Thursday, February 2, 2023

Cure For Hepatitis B Found

European Commission And Thervacb Join Forces

Treatment of Hepatitis B 2019: Easy to Treat, Hard to Understand!

The role of viral hepatitis as a public health threat has long been underestimated. Only very recently, the United Nations in their 2030 Agenda for Sustainable Development called for international action to combat viral hepatitis and reduce the disease burden. The major killer is the hepatitis B virus causing liver cirrhosis and liver cancer. Worldwide 880,000 humans die each year from the consequences of an HBV infection.

A prophylactic vaccine is available to prevent HBV infection, but more than 3% of the worlds population are chronically infected and do not profit from that vaccine anymore. For those suffering from chronic hepatitis B, until today no curative treatment option exists.

The European Commission therefore selected the project TherVacB led by Helmholtz Zentrum München for a five-year funding within the Horizon 2020 program. A consortium of leading virologists, immunologists and physicians specialized in treating viral hepatitis, will use a newly designed therapeutic vaccine, TherVacB, as an immunotherapy to cure HBV. TherVacB will be evaluated in a three-year clinical trial starting in 2022 conducted in Europe and in Africa. Integration of a partner site in Tanzania shall help building local capacities for diagnosing and treating hepatitis B and support an important goal of the consortium to raise awareness for hepatitis B.

What Are The Types Of Hepatitis B

There are two types of hepatitis B infection: acute and chronic.

Acute

An acute infection happens at the beginning, when you first get infected with hepatitis B. Many people are able to clear it from their bodies and recover. In fact, this is true of about 4 in 5 adults who are infected.

Chronic

If you are not able to clear the infection within six months or longer, you have chronic hepatitis B. It is chronic hepatitis B that leads to inflammation and the serious, and possibly fatal, illnesses of cirrhosis of the liver and liver cancer. Treatment can slow disease progress, reduce the chance of liver cancer and increase your chances of surviving.

Unlocking The Immune System To Control Hepatitis B

One sequence of the viral RNA code can contribute to several different hepatitis B virus proteins and also to viral replication. By targeting that sequence for clean out there is a potential broad impact on viral protein production, with the goal of eliminating the proteins effects on the immune system. This could set the stage for the immune system to take over and keep the virus suppressed for the long term without the need for ongoing medication.

Whilst the ultimate aspiration is to find a cure for hepatitis B, this approach could lead to what is called a functional cure, where the virus is undetectable in blood and at a low enough level in the liver that it can be controlled by the immune system without medication, meaning liver damage is less likely to progress and the burden of the disease on people will be reduced. Scientists hope this new approach will control the hepatitis B virus and lead to longer-lasting solutions for the 296 million people currently living with this disease.

Hepatitis B has been causing death and disability on a global scale for many years. We are committed to following the science to explore new approaches to address unmet needs and provide longer-lasting solutions for patients with this potentially life-threatening liver infection.

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How You Can Get Hepatitis B

You can get hepatitis B from:

  • injecting drugs using shared needles
  • being injured by a used needle
  • having a tattoo or piercing with unsterilised equipment
  • having a blood transfusion in a country that does not check blood for hepatitis B. Blood transfusions in the UK are checked for hepatitis B.

If you’re pregnant and have hepatitis B, you can also pass it onto your baby during pregnancy or birth.

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Hepatitis B During Pregnancy

If a woman with HBV becomes pregnant, they may transmit the virus to their baby. Women should inform the doctor who delivers their baby that they have HBV.

The infant should receive an HBV vaccine and HBIG with 1224 hours of birth. This significantly reduces the risk that they will develop HBV.

The HBV vaccine is safe to receive while pregnant.

