@ThomasTu @availlant thanks!
so I have to wait, and for this moment take maximum care of myself to wait for the medicine that will cure me 
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Hi Availlant
Your reply was a very good summarize of the pegINF. Thanks for that.
But why did you agree it should be explored more in the scenario you described? How is it different from the scenario that HBsAg is more than 1000 IU?
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Hi Bloke,
Previous clinical data have shown that this approximate threshold defines a HBsAg load where pegIFN works more effectively to achieve HBsAg loss and functional cure.
HBsAg (which is comprised mostly of non-infectious subviral particles) acts to block immune control of HBV infection. The higher the HBsAg load in the blood, the greater this inhibitory effect (which also blocks the action of immunotherapies like pegIFN).
It is important to note that this does not mean than anyone who does not have “low” HBsAg should be excluded from trying pegIFN on this basis alone but rather that, if an individual was shown to have low HBsAg, that pegIFN should be more strongly considered if the goal is to achieve functional cure.
Hope this helps.
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Hi Leonk. We update the Drug Watch every month, to make sure it stays up to date. We do include the phase of research (pre-clinical or clinical trial phases 1, 2, 3). Once a drug is suspended, we remove it from the Drug Watch. I think it might be too confusing (and too long!) to keep all of the drugs on there. But we can consider posting this somewhere else, perhaps. Thanks for your thoughts!
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Sorry @availlant for my simple question, by lower HbsAg<1000 you mean if anyone who has this condition can benefit from PegIFN?
I already has same situation I guess.
My recent lab tests are,
HbsAg: 24, Hbv-pcr: 193 IU/ml, Normal liver tests
For someone with same condition as mine, starting treatment of PegIFN could be benefitial or not? My doctor told me I did not receive any meds until my viral load increases more than 20K.
Hi IWillBeCured,
The chance of getting functional cure with pegIFN is increased when HBsAg is < 1000 IU/mL. It still does not happen in most people.
However, it is an option that you can discuss with your doctor.
Is this most recent HBsAg test result quantitative?
You have what we call inactive chronic HBV. People who have inactive HBV usually never develop liver disease or liver cancer. This is why treatment is not indicated in your case.
Best regards,
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Dear @availlant , it is very nice and kind of you that answer our questions. It is really encouraging.
about your question ,yes, it is my recent lab result which belongs at most 1 or two weeks ago. I accidentally found my HBV at my checkup this month, however, at my last year checkup everything was fine. All new tests are already available in case of more investigation. In addition, I am 31 years old,
Liver tests are normal(ALT, AST, Sono)
HBV-Viral load is 193 IU/ml,
HbsAg is 24(reactive)
HbsAb <2 (non-Reactive)
HBe-Ag: (NonReactive)
HBe-Ab:(Reactive)
Hbc-Ab(total): Reactive.
By all this information do you think it is worth to discuss it with my Doctor? because I think it is very hard to convince him to listen to me
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Dear IWillBeCured,
I think you should start from the perspective of realizing that you are an inactive carrier. You really have most of the benefits that someone with functional cure has (normal liver function, no progression of liver disease, reduced risk of developing HCC). However you do not have functional cure so the chances of relapsing into chronic HBV are higher and of course you are still infectious to some small degree.
With this in mind, I would think it would be hard to convince any well versed doctor to put you on any kind of medication since there is no short or long term concerns for patients in the inactive carrier state.
Your doctor will always choose to NOT put you on medication unless there is a valid reason and also only if there was a medication which reliably give you the clinical benefit you are seeking.
IN your case NUCs will not provide benefit since you already an inactive carrier.
PegIFN MIGHT provide a clinical benefit in transforming your partial cure into functional cure but even with your low HBsAg, there really isn’t any good clinical data showing that pegIFN therapy will be likely to succeed. Any doctor considering the risk benefit analysis in your particular case would be difficult to convince to place you on pegIFN therapy.
