Hepatitis B is expected to cure

2015 HEP DART conference: hepatitis B is expected to cureThe HEP DART conference in Hawaii brings together experts and researchers from arou

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2015 HEP DART conference: hepatitis B is expected to cure

The HEP DART conference in Hawaii brings together experts and researchers from around the world to review and discuss the latest research to find a cure for hepatitis B.

Biopharmaceutical companies show data about new treatments that use micro RNAs and other innovative programs to reduce the virus, showing the possibility of a cure for hepatitis B. However, most studies are still in the early preclinical stage, with a focus on laboratory cultures of hepatocytes or laboratory animals, although several trials are in phase I and phase II clinical trials.

2015 is the 20 anniversary of the HepDart conference, involving nearly 600 participants from 20 countries. At the opening ceremony, Dr. Patrick Marcellin of France pointed out that the cure for hepatitis C is a major breakthrough in medical science, we are now looking for a cure for hepatitis B.

This year's HepDart meeting, there are nearly two days devoted to discussing the development of hepatitis B drugs, which shows that around the world to find experts to find new ways to cure hepatitis B. The previous HepDart meetings, almost no discussion of the new treatment of hepatitis B. But this year, more than five companies have demonstrated the results of a new hepatitis B drug.

The researchers at the meeting noted that the resources devoted to research and development of hepatitis B cures are still relatively scarce. They pointed out that the U.S. government spending $175 billion for the treatment of HIV, and treatment of hepatitis B and C (up to 6 million U.S. population affected) spent only a small part of.

Despite the lack of financial investment in the search for a cure for hepatitis B, it is reported that the consensus is that it is possible to achieve a cure. Despite the complexity of HBV cure some obstacle based on but there are multiple therapeutic targets in the virus life cycle, direct acting antiviral drugs and immunomodulators (immune system) combination will be most likely to achieve cure.

In the short term, experts may be concerned about " functional " cure. For example, some new experimental drugs may increase the likelihood of a limited period of treatment to remove HBsAg. Although it will not consider the process of integrating the cccDNA or virus into the liver cells, it will also be an important advance in treatment.

The second day of the HepDart meeting focused on the target of the virus, the new treatment and possible cure. Experts discussed the following problems: any drug can achieve functional cure (similar to surface antigen disappeared and clear HBV infection), or to completely eradicate the virus in the liver (including cccDNA) to achieve complete cure. CccDNA disappearance is considered to be the Holy Grail of HBV cure".

Although the word "cure" is frustrating for patients, the HBV based life cycle is very complex, and progressive or functional approaches may be the most feasible. Everyone wants to be completely cured, including scientists in the field of hepatitis B, however, the realization of functional cure may be the most realistic in the next 10 years.

Functional cure means that the patient must only use a new drug within a limited period of time, in contrast to the existing long-term dependence on antiviral drugs to reduce viral load and prevent liver damage.

Functional cure also has its drawbacks, if the patient in the future need to take immunosuppressive drugs (such as chemotherapy) to treat cancer, then there is the possibility of reactivation of the virus. However, antiviral drugs can also be used when necessary. This is similar to the spontaneous recovery.

In order to highlight the complexity of finding a cure, the following figure shows the different targets of the HBV life cycle, which is the company's commitment to finding a cure.

There are several targets in the academic community, the National Institutes of Health (NIH), the Biotech Corp and the hepatitis B Foundation scientists are working to find a breakthrough target. At this point, small interfering RNA (siRNA) technology is the most advanced. However, there are some compounds in each of these pathways (see figure below). The research will continue and its prospects are optimistic.

Tim, chairman of the hepatitis B Foundation, chaired a special meeting at the HepDART conference to discuss what new endpoints are needed to assess the efficacy of the new drug (Block). This will involve immunology, virology, clinical functional healing and complete healing. Based on the differences in the stages of the new drug treatment (immune tolerance, immune activity, and inactive phase), the clinical endpoint may be different.

The latest breakthrough of HepDART conference:

The research progress of hepatitis B surface antigen (HBsAg) drug (ARC 520) of Arrowhead company: the first time using this kind of medicine, siRNA can reduce the level of HBeAg in patients with positive HBsAg by 10 times. The study is the small sample size, but impressive.

Arrowhead's ARC 520 may also tell us about vs.HBeAg negative patients with chronic HBeAg positive information. They believe that the amount of HBsAg in the blood of patients with HBeAg negative may come from the "integration" of the hepatitis B virus in the liver, rather than from "cccDNA". This has important implications for treatment.

Novira's oral drug is the first class of capisd inhibitors, in the initial human trials show that a small number of patients can reduce the level of HBV DNA up to 100 times.

Compiled from: There 's for a B at HEP DART 2015 Conference.HepB Blog, 2015, Hepatitis, Cure, the, Hope

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