This excellent article by Jon Cohen raises the prospect of a cure for hepatitis B by 2030.
The magnitude of hepatitis B (HBV) is enormous. Nearly 300 million people worldwide have chronic infection which can trigger liver damage leading to hepatitis B related liver cirrhosis or cancer and the death of nearly 900,000 people each year.
Hepatitis B can already be prevented with a vaccine and controlled with medicines. At present only a small minority of people living with hepatitis B have been diagnosed and vaccine coverage varies greatly from country to country. To help address this situation the World Hepatitis Alliance has launched a program to ‘find the missing millions’ unknowingly living with hepatitis B and board member Su Wang, a physician from New Jersey is speaking out about her own chronic infection to help reduce stigma and discrimination, a significant issue for many people with hepatitis B.
The current treatments suppress the hepatitis B virus to low or undetectable levels and reduce liver damage but do not provide a permanent cure. These treatments have not changed significantly for decades and have to be taken for a lifetime. One of the features of the HBV virus is that it hides in the DNA and can become undetectable during treatment but if treatment is stopped or if a person’s normal immune response is depleted, for example during chemotherapy, the hidden virus can multiply again.
Experts are now hopeful that a cure for hepatitis B will be found in the next decade.
The International Coalition to Eliminate HBV (ICE-HBV) formed in 2016 includes more than 50 scientists from 21 countries. More than 30 new treatments currently in human trials are focused on providing a ‘functional cure’ for the vast majority of people. This aims to reduce the hepatitis B virus to levels low enough to allow people to stop treatment. Even more work is however required to find a more permanent cure, this would require the complete removal of the hidden virus in the DNA so that it can never re-emerge.