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Functional Cure for Hepatitis B

A lot of the naps we use for hepatitis b was developed for hiv as the naps block the virus from multiplying. I notice in the HIV community they are always leaning for a functional cure where the hiv virus is still in the body but no longer able to effect the person. For hep b, will we lean toward a functional cure also ? Since most of the funding and research for hbv originated from hiv research, will we lose research and capital if hbv is not heading in the same direction. from my understanding isnt undetectable level of hep b virus in the blood a functional cure? can someone with experience please explain the difference if hbv can even achieve a "functional cure" (stopping hcc from the virus) if possible?
15 Responses
Avatar universal
Hi from what i understand

NO undetectable dna in the blood is not a "functional cure"

The definition of functional cure is no hbsag in the blood and hbsab presence.


A total cure would be the complete elimination of everything including the cccdna.

Just my opinion from my limited understanding.
Avatar universal
I understand it that way, normal ALT first of all, than no hbv dna and hbsag in the blood but with presence of hbsab, although some small amout of hbv dna and cccdna will stay in the liver like in some people who passed accute hbv.
Avatar universal
70-85% will be able to live fully healthy lives being chronic hbv.  It's the 15-30% who will or might have complication.  It seems liver disease is very deadly and no real advancements are being made.  Liver cancer is very deadly and kills quickly.  It's like pancreatic or stomach cancer.  

But the other way to look at it is the 15-30% of liver disease caused by being chronic hbv, is not all of liver cancer, so even if you fall into 15-30% you might be able to live to an old age.   On the other hand, hbv can turn into hcc anytime, without the damage of the liver.  This is what I get from readings from the Internet.  But a cure seems far, maybe not in our lifetime, but hope I am wrong
Avatar universal
for example hiv functioning cure defines as

" A functional cure for HIV would not necessarily involve eradicating all virus from the body.Instead, the goal of a functional cure would be to get rid of all HIV from the blood and remove any negative effects. In other words, people who had been functionally cured would never develop AIDS or other signs of HIV disease, such as premature aging. "

for example if we were to take hbv into that context, what it be that we still are hbsag + , no hbvdna , but the risk of hcc and cirrhosis will be removed. would that be an example of a functional cure? Is that even possible in hbv as it is in hiv. i know since hbv is cccdna it is a toxin that creates hcc , as hiv does not.
Avatar universal
also the above quotes are taken out of context

http://std.about.com/od/HIV-Treatment-Issues/f/What-Is-A-Functional-Cure-For-HIV.htm

link for full discussion about functioning cure
Avatar universal
Hi, this 15-30% chronic carriers, what happens to them if they take medication against hbv; do they avoid the complications or are they "doomed" to suffer from ,for example, liver cancer?
Avatar universal
what you posted is about untreated, nobody under treatment will die of hbv, hcc is 0....

Avatar universal
15-30% is also a wrong number, post the link of the study

even untreated a very small percentage will die of cirrhosis or hcc, because both can be treated on time if one is monitored.

the point is only those not knowing will die because there are no symptoms and they pass directly with nothing to do

it is diabetes the deadly diseases with the highest hcc rate
Avatar universal
Arrowhead Research Corporation, a biopharmaceutical company developing targeted RNAi therapeutics, presented data from a Phase 2a clinical study at The AASLD Liver Meeting 2015® demonstrating that ARC-520, its lead drug candidate against chronic hepatitis B infection (HBV), effectively reduced HBV viral antigens derived from cccDNA. HBV surface antigen (HBsAg) was reduced substantially with a maximum reduction of 1.9 logs (99%) and a mean maximum reduction of 1.5 logs (96.8%) in treatment naïve e-antigen (HBeAg)-positive patients. This direct antiviral effect was still evident 57 days after a single dose. These data strongly support advancement of ARC-520, and Arrowhead has initiated multiple studies aimed at producing a functional cure of HBV.

They are in the process of starting Phase 2b trials and we may see a cure of Hep-B in near future.
Avatar universal
Arrowhead only had 60% knock down. Thats tiny compared to Replicor!
Avatar universal
Yea, only 60% for hbeag negative (60% was actually the average value across the board when measured on the PEAK of effectiveness of this drug). Now they started testing it together with peginf and entecavir.

In 2 out of 48 patients it caused "heart block" during a previous trial...now with combo of peginf and entecavir sides will probably be harsher.
Avatar universal
it caused "heart block"....my...better keep hbv if we risk something like that with only 60% hbsag decrease
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