HBV was really quite breathtaking in its scale and how fast it occurred!

I’ll end with this note of optimism: We cannot tell when cure(s) will become available because it is impossible to predict the pace of scientific research. However, there are so many cool projects being pursued that some of them will certainly succeed. I feeling is that cure rates will start rising from their current ~5-7% rate within a few years, and that probably within a decade or so we will be routinely curing at least half of the patients entering treatment–maybe more!!! Rest assured, the HBV research community won’t rest till cure rates for HBV match those for HCV.

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Hi John,
Thank you for your comprehensive response. When you mention current cure rates of 5-7% currently is this based on the viral load number or are people truly being cured of the virus and able to lead healthy lives without concerns of liver disease?

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That is the number reported in clinical trials of people who meet the current definition of a “functional cure” following treatment with pegylated interferon alpha (usually determined after 1 year of therapy) or nucleoside analog drugs (usually determined after many years of therapy).

John.

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This is a good observation, @Bonzai123. @john.tavis has given great insight as someone in the research field for a long time, particularly during that period in which you’re talking about.

Just to add onto the effect of the HBV vaccine slowing down research for a Hep B cure, I think HIV research also did the same. As HIV drugs (nucleos/tide analogues such as lamivudine, clevudine, tenofovir, etc.) were found to lower the Hep B replication, liver inflammation and disease progression, this also lowered the drive of the field to try to find a cure (particularly when there was this very new and deadly HCV just discovered). Back then, the priorities (and funding) shifted because it was felt that we at least had some control for Hep B patients.

But now we know a lot more about Hep B and now have chances to finally cure the infection. Scientists are a lot more hopeful and can better see how important this is to patients. This is due to a major part to advocacy at various levels and in countries across the world. Many individual Hep B scientists never stopped working on HBV, but now they are better resourced to do what they do best and can then attract more students/staff to work for them on this important topic.

TT

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@ThomasTu @john.tavis thank you both for your responses. I have my first appointment with my specialist next Tuesday and I am very nervous to see my levels and whether there is damage to my liver. Reading your responses to the the myriad of questions from others on this forum has been very helpful to me. Knowing that there is a concentrated effort and potential timelines for better therapies and maybe one day a cure for this disease makes it easier to get up each day. Thank you for your research and diligent efforts.

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Hello!

Did anyone amongst us join the workshop on 30th Nov organised by ANRS for progress made so far on HBV cure? Is there a transcript available? @Joan_Block @ThomasTu @john.tavis

Also, from the twitter handle of TherVacB I understand clinical trials are starting from July 2022. It seems very promising but there are no centers in South East Asia. It is a bit disappointing as after getting to know my status I have been hearing about a lot of infected people around me. I hope the trials become successful in Europe and are soon launched in India and Nepal also.

Many thanks in advance.

Unfortunately, it was too late for me. Hopefully there will be a recording available soon.

Cheers,
Thomas

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Thanks @ThomasTu … I read your interview with Gavi. With champions like you we have more and more people talking about the virus. Cheers!

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Sorry but shouldn’t be generic entecavir and Baraclude the same?
I switched from Baraclude to generic some months ago and interested to know if they both have the same suppression efficacy and side effects.

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Hi Chersich,
I assume the generic medicine should be the as same as the name brand. However, I was not tolerant well with generic, so I switch back to Baraclude. I am taking Baraclude for more than 10 years now. Alt maintain low and undetectable DNA for a long time too.

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Yes, the active ingredient is the same in both cases.

Thomas

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Hello! TherVacc has been delayed again for a year? Does anybody know why? Is there any problem with the vaccine or just bureaucracy?