People with a high risk of HBV include:

  • the infants of mothers with HBV
  • the sexual partners of people with HBV
  • people who engage in sexual intercourse without contraception and those who have multiple sexual partners
  • men who have sex with men
  • people who inject illicit drugs
  • those who share a household with a person who has a chronic HBV infection
  • healthcare and public safety workers who are at risk of occupational exposure to blood or contaminated bodily fluids
  • people receiving hemodialysis, which is a type of kidney treatment
  • people taking medications that suppress the immune system, such as chemotherapy for cancer

People can prevent HBV infection by:

  • wearing appropriate protective equipment when working in healthcare settings or dealing with medical emergencies
  • not sharing needles
  • following safe sexual practices
  • cleaning any blood spills or dried blood with gloved hands using a 1:10 dilution of one part household bleach to 10 parts water

A vaccine against HBV has been available since 1982.

People who should receive this vaccine include:

Preparing For An Appointment

Youâre likely to start by seeing your family doctor or a general practitioner. However, in some cases, you may be referred immediately to a specialist. Doctors who specialize in treating hepatitis B include:

  • Doctors who treat digestive diseases
  • Doctors who treat liver diseases
  • Doctors who treat infectious diseases

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Should All Patients With Chronic Hepatitis B Be On Treatment

Not all patients with chronic hepatitis B need to be on treatment. The decision to treat HBV is based on several factors including blood tests results, the patient’s age, and the risk of developing cirrhosis or liver cancer. Sometimes a liver biopsy is needed to see if there is significant liver damage to make a decision.

Hepatitis B medications are recommended for patients with detected HBV virus on a blood test and evidence of liver damage. Liver damage can be detected with a liver enzyme known as ALT. People with cirrhosis should be considered for treatment even if the liver enzymes appear normal.

Chronic hepatitis B may change over time. Patients can go through different phases with low amounts of virus and normal level of ALT followed by high viral loads and ALT levels. These bursts of virus activity usually don’t cause any symptoms but may cause liver damage overtime. It is important that people with chronic hepatitis B have blood tests on a regular basis to see if treatment is needed.

There are some medications which can cause hepatitis B “reactivation” which can lead to life threatening liver failure. These medications are used to treat some cancers, inflammatory conditions and hepatitis C. Reactivation reactions can be prevented and it is important to let your provider know you have HBV before you start any new medications.

How Is Hepatitis B Treated

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Your healthcare provider will treat you based on what type of hepatitis B you have, acute or chronic.

Acute hepatitis B infections

If you develop an acute form of the condition, you probably wont need medical treatment. Instead, your doctor will likely suggest that you get plenty of rest, drink lots of fluids and maintain a healthy diet to support your body as it fights off the infection.

Chronic hepatitis B infections

If you have chronic hepatitis B, you might be a candidate for drug therapy. Usually, drug therapy is used only if you have active liver disease. There are seven drugs that are approved by the U.S. Food and Drug Administration to treat hepatitis B. Two are injectable forms of interferon, while the five other antivirals are tablets.

You will need to take these medications every day. They help by slowing the viruss ability to multiply in your system. This helps reduce swelling and liver damage. Youll need to be regularly monitored for early signs of liver damage and liver cancer. Your healthcare provider will want to see you once or twice a year.

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Approaches By Virus Life Cycle Stage

consist of a and sometimes a few stored in a capsule made of , and sometimes covered with a layer . Viruses cannot reproduce on their own and instead propagate by subjugating a host cell to produce copies of themselves, thus producing the next generation.

Researchers working on such ââ strategies for developing antivirals have tried to attack viruses at every stage of their life cycles. Some species of mushrooms have been found to contain multiple antiviral chemicals with similar synergistic effects.Compounds isolated from fruiting bodies and filtrates of various mushrooms have broad-spectrum antiviral activities, but successful production and availability of such compounds as frontline antiviral is a long way away. Viral life cycles vary in their precise details depending on the type of virus, but they all share a general pattern:

  • Attachment to a host cell.
  • Release of viral genes and possibly enzymes into the host cell.
  • Replication of viral components using host-cell machinery.
  • Assembly of viral components into complete viral particles.
  • Release of viral particles to infect new host cells.
  • Before cell entry

    This stage of viral replication can be inhibited in two ways:

  • Using agents which mimic the virus-associated protein and bind to the cellular receptors. This may include VAP , natural of the receptor and anti-receptor antibodies.
  • Uncoating inhibitor

    Inhibitors of uncoating have also been investigated.

