On March 9-10 I participated in “Hepatitis on the Hill” in Washington, DC. The event was organized by Hep B United (HBU), the National Viral Hepatitis Roundtable (NVHR) and the Hepatitis Appropriations Partnership (HAP), and brought together both hepatitis B and C advocates. This was an incredible opportunity to work together, network, and advocate on the Hill. Continue reading "Hepatitis on the Hill – HBV Personal Perspective and Action Alert"
Please tell your Representative that viral hepatitis is important to YOU, and ask for support of the President’s proposed FY16 budget increase for the Division of Viral Hepatitis, CDC. Increased funding is essential to support HBV and HCV programs. You don’t have to be politically savvy to participate, but we need your help. Call, email or write today!
Representatives Mike Honda, Hank Johnson, and Judy Chu are asking all House Representatives to sign an important letter supporting a doubling in funding for hepatitis B and C programs in the Fiscal Year 2016 appropriations bill (see text of letter below). This is the same increase in funding that President Obama recommends in his proposed budget, which was released last month. The deadline for Representatives to sign the letter is end of day, March 19, 2015.
This is an extraordinary opportunity to ask our House Representatives for leadership in the fight against the hepatitis B and C epidemics. The more signatures on this letter, the better chance of securing badly needed funding to expand testing, linkage to care, surveillance, and other vital services.
Please take a few minutes before March 19th to call your House Representative’s office in Washington, DC and ask/him to sign this letter. Continue reading "Action Alert! Urge Your House Representative To Support Increased Hepatitis B and C Funding!"
You can’t neatly package and control everything, but you can use good judgment and not over react when thinking about hepatitis B transmission. Hep B is not casually transmitted, but you know yourself, and both infected and uninfected individuals can take simple precautions. If you don’t have hepatitis B and you are sexually active, make sure you are vaccinated. If you have hep B, encourage your partners to get vaccinated. If you’re not in a monogamous relationship and/or one partner has not completed the hepatitis B vaccine series, use a condom!
(Click here if you’re looking for Part 1) Continue reading "The Fifty Shades of “Gray” of Hepatitis B Transmission – Part 2"
All pun and a little fun is intended with this title, but the “adult” version of hepatitis B transmission is a serious concern. There are “shades of gray” when it comes to hepatitis B transmission and the degree of risk with sexual activity. Continue reading "The Fifty Shades of “Gray” of Hepatitis B Transmission – Part 1"
Great insights and advice on dating with chronic HBV from a member of the Hepatitis B Information and Support List.
Continue reading "Dating and Hepatitis B – A Personal Perspective"
HBF is pleased to connect our blog readers to Christine Kukka’s monthly HBV Journal Review that she writes for the HBV Advocate. The journal presents the
latest in hepatitis B research, treatment, and prevention from recent academic and medical journals. This month, the following topics are explored:
Continue reading "HBV Journal Review February 2015"
It takes talent, dedication, lots of time, and a sizable investment to bring a safe and effective drug to market. The Drug Discovery Process YouTube video, compliments of PhRMAPress, introduces the long and arduous drug process from the identification of a compound in the lab, though clinical trials and the FDA approval process. It may sound simple, but this process may take up to 1,000 people, 12-15 years and up to 1.3 to 1.6 billion dollars to put a new drug in the hands of the patient.
Consider this process when following the progress of hepatitis B drugs on the Hepatitis B Foundation Drug Watch page. Compounds could remain in various stages for years. Note that the “preclinical” phase represents the drugs that are still in the lab and not yet ready for human clinical trials.
The Hepatitis B Foundation also maintains a webpage with the latest hepatitis B related clinical trials. Contact information is provided for each trial for those wishing to volunteer to participate. Volunteers must meet the criteria for participation in a trial.
The future looks bright for a functional cure for hepatitis B. It may take a few more years to get the drug into the hands of the patient, but each step of the process is crucial in order to produce a drug that is both effective and safe.
HBF is pleased to connect our blog readers to Christine Kukka’s monthly HBV Journal Review that she writes for the HBV Advocate. The journal presents the
latest in hepatitis B research, treatment, and prevention from recent academic and medical journals. This month, the following topics are explored:
Continue reading "HBV Journal Review – January 2015"
Take a look at HBF’s Top Ten picks for 2014… Continue reading "Top 10 Hepatitis B Related Stories of 2014"
Hepatitis C is now declared curable. Hepatitis B is still not, despite having been discovered nearly 50 years ago. An interview with Dr. Timothy Block of the Hepatitis B Foundation and the Baruch S. Blumberg Institute. The future does look bright…
Perhaps this should not be a surprise, thinks Timothy Block, PhD, president and co-founder of the Hepatitis B Foundation (HBF) and its research arm, the Baruch S. Blumberg Institute. According to Block,there are two main reasons for the “cure deficit” between hepatitis B and C — funding and physiology.
