Neutralization Of Hepatitis B Virus With Vaccine
The hepatitis B vaccine is recognised as the most effective approach in reducing hepatitis-B-related morbidity vaccine-escape mutations are however capable of infecting vaccinated individuals. In this work, authors aim to establish a hepatitis B vaccine candidate, which they assess in rhesus macaques in terms of efficacy and safety.
11 July 2022 | Open Access
Clearb Therapeutics Announces Upcoming Poster Presentations Of Pre
CONCORD, Mass.—-ClearB Therapeutics, Inc., a company developing CLB-3000, a therapeutic vaccine designed to drive functional cure in patients chronically infected with Hepatitis B, announced today that two abstracts were accepted for poster presentation at the American Association for the Study of Liver Diseases , The Liver Meeting, to be held in Washington, DC, USA, November 4 8, 2022.
We are excited to continue to make the Hepatitis B community aware of our progress for the therapeutic vaccine candidate CLB-3000, toward first in human trials and our confidence in this novel and differentiated approach said Aileen Rubio, PhD., CEO for the company. Chronic infection with Hepatitis B remains a significant global disease infecting hundreds of millions of people, where functional cure remains elusive and combination therapies are likely needed. We believe that re-education of patients immune systems to break tolerance of their chronic HBV infections through administration of ClearBs therapeutic vaccine could become an important component of combination treatment regimens.
Abstract Number / Poster Number: 36528 / SAT1193Abstract Title : Evaluation of the Hepatitis B therapeutic vaccine candidate CLB-3000 : a 9- or 15-week toxicity study in New Zealand White rabbits with a 4-week recovery periodDate: Friday, 4 November 2022Time: 12:00 pm EDTPresenter Name: Aileen Rubio, ClearB Therapeutics
For more information regarding AASLD 2022 please visitThe Liver Meeting | AASLD
The Future Of Treatment
Chairman of the Scientific Advisory Council for the annual International Hepatitis B Virus Meeting and the Incoming Chair of the International Coalition to Eliminate HBV, Dr Tavis works on the front line of researching new developments in HBV treatments.
Dr Tavis says the cure to HBV is coming. The feeling within the scientific community is that major improvements will happen somewhere in the next five to 10 years it isnt going to be one optimal combination at first.
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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
How Can We Better Explain How The Virus Is Transmitted
When Sadowska was diagnosed, she was advised that her family members should be tested to see if they were carrying the virus, but no one explained to her what the virus could do to her body. Freeland asked her if there was anything she wished she had known in those early days. In response, Sadowska said: I wish I had known how easy it can be transmitted to a baby at birth, and that the vaccination does not work from day one. She added that she was asked if her mother had the virus, but no one had mentioned it was also a sexually transmitted disease.
Freeland then asked Douglas and Elsharkawy to recommend how to communicate a hepatitis B diagnosis effectively to patients. Douglas began by saying: I would explain how it is transmitted, that you can catch it when you are a baby, and that there is a 95% chance you will develop a chronic infection for life. Whereas if you are exposed as an adult, it is the opposite, and you have only a 5% chance of a chronic infection. Most people infected as adults clear the infection over a few months. He continued by saying that it is crucial that the patient is not made to feel isolated or guilty, and that it is made clear to them that the vaccine does not work if the individual is already infected with the virus.
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Can We Do More To Support Patients When Discussing Treatments
Freeland asked Sadowska about her experience of finding out she needed treatment for her hepatitis B. Sadowska described how at a regular follow-up appointment, she was told her liver enzymes were raised slightly, and the doctor wanted her to start medication, which she accepted. However, she said: My initial reaction was that this was bad, and I wondered what time I had left. Is this the end, or is it coming? I didnt have any other questions. It came as a shock that the liver was not doing that well. Sadowska left the surgery and started researching at home, and that is how she found out that hepatitis B infection can lead to cirrhosis and liver cancer. That was when I started feeling slightly ill with stomach pain, she explained.
Elsharkawy responded that starting treatment does not need to be an immediate decision. I might say to a patient, you may need treatment in the next year or two as the virus levels are starting to creep up. Your alanine aminotransferase level is okay. We can afford to wait 3 months, but I want to see you in 3 months rather than 6 months. This gives them time to get used to the idea that treatment may start soon. Then I explain what treatment entails and what the potential side effects might be.
How Can We Explain The Complexities Of Viral Immunity To Patients
One of the things that never came through in the conversations I had with my doctors is that once you have had the virus, you have it for life, Sadowska asserted. Doctors say youve had the virus, and you fought it off, and you are fine. But you might not be fine later when your immune system gets weaker for whatever reason.