    During viral synthesis

    Transcription

    World Health Organization Recommendations

    The 2015 WHO guidelines for the prevention, care, and treatment of persons with chronic hepatitis B infection indicate treatment priority for individuals of all ages who have chronic hepatitis B infection and clinical evidence of compensated/decompensated cirrhosis , regardless of their levels of ALT or HBV DNA, or their HBeAg status.

    Treatment is recommended for adults with chronic hepatitis B infection without clinical evidence of cirrhosis , but who have all of the following features , and regardless of HBeAg status :

    • Are older than 30 years
    • Have persistently abnormal ALT levels
    • Have evidence of high-level HBV replication .

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    Is There A Cure For Hepatitis B

    There is no cure or medication that totally eliminates the virus or makes HBsAg negative, but there is hope. There are approved therapies for hepatitis B and many in development. First-line therapies in the U.S. and globally are entecavir, tenofovir and tenofovir , which are antivirals. Sometimes, pegylated interferon is used. These drugs control and manage the virus and reduce potential liver damage. The virus is suppressed, liver enzymes and liver function tests may normalize and the liver is better able to heal. In rare cases, they may even get rid of the virus .

    You might be interested in the recent by Dr. Timothy Block, president of the Hepatitis B Foundation Dr. Chari Cohen, our senior vice president and Maureen Kamischke, the Foundation’s patient engagement and consult specialist.

    You might also listen to this podcast by HBFs Dr. Tim Block, the co-founder of the Hepatitis B Foundation about efforts to find a cure, and how the time is right for these great medical discoveries to be achieved sometime soon.

    For a complete list of FDA-approved drugs and other promising drugs in development for hepatitis B, visit our Drug Watch page.

    Additional Resources:

    With The Momentum Growing Around Hepatitis B Drug Discovery Research We Are Closer Than Ever To A Cure

    Living a normal, productive life with hepatitis

    From the Spring 2016 B Informed Newsletter

    With the momentum growing around hepatitis B drug discovery research, how far are we from a cure?

    Closer than ever, according to Timothy Block, PhD, president and co-founder of the Hepatitis B Foundation and its research arm, the Baruch S. Blumberg Institute. He points out that hepatitis C, initially thought to be incurable, can now be cured with new combination treatments.

    Hepatitis B is in a similar position, Block believes. And the need for a cure has never been greater, with over 240 million people living with chronic hepatitis B infection worldwide, resulting in 1 million deaths per year from related liver failure and liver cancer.

    Treatments are available, explains Block, but we have become a little too comfortable with the seven medications that are currently approved for use. While these drugs are effective, the interferons have many side effects and the oral antivirals require lifelong use. Moreover, they work in only about half of the infected population, and reduce the rate of death due to liver disease by only about 40 to 70 percent.

    For those who benefit from treatment, the antiviral drugs prove that medications can be effective. However, there are millions who do not benefit and are still left vulnerable. We should not accept that a significant number of people will still die from hepatitis B-related complications despite taking the current drugs, Block declares.

    What would a cure look like?

    cccDNA Inhibitors

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    Treatment For Hepatitis B In Patients With Drug Resistance

    Frank Tacke, Daniela C. Kroy

    Department of Medicine III, RWTH Aachen University Hospital, Aachen, Germany

    Contributions: Conception and design: All authors Administrative support: None Provision of study materials or patients: None Collection and assembly of data: None Data analysis and interpretation: None Manuscript writing: All authors Final approval of manuscript: All authors.

    Correspondence to:

    Keywords: Hepatitis B virus antiviral drug resistance polymerase

    Submitted Jul 28, 2016. Accepted for publication Aug 24, 2016.

    doi: 10.21037/atm.2016.09.19

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    Nucleoside Analogues Or Oral Antivirals

    Antivirals, or NAs, slow down or stop the hepatitis B virus from reproducing, decreasing the risk of liver damage. Less liver damage occurs when there is less virus present.

