Viral hepatitis updates: 7 reports on risks, therapy pipelines

Direct-acting antiviral therapy has offered a highly effective cure for hepatitis C. Unfortunately, curative options are not yet available for other hepatitis viruses. Researchers continue their efforts to improve treatment and ongoing care for individuals infected with hepatitis A, hepatitis B, and hepatitis D.

The following reports include recent data on HBV treatment outcomes, new developments in the research of HDV therapy, and a report that highlights the potential efficacy of high-dose, accelerated hepatitis vaccination for individuals with HAV.

TDF for HBV does not worsen renal function in most patients

Treatment with tenofovir disoproxil fumarate for chronic hepatitis B did not correlate with a higher risk for worsening of renal function among patients with significant renal impairment in a study that compared therapy outcomes with Baraclude.

“Our results suggest that for healthier patients, TDF and [Baraclude] are comparable [chronic HBV] treatment choices regarding renal safety,” Sam Trinh, BS, from Stanford University Medical Center in California, and colleagues wrote. “However, for those with moderate renal impairment or over 60 years old, renal outcomes with TDF may be worse while improvement can be expected for patients treated with [Baraclude].” Read more

High-dose, accelerated hepatitis vaccination may improve response

Results from a recent study showed a potential benefit from initial high-dose, accelerated hepatitis A vaccination in patients with cirrhosis including improved immune response with minimal increased cost.

“Patients with cirrhosis have increased morbidity from hepatitis A (HAV) and B (HBV) infections, and vaccination against these infections is an important standard of care,” Alan J. Wigg, PhD, from the Flinders Medical Center in Adelaide, Australia, and colleagues wrote. “However, vaccination in patients with cirrhosis is hindered by immune dysfunction and there is limited high quality literature available.” Read more

Eiger Biopharmaceuticals enrolls first patient in trial for hepatitis D therapy

Eiger BioPharmaceuticals announced the first patient enrollment in its phase 2 study of combination interferon lambda with ritonavir-boosted lonafarnib, according to a press release.

“Eiger is developing lonafarnib-based regimens alone and in combination with pegylated interferon-alfa as the first potential therapies for the treatment of HDV, and this program is advancing into phase 3 with the international, multi-center, D-LIVR study, planned to begin later this year,” David Apelian, MD, PhD, MBA, chief operating officer and executive medical officer of Eiger, said in the press release. “Lambda represents a potentially better tolerated interferon for the treatment of HDV, and our goal is to expand future therapeutic options for patients with HDV infection.” Read more

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Patients with HBV die at younger age

Patients with chronic hepatitis B virus infection died an average of 14 years younger and had higher incidences of death from all causes compared with the general U.S. population, according to study results recently published in Clinical Infectious Diseases.

“In the United States, about 1,800 death certificates annually list hepatitis B virus (HBV) as an underlying or contributing cause of death,” researchers wrote. “However, accurately quantifying mortality related to hepatitis is difficult because of the prolonged period between infection and death and because death is not always linked to underlying infection. ... Underestimating the true prognosis of [chronic hepatitis B (CHB)] infection may have real consequences for patients.” Read more

SomaGenics receives NIH grant to develop hepatitis D therapeutic

SomaGenics received a 3-year, $2.9 million award from the National Institutes of Health’s Small Business Innovation Research program to support development of the company’s RNA interference-based approach for hepatitis D, according to a press release.

The company’s HDV therapeutic was designed to simultaneously target the virus at multiple stages of its life cycle using proprietary synthetic short hairpin RNA technology. Read more

HBV therapy nonadherence increases risk for liver-related complications

Medication nonadherence among patients with hepatitis B increased the risk for hepatocellular carcinoma, cirrhotic complications and all-cause mortality, according to recently published data.

“Adherence appears to be a key factor in minimizing [liver-related events (LRE)],” Neung Hwa Park, MD, PhD, from the University of Ulsan College of Medicine in the Republic of Korea, and colleagues wrote. “Considering that poor adherence increased the risk of LREs in this study, identifying an effective medical strategy to improve adherence to medication may substantially improve clinical outcomes.” Read more

HBV antibody levels after NA discontinuation predict relapse risk

Discontinuation of nucleos(t)ide analogue therapy for chronic hepatitis B correlated with risk for clinical relapse based on total serum level of HBV core antibodies after 2.5 years of follow-up, according to recently published data.

“Studies have suggested that the recognition and targeting of [HBV core antibodies (anti-HBc)] by the adaptive immune system play an important role in viral clearance,” Heng Chi, MD, from the Erasmus MC University Medical Center in Rotterdam, the Netherlands, and colleagues wrote. “Our results suggest that a high level of anti-HBc may be correlated with a more enhanced HBV-specific immune response.” Read more