Freeland asked the other panel members to explain how they communicate the complexities of viral immunity to their patients. Elsharkawy said: We need to be clear with patients what we mean by cure. What I say to patients is that your body has fought off the infection, the virus is low and is unlikely to cause any damage in the future, unless you require treatment for another condition that suppresses the immune system, such as chemotherapy for cancer, in which case the virus may return.
Douglas added that explaining the complexities of hepatitis B infection and immunity to the virus is challenging, and even medical students and general practitioners can struggle with the concepts. It is important to talk to the individual and find out how they want to approach it and how far they want to go in understanding. The more they ask, the more information you can give them. You dont need to explain everything at once. You can have an immediate goal of where we are at and what we are aiming for in terms of cure. You can always discuss the caveats later. Douglas added: Too much information at one time can be a problem.
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Closing In On A Cure For Hepatitis B
For Thomas Tu, eliminating hepatitis B is a deeply personal goal.
Tu, a molecular virologist at the Westmead Institute for Medical Research in Sydney, Australia, learnt he had chronic hepatitis B as a teenager. A blood test revealed telltale signs of the infectious liver disease, which Tu had probably acquired at birth.
In his late 20s, Tu started taking a medication to limit the viruss replication and prevent collateral damage to his liver cells. Now 36, he has been on that daily treatment a pill known as a nucleoside analogue ever since.
Yet, even with a therapy that keeps his infection well under control, Tu remains at heightened risk for liver disease. He must juggle visits to specialist doctors and bear prescription-drug costs. And he knows that many others racked by the financial instability, emotional toil and stigma that the lifelong infection can bring have it much worse.
Part of Nature Outlook: Hepatitis B
Im in this quite privileged space to be able to be on therapy and not have any side effects or feel any burden from taking daily medicines, Tu says. Thats not the same for the majority of people living with hepatitis B.
We are using all our weapons to tackle every single step of the virus, says Man Fung Yuen, a hepatologist at the University of Hong Kong.
What You Should Know About Hepatitis B:
HBV is transmitted by blood-blood contact, by sexual contacts or directly from a mother to her child around birth. The latter is the most frequent route of transmission resulting in chronic infection, of unrecognized for decades. Adolescents and adults who are not vaccinated can catch the virus during unprotected sexual contact or by contaminated blood products or instruments, e.g. by tattooing or any invasive procedure, or by drug abuse with contaminated syringes and supplies.
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Who Is At Risk
Rate of chronic hepatitis B virus infectionSource: Man-Fung et al., Nature Reviews Disease Primers, 2018
People who are, or whose parents are from one of these countries or regions
Children of mothers infected with the hepatitis B virus
People who are in close contact with an infected person and share unclean sanitary facilities, dishes, cutlery, etc.
People who have unprotected sex with a person at risk or have more than one sexual partner within 6 months
People with HIV or an other sexually transmitted disease
Men who have sex with men
People who share needles, inject drugs, or come into contact with blood
Emergency personnel, social workers and health care providers, with direct contact to infected persons
Dialysis patients
People that live or work in an institution like a prison or a group accomodation
For more detailed information about hepatitis B disease, prevention, diagnosis and currently available treatments, we kindly refer to theHepatitis B Foundationwhom we closely collaborate with.
What Do You Mean By A Hepatitis B Cure
The nature of the Hepatitis B virus is complex and can cause different kinds of infection. Thus, there are actually four levels of cure, each building on top of the last: level I partial cure, level II functional cure, level III complete cure and level IV sterilizing cure.
Answered by: Thomas Tu, Australia
Founder and Director, HepBCommunity.org President, Australian Centre for Hepatitis Virology Group Leader, Westmead Institute for Medical Research, University of Sydney, Australia
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What Do We Know About The Symptoms Associated With Hepatitis B Infection
Often clinicians see hepatitis B as an asymptomatic disease, and yet many patients experience symptoms, explained Freeland, which makes many people feel unheard by their practitioners. Sadowska agreed, saying that she only became aware of her symptoms when she started reading about what symptoms she might get. It may be psychosomatic, but I experience pain on the right-hand side around the liver. It comes in waves, not every day. I wasnt aware of it before I started reading about medications. But my doctor told me that it was not possible to feel liver pain until late-stage disease, so it was not possible for my pain to be liver pain.
Elsharkawy explained: Traditionally, we say the liver disease is asymptomatic, but there are symptoms and impairments to quality of life that may be subtle, but they are still there. He continued: The story I sometimes hear when I start someone on a new medication is that I didnt realise how fatigued I was until I was on medication, and now I feel a lot better. We need to better understand the mechanisms of liver inflammation, because even if inflammation is dampened, some people are still plagued by fatigue. Freeland concurred, and added that the fear of liver cancer is a concern for people with CHB infection and often in peoples minds.