    People take NAs orally as a pill and experience very few side effects.

    First-line treatments, such as Tenofovir disoproxil and entecavir, are potent and effective in suppressing the virus, but they only work for as long as a person takes them. Discontinuing treatment

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    How Common Is Hepatitis B

    The number of people who get this disease is down, the CDC says. Rates have dropped from an average of 200,000 per year in the 1980s to around 20,000 in 2016. People between the ages of 20 and 49 are most likely to get it.

    About 90% of infants and 25-50% of children between the ages of 1-5 will become chronically infected. In adults, approximately 95% will recover completely and will not go on to have a chronic infection.

    As many as 1.2 million people in the U.S. are carriers of the virus.

    The Best Way To Cure Any Disease Is The One

    The Truth about Hepatitis B

    Instead of the cure being a singular treatment or a singular element, like the kryptonite that threatens to destroy Superman, Dr Tavis says the cure to HBV will likely be a collection of powerful tools that together will have the strength to take on the virus.

    Scientists all over the world are making huge advancements in new treatments that can attack the virus from every angle, he explains.

    Like a squadron of disease-demolishing superheroes, some of the therapies in development focus on blocking the virus entering the cell in the first place, whilst others deactivate the DNA. There is one therapy that will distort the shell of the virus so HBV becomes inactive and unable to survive. Another will lock itself to the genetic material of the virus and either cause it to fall apart or stop it from working.

    Clinical trials are underway to investigate how these various treatments can be combined to work safely and effectively with one another, so healthcare professionals will be able to pick from a toolbox of therapies to deliver patient-specific treatment. One pharmaceutical company, Replicor, is already doing it. Using a three-part combination of drugs, Replicor is achieving a functional cure rate of 35% in early clinical trials.

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    What Are The Risk Factors For Getting Hepatitis B

    Due to the way that hepatitis B spreads, people most at risk for getting infected include:

    • Children whose mothers have been infected with hepatitis B.
    • Children who have been adopted from countries with high rates of hepatitis B infection.
    • People who have unprotected sex and/or have been diagnosed with a sexually transmitted infection.
    • People who live with or work in an institutional setting, such as prisons or group homes.
    • Healthcare providers and first responders.
    • People who share needles or syringes.
    • People who live in close quarters with a person with chronic hepatitis B infection.
    • People who are on dialysis.

    How Long Can You Live With Hepatitis B

    Most people who contract hepatitis B during adulthood fully recover within 1 to 3 months.

    People with chronic hepatitis B may have a higher risk of developing long-term liver problems, like cirrhosis or liver cancer, which require treatment and may be life threatening.

    Keep in mind that the risk of developing chronic hepatitis B is higher for babies and children, especially if they have not been vaccinated against the virus.

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    Who Should Get The Hepatitis B Vaccine

    All newborn babies should get vaccinated. You should also get the shot if you:

    • Come in contact with infected blood or body fluids of friends or family members
    • Use needles to take recreational drugs
    • Have sex with more than one person
    • Are a health care worker
    • Work in a day-care center, school, or jail

    Is Hepatitis B Contagious

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    Hepatitis B is highly contagious. Its transmitted through contact with blood and certain other bodily fluids. Although the virus can be found in saliva, its not transmitted through sharing utensils or kissing. Its also not transmitted through sneezing, coughing, or breastfeeding.

    Symptoms of hepatitis B may not appear for 3 months after exposure. Symptoms can last for several weeks.

    But even without symptoms, you can still transmit the infection to others. The virus can live outside the body and remains infectious for at least

    Hepatitis B is a highly contagious condition. Its associated with many serious complications, some of which can be life threatening.

    But there are many treatment options available and multiple ways you can prevent infection, including getting vaccinated.

    If you suspect you may have been exposed to hepatitis B, its important to talk with a doctor to prevent infection and determine the best course of treatment for you.

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