Review of The Digital International Liver Congress (ILC) 2020
A Wide Field of Novel Treatments for Chronic Hepatitis B
NEW agents have shown promise for a functional cure for chronic hepatitis B virus (HBV) infection. The results of early trials for several novel agents were presented at The Digital ILC 2020 and in a press release dated 28th August 2020, with evidence of early progress in combatting this chronic liver disease discussed.
Current treatments for chronic HBV infection can suppress viral replication, but rarely result in a functional cure, defined by loss of detection of the hepatitis B surface antigen (HBsAg). The two currently approved treatments for chronic HBV infection are nucleos(t)ide reverse transcriptase inhibitors (NRTI) and interferon-α. The new agents discussed at The Digital ILC 2020 exploit different mechanisms to address HBV infection: disruption of viral proteins, including HBsAg; direct inhibition of the HBV core protein; and immune system targeting.
Four studies at The Digital ILC 2020 discussed trial results of agents that target the production of viral proteins, either by RNA interference (RNAi) or using antisense oligonucleotides.
A further study examined the impact of targeting the viral core protein directly in patients who were already virologically suppressed on NRTI therapy; this study found a greater percentage of patients went on to have HBV DNA <5 IU/mL compared to baseline in the treatment group versus placebo (63% at baseline to 94%, versus 80% to 70% with placebo). A final study considered the strategy of improving the innate immune response to chronic HBV infection; there were dose-proportional increases in cytokines, changes in immune cells, and 5% of patients receiving the new agent (a toll-like receptor 8 agonist) had a loss of HBsAg.
“The development of novel therapeutics for persistent HBV infection is currently one of the most vibrant fields in hepatology,” outlined Dr Tobias Böttler, University Hospital Freiburg, Germany, and a member of the EASL Governing Board. “With so many different approaches that show promising results regarding HBsAg-decline, and even HBsAg-loss, we appear to be edging closer to the development of a functional cure.”作者: StephenW 时间: 2020-12-26 14:51
Digital ILC 2020的四项研究讨论了通过RNA干扰（RNAi）或使用反义寡核苷酸靶向病毒蛋白生产的试剂的试验结果。
进一步的研究检查了直接针对病毒核心蛋白的靶向对已经被NRTI治疗进行了病毒学抑制的患者的影响。这项研究发现，与安慰剂相比，治疗组与基线相比，HBV DNA <5 IU / mL的患者比例更高（基线时为63％至94％，安慰剂时为80％至70％）。最终研究考虑了改善对慢性HBV感染的先天免疫反应的策略。细胞因子呈剂量比例增加，免疫细胞改变，接受新药（toll样受体8激动剂）的患者中有5％的HBsAg丢失。