Dear @chigoziekingsley5454,
Production of anti-HBs antibodies is not tied to functional cure. Many people who have achieved functional cure do not have detectable anti-HBs. This does not mean that they do not have an anti-HBsAg response in their immune function, just that we do not see antibodies like in vaccinated individuals.
Hello, I have been positive for hepatitis B for more than 20 years and now I am presenting with liver cirrhosis. What would be the best treatment for me?
Dear @Isuzo,
I am sorry to hear of your cirrhosis diagnosis. Cirrhotic HBV patients can have a wide variety of clinical issues that impact treatment options, so I strongly encourage you to see a hepatologist for the medical guidance you seek. S/He will have access to your full medical data and the training to guide you to what is best for you.
I wish you the very best.
John.
Has anyone heard of this drug? It does not seek to cure but rather to reduce and prevent fibrosis. If it is in fact effective, it can help us a lot, friends. It is good form to keep ourselves informed about this research already in phase 3.
Thanks, @La.sciamachie. Great finds!
Yes really interesting work from some of my Singaporean colleagues at Lion TCR to try to treat HBV-associated HCC using a person’s own immune system. @nina.le.bert works with the founder of this company (Prof Antonio Bertoletti) and could answer any questions you have about this technology.
Regarding the Gyre therapeutic drug, I had not heard of it before, but it looks exciting!
@chari.cohen and other Hep B Foundation people, it may be worth putting in an additional section in the Drug Watch page to account for these therapeutics for liver health!
Hello, Dr. @thomastu. It’s always a pleasure for me to receive your messages. I’m immensely grateful for your attention. As Simone Weil says, “Attention is the rarest and purest form of generosity…” Regarding new medications, I think it’s always a new hope… first, knowing that they care about our condition and, within their abilities, are seeking to improve our lives. I also follow the Hepb Foundation’s list of medications, and indeed, these weren’t listed by them. I hope you’re well and that good news always reaches us.
Dear @Berserk123
In one of my six monthly blood tests, I had low iron. Oops opposite to you.
I have not heard of high iron being an issue with HepB. I’m not a professional I any area of science. Lived experience and gained knowledge of HepB .
Please don’t stress, stress isn’t good for your liver. I used to worry about unusual results from my tests. Always turned out to be nothing.
Unless doctor says it’s a worry-don’t worry.
I’ve had HepB 40+ years. Am 65 going strong. Worry and stress will shorten your life.
Blessings
Could this case, combining existing medications in this form of “persecution” of the development of the virus B, be effective for all of us?
Hi @La.sciamachie,
Good question. This is only a single case, but trials of much larger groups have been tested with PEG-IFN with and without antivirals and have not shown very high levels of effectiveness in the majority of patients.
Thomas
What do you think of this list of developing cures?
Cuts production of all HBV proteins (including HBsAg).
Phase 2b (B-CLEAR): ~9–10% achieved off-treatment HBsAg loss in best arms; works best when baseline HBsAg is low. Now in Phase 3 with FDA Fast Track.
JNJ-3989 (ARO-HBV) and elebsiran (VIR-2218): consistently drive big HBsAg drops; when combined with other agents, some patients reach HBsAg loss after therapy ends.
Combo with anti-HBs monoclonal (tobevibart) ± peg-IFNα: in the MARCH study, HBsAg loss 17–21% at 24 weeks post-treatment in people with low baseline HBsAg. (Company plans Phase 3 only with a partner.)
Longer follow-up shows siRNA effects can persist for years in some patients.
VTP-300 (Barinthus/Vaccitech): induces HBV-specific T-cells; in recent Phase 2 studies (with low-dose nivolumab or with siRNA add-on) showed meaningful HBsAg reductions, especially when baseline HBsAg <100 IU/mL; some patients hit very low or undetectable HBsAg.
TherVacB (new ther. vaccine) entered first-in-human trials in 2024.
Selgantolimod (GS-9688, TLR-8 agonist): oral immune booster; safe with TAF, modest but durable HBsAg declines; now being tested in combination with other agents for higher cure rates.
Vebicorvir (VBR) and others: deepen DNA/RNA suppression when added to NAs; safe long-term, but by themselves haven’t produced high HBsAg loss—most useful as part of combos. Next-gen CAMs are in development.
Hi @nita_gabriel1,
Any curative approach is likely going to be a combination of different agents to drive the virus out. We currently don’t know what kind of combination works best, but having a lot more options with new antiviral therapies coming out will help.
Thomas
I heard about Bepirovirsen from a hepatologist today, and it really gave me hope. The results seem like real progress toward better treatment options for everyone living with hepatitis B. I know that peg-interferon responses can vary a lot depending on HBV genotype. Since the new therapy combines bepirovirsen with Peg-IFN, do we know whether the outcomes in the recent trial were linked to specific genotypes? Or is genotype expected to matter mainly because of the Peg-IFN portion of the therapy?
I’ve read in prior posts that that drug only works in patients with already low enough QHBSAG (Iike 1000 iu/ml), so most of us wouldn’t see a benefit since the average qhbsag is 15,0000 iu/ml.
And that their cure rates in trials weren’t that much better than pegylated interferon alone in patients with already low enough surface antigens.
I attended AASLD last month and there are newer treatments in development that are providing much better results to achieve a functional cure than Vemlidy or entecavir, without having to go on interferon.
I see a lot of negative feedback on “unicorn trials” in this forum… The way that I see it, its a good start to have a drug that would cure a good portion of people albeit under 1000 or 3000 hbsag. Because once you have that maybe science can build on that and get people who have higher hbsag down to a value where these drugs would work in them as well. Secondly, these trials ARE enrolling people with these low starting hbsag values. So it’s not like they dont exist or are extremely difficult to find. Some trials are enrolling pretty fast actually. And if someone has hbsag in the hundreds and gets their hbsag <Lloq then thats amazing and its one less chronic hbv patient in the world. Lastly, it is very difficult to actually find information about what the average or median hbsag level is in avg population. I know it’s been mentioned here that its ~10,000 but is it?
Hello, in my case it is 48,000 under entecavir. It is elevated according to my hepatologist.
Hi @Mike2,
Yes, I agree with this perspective on how progress works in health care. You can necessarily get to your goal in one jump, but you build a section of road for the people that will come along later to travel.
Thomas