Hepatitis B Virus treatment: the challenge

Hepatitis B Virus infections are extremely common around the world. About 257 million people are chronically infected, 80 million of whom live in China alone. As a direct result of their infection with Hepatitis B Virus, quite a sizable number of the individuals will go on to develop hepatocellular carcinoma, one of the deadliest forms of liver cancer. Worldwide, Hepatitis B Virus resulted in 887,000 deaths (2015)[1].
While vaccination is highly efficacious in preventing infection, vaccine coverage is incomplete and ongoing mother-to-child transmission contributes to the continued propagation of the disease. Although current Hepatitis B treatments effectively suppress viral replication, they are typically not curative. There is therefore a high unmet need for curative Hepatitis B Virus therapies.

However, research has shown that Hepatitis B Virus has a far higher mutation rate than previously thought. In a surprisingly short period of time, the virus effectively takes over the human cell's replication machinery in order to proliferate billions of viruses per day with every possible mutation represented[2]. With modern sequencing, these mutant viral strains, sometimes called 'quasispecies', can be precisely characterized.

You understand the problem: if a treatment is curative today, it might not be so tomorrow.

[1] WHO: Factsheet Hepatitis B. See here.
[2] Lin et al: New insights into the evolutionary rate of hepatitis B virus at different biological scales in Journal of Virology – 2015

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