Tips to not think about hep b all day long

Hi All,

Greetings and hope everyone is doing fine. I am 30 years old and was diagnosed with hep b in oct 2022 during my routine checkup. Since that day i am constantly on my phone searching and educating myself about the hep b world and scared to see liver cancer can get you anytime. All day long i keep searching for hep b news and reading about possible cures or novel medicines. My heart sink seeing the functional cure rates and drug development rates. Most of them just failing.
Can people share tips to take my mind off my condition? I live in east coast so weather is really depressing in winters to even go out for runs.
What are some ways i can deal with hep b without thinking something bad is going to happen.

My condition is i am not on any medicine and my fibroscan showed one area with 7.4kpa but rest all below 7kpa not sure if average is taken. Hep b viral load is 16800IU, ALT was 18 and necroinflammation 0.04. My doctor said she will see me again in feb but i am so worried that something is gonna happen till that time. Please suggest ways i can take my mind off and accept my condition and not think about cancer.

Thanks everyone and looking forward to learn from people how they deal with this monster everyday

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It ll take you a while before digesting all of it. I have no real tip. It’s always on the back of mind. Just take your time and take it all in.

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Dear @Ash_Malhotra,

Yes, it’s hard to stop thinking about something. It does get easier with time, as your mind slowly realises it is not in immediate danger. If it is really beginning to affect your life and it isn’t getting better, then it is probably best to seek some professional counselling or other mental health support.

I can’t really give a good answer as I’ve gone the complete opposite and started a job where I am thinking about Hepatitis B all day every day. But I find keeping my mind engaged helps as well.

Thomas

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Hi it is really hard to stop thinking about it. I have been living with HepB around 15 years. I can’t find way to stop thinking about this virus and I keep search and follow up news about cure but sadly there is no completely cure. I still hopping one day the cure will come out like HepC.

Whenever I got any illness and have any symptoms related I will keep search for the meaning of it.

My suggestion it to calm yourself, thinking it is not a sudden problem, just taught yourself how to live happy, eat healthy and enjoy life.

Hope you are fine.

Hi @Ash_Malhotra,

I also don’t have any tips to help get your diagnosis off your mind, but I can offer some information that might help, and I can offer my personal concern and support for you.

HepB is a very slowly progressing disease and you are young. I am presuming you are under a doctor’s care (if not–please see your doctor to set up routine care visits). S/he will monitor your condition carefully and start you on safe and effective drugs that slow disease progression even more if that becomes necessary. So you are in good hands!

Second, please don’t worry about the slow pace of drug discovery. That is completely normal and just indicates that the scientists and research doctors are being careful as they move forward. There are tons of new drugs with a really wide range of mechanisms under development, and some of them are certain to be approved. Better treatments for HBV are definitely on their way. No one can say when they will become available because it is impossible to predict the rate at which science progresses, but they are coming! I pay close attention to the drug development status (I work in that area), and other experts in the Community are even more involved than I am. For example, Andrew Vaillant is very active in the Community and runs a company developing one of of the leading types of new therapies, and the Community’s founder, Thomas Tu, is one of the best young HBV virologists in the world. We are here to help the HBV community as much as we can, so feel free to ask us questions about the science if you would like.

Finally, I want to give you my support. You are not alone, and there is a huge collection of people fighting to help you.

John.

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Thanks everyone for the support. I am really rooting for NAP + BRII-179 to be the therapy which will induce sustained t cell responses. I was actually wondering since all major companies Gilead, VIR and BRi are joining hands to see if combination therapy will achieve success.
Does NAP have any plans of joining hands with these giants or have plans to integrate with them in trials? Since they are all lacking HBsAG controls and majority of people with low HBsAG are achieving promising results. @availlant

Dear Ash_Malhotra,

For the patient community at large to set its expectations properly, it is important to have a good understanding of some not-so-basic concepts, especially with respect to therapeutic vaccination.

In considering the utility of the vaccination approach in a therapeutic setting, we have to consider the very different requirements of the vaccine in a therapeutic setting from a prophylactic setting (the traditional way vaccines are used).

HBV viral innoculum mostly consists of wildtype HBV, so establishing immune response to wildtype HBV antigens (e.g. HBsAg) is a good way to build immunity which will prevent the establishment of HBV replication in the liver. There are several vaccines now approved which are very effective, the best of these being Prehevbrio (Sci-B-Vac) because the HBsAg that is used is presented as subviral particles or SVP (the way HBsAg is presented in real infection).

In a therapeutic setting the requirements of an effective vaccine are very different. With persistent infection, the genetic plasticity of HBV results in the evolution of numerous quasispecies of HBV (and thus HBsAg). Many HBsAg species will be able to escape the existing immune function or because of the immune exhaustion that HBsAg causes, many of the immune cells which direct immune responses against HBV will be asleep. This is the reason why HBsAg clearance during therapy is critical.

So any therapeutic vaccine must be capable of stimulating new immune cells (or waking up immune cells that are asleep) to numerous different strains of HBsAg, otherwise there will always be a portion of circulating HBsAg (and HBV) which will not be targeted and eventually overwhelm the effects of vaccination.

BRI-179 (VBI-2601) represents the best of the therapeutic vaccines evaluated so far (it uses SVP just like Brehevbrio) but it still only contains one (wildtype) strain of HBsAg.

In a phase II study, this therapeutic vaccine was able to engender the activation of immune cells to HBV (and even anti-bodies to HBsAg) but these antibodies were not able to target the HBsAg which was circulating in these patients and HBsAg levels remained unchanged. These results unfortunately demonstrate the very different demands on a therapeutic vaccine. Currently all therapeutic vaccines have this design limitation.

There are still only two compounds which can restore effective immune control of HBV (once HBsAg is cleared). These are pegylated interferon and thymosin alpha 1. These agents work by activating all of the different species of HBV (and HBsAg) reactive immune cells which already exist and which recognize many different HBsAg species as a result of having to respond to the many circulating HBsAg quaspsieceis present in chronic infection.

Best regards,

@Ash_malhotra
I can confirm it gets better with time. I am on medication for over a year now and the thoughts about hep b accompany me every day, but they are less intrusive and less scary than a year ago. The more you learn about hep b, the more you understand and you try to live a normal and healthy life. People around me would say - try not to worry too much and I was not happy with that advice but at the end of the day it was not such a bad piece of advice :)! All the best to you!

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