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.
@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.
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.
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.
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.
I am CNN. Curious if this (TherVacc t rt ials status in relation to human tr itals )ever got a response? Field Trials began or still pending? There were comments on a Tanzania based site.
Does any of our scientist and experts part of this research. Such articles is the fuel that keeps us moving in hope that cure will come soon.
I would love to hear what our experts will say on this.
Thanks.
Unfortunately, this kind of press serves more to create hype around a particular technology than actually provide real evidence of the potential to achieve functional cure. This of course can be very misleading for patients who in many cases are desperate for a drug which can achieve functional cure.
(Disclosure here I am an the Chief Scientific Officer of Replicor Inc, a Canadian biotech developing a drug for treating HBV).
In the case of the GSK drug in question (bepirovrisen), the study in question (presented at the EASL liver conference last week) demonstrated that the HBsAg responses to this drug are occurring by stimulation of the innate immune response instead of the initial mechanism of action proposed for this drug (antisense-mediated degradation of HBV mRNA). This recent acknowledgement of the correct mechanism of action for this drug is actually in line with its limited effect on HBsAg during treatment but has no impact on any progress towards functional cure.
I urge all HBV patients to be very careful with interpreting media surrounding drugs in development the HBV space.
Unfortunately, vaccines at birth and or vaccinations are only effective to prevent the development of disease in uninfected persons. They have some ability to prevent the development of disease in newborn babies to infected mothers but have no ability to treat disease in persons already infected.
You are correct approved agents are mainly only effective in controlling the disease and are lifelong.
The term currently used in the field for a true cure is “sterilizing cure” where all remnants of the infection are removed. Unfortunately, the nature of HBV infection makes this event very unlikely to achieve with any treatment.
Functional cure is the same as the successful resolution of acute infection. The immune system continually suppresses the infection in the liver in the absence of therapy. We have seen that this can be achieved in a small fraction (6%) of patients with pegIFN and in 40% of patients when NAPs are combined with pegIFN in clinical trials.
Hi just to add to what Andrew just wrote - a Functional Cure means that there would be loss of circulating virus (HBsAg or Hep B surface antigen) and treatment would be finite (maybe a year or less?); however, the darth vader of a chronic hep b infection known as “cccDNA” would not be eliminated. A “sterilizing” or “sterile” cure - meaning a true, complete cure - is defined as the elimination of cccDNA, which is very wily and elusive. But for most of living with hep b, just knowing that we would only have to be on treatment for a limited time rather than a lifetime would be freedom. At least I would really not have to take an antiviral every day and to know my risk of liver cancer would be significantly reduced with the loss of HBsAg. If I’ve created any confusion or gotten something wrong, I know that others will chime in! Always, Joan
Yes Joan has the right of it (I love the “Darth Vader” analogy for cccDNA )
Sterilizing cure = removal of cccDNA
Complete cure = removal of cccDNA and integrated HBV DNA
However, HBsAg loss component of functional cure (which requires removal of integrated HBV DNA) is the key to reducing the risk of HCC. This is why functional cure is the goal of all current drugs in development.
Hi CNN, there is a complete cure for HCV with a pill taken daily for 8-12 weeks. The virus is completely eliminated!! Because of this breakthrough - no one thought HCV could be cured - scientists are now more hopeful and energized to find at least a “functional” cure for HBV. It may not be “sterilizing” or “complete” as defined by Andrew above, but at least we wouldn’t have take a pill for the rest of our life! AND our risk of developing serious liver diseases like liver cancer would significantly decrease. So although I would LOVE to have a complete cure like HCV, I’ll take a functional cure for now. Thanks for asking and hope others jump in! Always, Joan
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