Now I suspect that you are considering taking pegIFN to see if you can push your partial cure to functional cure. If you were to do this you must also start TDF or TAF and take this medication at the same time as the pegIFN to control any HBV DNA flares which could occur (these are dangerous). There is also a danger that you will not respond to the pegIFN or that after you complete a 48 weeks course of therapy with TDF + pegIFN that you will not be able to stop the TDF afterwards.
We really have no data what happens to inactive HBV following pegIFN.
Best regards,
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Pls when would the treatment for functional cure be available ?
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@Scientists in the house, is this of great significance to ongoing search for cure? If yes, how significant? The Rockefeller University » New tool to study hepatitis B could open the door to a cure @availlant @ThomasTu and others
Hi @CNN,
The system was developed by a very well-known group, and our group is directly working with Bill Schneider to use this model for our own work.
This is a really interesting tool that makes it easier for us to study hepatitis B. One of the major advantages is that it is relatively easy for scientists to test drugs against a “quasi-species” of HBV, rather than just a clone (that is, not just a single sequence of HBV, but a “cloud” of variants that may respond differently to any given drug). This is really important for cure, as quasispecies can be a source of resistance to treatments.
Hope this helps,
Thomas
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Just seen this.
http://www.cubanews.acn.cu/science/21115-hebernasvac-cuban-scientists-achievement-against-hepatitis-b
Dear @beinghealthy,
Thanks for raising this. Nasvac has been discussed elsewhere in the forum:
Cheers,
Thomas
what is the current update on TherVacB as we are near end of 2023, I know the deadline is dec 2024, but how does it look so far if any knows?
Hi @john.tavis, a cure for HepB in less than 10 years in the clinical world would be like a dream come😊 . I pray they succeed soon .
However in some part of west Africa mostly Ghana, Nigeria, Sierra Leone etc, people has been cured through herbs. They usually take it for a month and they will lose the HBsag and it will never relapse.
So I think whilst we are waiting for the clinical cure, let’s look on the other side. Combining both herbal and clinical therapy to attain atleast a functional cure is our only hope now.
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The trial was meant to start in 2022, it now says 2024 just another carrot on a stick so far
Dear @Agibaby,
Work to cure HBV is progressing. From an HBV+ person’s perspective, I am am sure it is maddeningly slow, but HBV is a very difficult problem and some very smart people are working on it as hard as they can. There is no way to predict the rate of scientific/medical advances, and HBV clinical trials are slow due to the nature of the disease, so the “10 year” estimate is just that – an estimate. The current generation of clinical trials are producing functional cure rates of up to ~30%, at least in people with low HBs levels, so significant progress is being made.
As to the herbal medicines: Such medications have been used by people since the dawn of time. Some of them are effective, but most have only modest effects or no effects at all. That is not to say that they are not worth pursuing–Far from it! A good example is the drug tamoxifen (widely used for breast cancer) that was first isolated from tree bark. Another example is penicillin (made by a fungus) that may explain why some cultures put spider webs on wounds (the web would catch the fungus spores, some of which could be beneficial). However, there is a huge variation in efficacy for most of such herbal treatments even when they are effective due to lack of standardization on how they are produced, stored, and used. Most fail when subjected to controlled clinical trials.
I cannot comment on the particular treatments you refer to, but I would be skeptical about claims of high efficacy. If they were that effective, word would have spread among the HBV+ community and infection and disease rates would not be so high in W Africa. I hope the scientists who study such “natural products” in search of cures for HBV know of these treatments and take a look at them. Natural product drug discovery is a major branch of the drug discovery field, but unfortunately it is extremely complex because the effective agents in herbal treatments are often combinations of very complex biological molecules. That makes identifying, improving, and standardizing them enough to convert them to drugs extremely hard and time consuming.
Finally, a word of caution. About 1/3 to 1/2 of the supplements sold int the USA don’t have anywhere near the level of the advertised active ingredient, and a large fraction have none at all! These products are unregulated and untested for safety issues. So even if some of them work, there is a risk of harm as they’ve not been examined carefully.
I hope this helps.
John.
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