Is Hepatitis B Preventable
Chronic hepatitis B infection affects at least 250 million people worldwide, causing over 880,000 deaths annually. It is also the major cause of liver cancer, the second leading cause of cancer-related deaths in the United States.
Unlike its cousin hepatitis C, hepatitis B can be prevented with vaccines. If you are accidentally exposed to the virus, there are also drug therapies you can takeâcalled postexposure prophylaxisâto avert the infection.
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Investigational Hbv Treatment Moves Goal From Suppression To Cure
Phase 2 trial with bepirovirsen demonstrates possibility of a functional cure of chronic hepatitis B infection that is sustained after treatment is discontinued.
Bepirovirsen, an antisense RNA-based investigational agent, exerted effects possibly consistent with functional cure of hepatitis B virus infection in some participants of a multi-national phase 2 trial.
The agent sustained the primary efficacy measures of reducing hepatitis B surface antigen below the lower limit of detection and HBV DNA level below the lower limit of quantification for 24 weeks after treatment in approximately 10% of the trial participants with chronic HBV infection. That level of response was more likely with a loading dose, the longer of two tested regimens, and lower levels of HBsAg at baseline.
“Although this is a relatively low percentage of participants overall, it indicates the possibility of enhanced efficacy with the selection of patients according to baseline characteristics , with combination therapies, or both,” indicated Man-Fung Yuen, MD, PhD, DSc, Department of Medicine, Queen Mary Hospital, School of Clinical Medicine, Li-Ka Shing Faculty of Medicine, and the State Key Laboratory of Liver Research, University of Honk Kong, Hong Kong, and colleagues.
Treatment response was more likely with a loading dose and in those with lower baseline levels of HBsAgin 19% of those whose baseline HBsAg was 3000IU/ml vs 7% with higher baseline levels.
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Why Is It Important To Support The Hepatitis B Foundation
Gosh, where should I start? First off, support this cause if you care about people living with hepatitis B. Because honestly, many people dont. Most people dont know much about hepatitis B, and people dont support things they dont know much about or care about. So, if you are one of the few that do, please consider it, because there arent enough of us. We NEED you.
Second, if you do care about people living with hepatitis B, the Hepatitis B Foundation should be on your giving radar. Your support would mean so much, because we have so much to do together.
If youve made it this far on our website, you probably already know that 300 million people in the world have hepatitis B. Every 40 seconds, someone dies of liver cancer as a result of hepatitis B. Maybe you know someone who has hepatitis B, died of liver cancer, or maybe you have hepatitis B yourself. YOU. MATTER.
This website is full of information about what the team is doing across the globe to eliminate hepatitis B. Theyve accomplished so much this past year that will help us gain more momentum in 2023 and beyond. We have to leverage those gains!
This team is a group of WARRIORS. They are so smart and so dedicated, it blows my mind.
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When Should We Use The Term Patient
Many people affected by disease prefer not to be described as a patient. For them, it suggests they are not actively involved in their own care. Freedland asked Sadowska how she felt about being referred to as a patient. I started feeling like a patient when I found out I needed to go on medication. Until then, I didnt feel ill, and I wasnt thinking of myself as a patient. But when I started treatment, I started getting some symptoms, including stomach pain that may have been psychosomatic. I was much more conscious of my body and how it reacts. Im on medication for the rest of my life, so I am a patient.
Elsharkawy added: For some people, it is not appropriate to refer to them as patient. As a clinician, its important to be culturally aware and sensitive to differences among patient populations. Perhaps we should ask the question, Are you happy to be called a patient? This is particularly important when it comes to advocacy when someone is asked to raise their voice and share their story, it is essential to establish an agreed language that people feel comfortable with.
Douglas noted: Some people are happy for the doctor to make choices. Others are more actively involved. We need to respect them and treat them as an individual, and adjust our interaction with them if necessary. Freeland agreed, saying: It is important to have those conversations. For most people, there are lots of things going on in their lives that go beyond having hepatitis B.
Is There A Cure For Hepatitis B
The long and short answer is that there is not yet a cure for hepatitis B. Understanding why requires insight into the virus itself and the challenges cure researchers face.
Hepatitis B is an infectious disease caused by the hepatitis B virus . While most people exposed to hepatitis B will spontaneously clear the virus soon after infection, a proportion will go on to develop a chronic infection.
Of these, around one in four will develop severe liver complications, including cirrhosis and liver cancer, typically years after the initial infection.
Efforts to find a cure for hepatitis B have been underway since the virus was first identified by scientists at the National Institutes of Health in 1966. It soon became clear, however, that numerous hurdles would need to be overcome before an actual cure could be achieved. Chief among these are:
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