Nivolumab seems to cure Hep B with a low dose. Any thoughts or opinions?

[landloper]

https://www.sciencedirect.com/science/article/abs/pii/S0168827819304003


Highlights

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    In patients with chronic hepatitis B virus (HBV) infection, T-cell immune responses are inhibited, leading to an inability to control or eliminate the virus.
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    One of the most common inhibitors present in these patients is programmed death receptor 1 (PD-1), especially on T-cells within the liver.
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    In this study, we assessed the efficacy and safety of a single dose of either 0.1 or 0.3 mg/kg of nivolumab, an inhibitor of PD-1, with or without GS-4774, a therapeutic vaccine, in patients with chronic HBV.

[Jatashankar]

Treatment with nivolumab is generally safe. More than 10% of treated participants had seriously elevated liver enzymes and 5% developed immune-mediated hepatitis requiring corticosteroids. The major concern with checkpoint inhibitors like nivolumab is immune-related adverse events; the drugs work by restoring immune responses against cancer cells, but they can also cause excessive inflammation of healthy tissue.

[Jatashankar]

It is very expensive around 2000$ per 100mg vial. Who can bear this and also the health hazards on healthy body

[stef2011]

in western countries nucs are more expensive than that over the years....we have them free by public health care but vired was about 400€ per month (now off patent i believe it is about 100€) and entecavir was about 800-900€...you reach 2000usd in a bit and 100mg is really a lot for hbv

[stef2011]

i hope there will be new trials for longer periods and higher doses and i am sure most will clear especially when some immune response is ongoing already (hbsag already on slow decline)

[Liverpatient]

This seems to be very promising, activating the inactivated T-cells, especially the ones in hepatocytes would be very promising to rid the hbv infected liver cells. Combine this with nucs to remove the virus from the blood, then it would cure the disease. But, I wonder whether all the infected hypatocytes would be targetted, especially those cells that have integrated hbv-dna in their genome? Plus, these researche take years if not decades to materialise into real drugs, so quite disappointing the pace at which the drugs are developed. I think the big drug companies that conrol the medication against hepB, like Gilead, are too much power. What would these companies and their investors do, if suddenly, someone develops a drug that cures hbv with few doses in a matter of few weeks? Their billions of income would suddenly disappear, so these guys want to keep us on nucs, so that we never get cured but continue to buy their drugs for our entire lives, very sad!

[stef2011]

finally somebody did a study on it, we always knew it is an hbv cure and the fact such a low single dose lowered hbsag without sides definitely makes it off label hbv cure.let's see in which country this might be possible...

[stef2011]

and of course this is an extremely dangeours drug, only these low doses under strict medical supervision are safe....those with very low hbsag under nucs many years would be the best for future trials

[landloper]

It's dangerous in large quantities, but it appears that the quantities needed for HBV are very low indeed.

I wonder what multiple doses at a very low level would do.

We're talking like 10x less than the standard dose for cancer - it may not be the least bit dangerous in terms of autoimmune disease etc - such low doses' effects have not been trialed - but my personal intuition is that such low doses would be unlikely to cause serious problems.

[stef2011]

if i had no thyroid issues due to my pegintf treatment i d go for it immediately buying the drug myself in india but i'm slowly recovering from my subclinical hypo and i cannot risk that.plus if i get hypothyroid the t4 drug is not the solution, i was extremely unwell on it

[stef2011]

better wait for more trials in my case

[landloper]

i did buy some from india and i attempted to administer it to myself. i bought all the equipment, including a drip, etc... to try and give myself a low dose of it. but i was unable to get the needle into my vein on multiple attempts. i watched internet tutorials etc but i just couldn't get it in there, it was very frustrating. now the nivolumab has been sitting in my fridge for so long it expired.

also when i ordered it, it arrived in what had been ice, but it was no longer very cold, i wasn't sure if the temperature had been correctly maintained

[stef2011]

i sent you a PM

[Jatashankar]

Y will you disturb the natural program of the cells. Their deaths are predecided by the body if u induce death in them that may trigger status me very noxious chain reactions

[stef2011]

no this treatment only activates tcell that are inactivated by hbv virus as they should be active in nture.the only trouble might be autoimmunity but using this treatment at higher dose and for long periods, a single dose is not going to do anything dangerous...i think this is the best treatment available now

[imran4535]

One key question would be that these FLARES that kill off the virus, are they so strong that they will cause HCC integration?

[stef2011]

hcc integration happens with persistent infection, the flares will kill most infected cells and also increase tcell cancer immunity.this drug is also used on hcc