He points out that commercial and federal investment in hepatitis C have been far greater than in hepatitis B. And that has clearly paid off in terms of finding a hepatitis C cure. “You get what you pay for,” he observes.
Physiologically, hepatitis B also presents unique challenges not found with hepatitis C — most notably cccDNA (or covalently closed circular DNA), the “mini- chromosome” produced by the hepatitis B virus. The cccDNA persists in the nucleus of the liver cell, where it can hide amidst the host’s own chromosomes, apparently out of reach of the cell’s own defense systems.
Acting like “an indestructible template,” cccDNA continues to produce virus particles throughout the life of the infected liver cell, even in people being treated with antiviral agents.
Hepatitis C, on the other hand, doesn’t enter the cell’s nucleus, so it’s possible to cure a person by stopping this virus from replicating long enough for the liver cells to regenerate.
But remember that people who have been “cured” of hepatitis C can still get re-infected,” Block cautions. The hepatitis C drugs apparently do not trigger an immune response that protects against re-infection.
In contrast, some people can be cured of hepatitis B, either naturally or through drug therapy. These individuals do seem to have long-term protective immunity. “And that’s what we are aiming for,” he declares.
Why We Need a Cure for Hepatitis B
It can be argued that the approved antiviral agents are very successful in keeping the virus under control. So do we really need a cure? Definitely yes, Block replies emphatically.
Current antiviral drugs are effective, but need to be taken lifelong and are recommended for use in only about half of the infected population. And even after 10 years of use, the antivirals reduce HBV-related diseases by only about 50 to 60 percent. The drugs can also lead to the development of resistant hepatitis B strains (drug resistance).
For those who benefit from treatment, the antiviral drugs have been transformational and prove that medical intervention can be effective. However, there are millions who do not benefit and are still left vulnerable.
Clearly, new approaches to a “functional cure” are needed, which Block defines as “returning the risk of death due to hepatitis B to the level of someone who has a resolved infection.” And the person should not need to take any drugs to stay at this low-risk level.
Targeted Strategy for a Cure
The HBF/Blumberg Institute scientists, with their research partners from Drexel University College of Medicine, both located in the HBF’s Pennsylvania Biotechnology Center, are developing two types of therapies: direct-acting antivirals and innate host defense activators. The first type inhibits virus-host interactions and viral gene products; the second recruits the host’s immune system to attack and eliminate cccDNA and infected liver cells.
For each of these approaches, the researchers have identified key steps to target in the hepatitis B infection cycle, from virus entry into the liver cell, to cccDNA replication, to formation of virus particles.
For many of these steps, “Our scientists have developed assays that can be used to screen for new drugs. We are a recognized leader in designing and developing these assays and, for a time, had the only cccDNA- dependent cell lines,” notes Block. Almost 100 different cell lines for assays have been developed that can be used to screen for drugs that activate the innate host defense pathways.
For drug screening, cell lines are incubated with potential drug candidates to try and find new therapeutic drugs for future hepatitis B treatment. The strategic goal is to discover new drugs that complement existing therapies, but also enable the immune system to provide long-lasting antiviral protection, even when the person is no longer on drug therapy.
The strategic goal is to discover new drugs that complement existing therapies, but also enable the immune system to provide long-lasting antiviral protection, even when the person is no longer on drug therapy.
Several compounds in development already show some effectiveness in animal models. “We have a capsid inhibitor, a pregenomic RNA capsid inhibitor (JT Guo), an HBsAg inhibitor (A Cuconati), a cccDNA repressor (H Guo, A Cuconati, JT Guo), and an activator of innate host defense pathways (J Chang and JT Guo),” Block reports.
He is particularly excited about their stimulator of interferon genes (STING) agonist, which was very effective in mouse models. The research group is now working on a human STING agonist, although an appropriate assay for this compound still needs to be developed.
What the Future Holds
“The Hepatitis B Foundation and its Blumberg Institute have contributed
to some of the most important work in studying the phases of the virus lifecycle that has led to the currently available drugs. Our researchers continue to be at the forefront in developing a promising pipeline for hepatitis B drug discovery,” says Block.
“I am absolutely confident that a cure is possible” he asserts. “After all, enough people with hepatitis B resolve their infections, either medically or spontaneously — even some people with chronic infections. So we know it’s possible.”
