The doctor said that this vaccine Vaccin antihepatic B - Wikipedia will it help me to increase the amount of AcHBs < 3.1 and Aghbs to become negative, what do you think? what are the risks if Aghbs does not become negative but I will also have AcHBs, will it lead to liver inflammation, can the degree of fibrosis increase over time?
I mention the fact that I am not on hepatitis B antiviral treatment, there was no such thing because the highest viremia was 64 Ul/mL and the lowest < 10 Ul/mL , in these 2 years since I found out that I have this virus .
The paper you refer to is out of date as a great deal of good work has been done with therapeutic vaccination since then. Multiple major drug companies and one large academic consortium are starting clinical trials for therapeutic vaccination using the latest technologies. I am personally excited to see the results, but with caution in my thinking. Therapeutic vaccination has been explored for as long as I’ve been studying HBV (~30 years), and in all that time, the only impressive results are the ones that are coming out now (for example TherVacB; https://www.thervacb.eu/), and those are still pre-clincial data.
As to getting re-vaccinated with the standard HBV vaccines: That will not hurt anything, but long experience with the vaccine in HBV+ people has not led to good results. There is always a chance that you are on the cusp of naturally seroconverting to anti-HBs positive state (ie, a natural “functional cure”–this happens rarely but it does happen) and re-vaccination might push the virus over the edge. However, there is no substantial body of clinical or lab-based data saying that would work.
I came across discussions suggesting that achieving a cure with TherVacB may be difficult due to the presence of HBsAg. in this forum posts and research papers have mentioned the potential benefits of using small interfering RNA (siRNA) in treatment.to reduce HBsAg and then with TherVacB, However, I’m curious if there are any siRNA treatments that have been approved. If not, why do they suggest siRNA? Is siRNA promising for decreasing HBsAg levels? Additionally, why not consider nucleic acid polymers (NAP) since they have demonstrated efficacy in reducing HBsAg levels?
i see this statment in TherVacB post, To treat high-titer infection, a combination with siRNA is promising,
siRNAs are one of the leading classes of drugs under development. None are approved yet, but I’ll be surprised if none of them eventually end up being approved. You are correct about TherVacB–the current data indicate that it works best in animals where HBs is low. We do not know if that will translate to humans, but it seems likely. Trying siRNAs or NAPs with it is logical, but it is unknown how long (or if) therapeutically suppressing HBs levels would allow a vaccination strategy to work. Results with the NAPs very strongly imply that removing HBs with them in combination with nucleoside analog drugs and interferon alpha can reactive the immune system to clear HBV in a very impressive fraction of patients. Andrew will of course know a lot more about the NAP data than I do.
Thanks youDr @john.tavis for clarifying.
I don’t know if it’s me. but … find that articles coming out from Pharmaceuticals companies related to HBV cure clinical trials ( functional) are always a little over positive towards the outcome,
with little or not explanation to problems like in this case it would only work on patients with low HBs. Same with Bepirovirsen…
while it’s encouraging to see many studies being conducted, and always hopeful and thankful it always lives a bittersweet taste when we bring those articles here in the forum and thanks to you experts, we get the real “scoop”.
Unfortunately, I find it can create fake hopes and be emotionally unstable especially while one is waiting for good news.
Thanks you
Gregory
I certainly understand your frustration, and it is understandable that the ups and downs of scientific research can be a bit bittersweet, especially for HBV+ people with so much riding on the outcome.
For what it’s worth, learning to control the bittersweet feelings when a project does not live up to expectations while holding onto the excitement for research is one of the hardest things for young scientists to learn. After a while, you get used to the emotional equivalent of being hit across the shins with a 2x4 board, or you end up dropping out of science!
The source of the consistently optimistic way of presenting things in science is in human psychology. After spending all that time and effort on a project, it is natural to focus on the positives. We work hard to teach our students to maintain a balanced, dispassionate attitude when interpreting data, but it is extremely hard to do that all the time. This pressure is magnified in press releases from companies because huge amounts of money are on the line.
Please remember that we really don’t know what we’re doing in science! We have valuable skills and a large information base to work with, but we’re trying to learn things for the first time in the world and we cannot predict how a project will turn out. A single result can crash a promising project or cause it to take a sharp turn in direction. Keeping a positive outlook is essential under those conditions, and that likely contributes to the positive spin in communications.
Finally, I’m happy to help convey the complex aspects of HBV to HepB Community members as best I can. I hope it helps.
