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6 recent reports on HBV risk factors, disease outcomes

The current options for targeting hepatitis B include vaccination as prevention and immunomodulatory therapies for treatment. While the concept of a functional cure is beginning to gain some grounds, it is years away. For now, researchers continue to focus on discerning risk factors and disease progression to help patients.

Healio Gastroenterology and Liver Disease presents the following reports on HBV including seroconversion rates in untreated patients, regional elimination goals, undiagnosed cases, and mortality outcomes.

Western Pacific Region progressing toward HBV control, MTCT elimination

Between 2005 and 2017, countries in the Western Pacific Region achieved marked progress toward hepatitis B control and elimination of mother-to-child transmission through increased vaccination among newborns, according to a report from the CDC.

“Hepatitis B vaccine (HepB), which has been available since 1982, provides lifelong protection against hepatitis B virus (HBV) infection,” Joseph Woodring, DO, from the World Health Organization, and colleagues wrote. “Continued implementation of proven vaccination strategies will be needed to make further progress toward [Western Pacific Region (WPR)] hepatitis B control targets.” Read more

ALT flares in HBV low, linked to seroconversion in untreated patients

Among patients with chronic hepatitis B, the cumulative incidence of severe alanine aminotransferase flares was low and correlated with decreased HBV DNA levels and loss of HBV e-antigen, according to recently published data.

“With the advent of sensitive HBV assays and new therapeutic agents, our understanding of the natural history, clinical outcomes, and management of ALT flares in chronic HBV infection has evolved,” Mayur Brahmania, MD, from Toronto General Hospital in Canada, and colleagues wrote. “Although ALT flares are infrequent, they do occur and can be associated with significant rises in ALT values ... which probably warrant close monitoring in patients with advanced liver disease given the risk of decompensation.” Read more

Rates of deceased donor organs with HCV, HBV, HIV increasing in US

Between 2010 and 2017, the number and percentage of deceased donor organs with a transmissible infectious disease — such as hepatitis C, hepatitis B or HIV — increased in the U.S., which may likely be tied to the ongoing opioid epidemic, according to a recent report from the CDC.

“These findings demonstrate the continuing need for identifying viral bloodborne pathogen infection risk factors among deceased donors to reduce the risk for transmission, monitor posttransplant infection in recipients, and offer treatment if infection occurs,” Winston E. Abara, MD, from the Division of Viral Hepatitis at the CDC, and colleagues wrote. Read more

Undiagnosed HBV, HCV, HIV prevalent in newly diagnosed cancer cases

Researchers discovered a substantial proportion of patients with newly diagnosed cancer and concurrent hepatitis C or hepatitis B were unaware of their viral infection and many had no identifiable risk factors, according to a recently published study.

“Screening may be especially important now that we've entered the age of immunotherapies for cancer — treatments that may affect cancer patients’ immune systems and alter the course of their viral infections,” Scott D. Ramsey, MD, PhD, lead study author from the Fred Hutchinson Cancer Research Center in Washington said in a press release. “While we don’t know much about the impact of immunotherapies on patients with cancer and hepatitis and other viral infections, oncologists should know as much as possible about the overall health of the people they treat.” Read more

Advanced fibrosis found in one-third of patients with HIV/HBV coinfection

Researchers observed significant fibrosis in more than one-third of patients with hepatitis B and HIV coinfection undergoing long-term combination antiretroviral therapy with viral suppression, according to a study published in American Journal of Gastroenterology.

“HIV treatment guidelines recommend that all HIV-infected persons with active HBV infection ... undergo treatment of both infections with [combination ART] including tenofovir,” Richard K. Sterling, MD, MSc, FACG, from Virginia Commonwealth University, and colleagues wrote. “Our data provides novel and clinically important findings regarding the spectrum of liver disease in persons living with HIV/HBV coinfection.” Read more

Antios Therapeutics raises $25 million for potential HBV curative therapy

Antios Therapeutics completed a $25 million oversubscribed Series A financing to develop ATI-2173, an oral drug candidate for treating patients with hepatitis B and potentially coinfected with hepatitis D, according to a press release.

“The next frontier in virology is to cure hepatitis B,” Abel de la Rosa, PhD, co-founder and CEO of Antios, said in the release. “The strong financial support from our investors along with their extensive experience in clinical development and success building innovative companies in the infectious disease field will enable us to accelerate the development of ATI-2173 as a potential backbone of therapy to cure HBV.” Read more

MELD score change during HBV therapy reduces mortality risk

On-treatment improvement of MELD scores correlated with reduced risk for all-cause mortality and hepatic events among patients with chronic hepatitis B and cirrhosis, according to a recently published study.

According to Terry Cheuk-Fung Yip, MPhil, from the Chinese University of Hong Kong, and colleagues, an increase in MELD score correlated with new cirrhotic complications and mortality, whereas nucleos(t)ide analogues therapy for chronic HBV led to an improved MELD score. Read more