ICE-HBV welcomes the following new funding opportunities for HBV Research:
This is an opportunity to submit proposals for hepatitis B research. You can download the application and eligibility criteria at https://cdmrp.army.mil/funding/prmrp. Pre-application letters of intent are due by April 16, 2020.
This opportunity seeks to fill “scientific gaps needed to (a) inform HBV functional cure strategies by furthering our understanding of the interactions of HBV and HIV; and (b) advance the discovery and development of novel HBV interventions targeting HBV/HIV co-infection.” For more information, please visit: https://grants.nih.gov/grants/guide/pa-files/PAS-20-121.html
The Melbourne Declaration was signed on October 5th 2019, by leaders of ICE-HBV, The Peter Doherty Institute for Infection and Immunity, the WHO Collaborating Centre for Viral Hepatitis, the Burnet Institute, the Hepatitis B Foundation, ANRS, Sidney Vo ( ommunity member) and was endorsed by the International Hepatitis B Meeting.
ICE-HBV & partners are organizing a side-event at the Global Fund Replenishment Conference on October 8 from 1pm to 2:30pm. The session aims to underscore the potential public health impact of expanding viral hepatitis elimination programming, including through strategic integration with existing efforts to improve HIV care and prevention outcomes. To register, please contact info@ice-hbv.org.
As highlighted in WHO’s Progress report on HIV, viral hepatitis and sexually transmitted infections 2019, viral hepatitis caused 1.4 million deaths in 2016, a number comparable to deaths caused by tuberculosis and higher than those caused by HIV. However, the number of deaths due to viral hepatitis is increasing over time, while, thanks to the global effort to tackle these epidemics, mortality caused by tuberculosis and HIV is declining. Most viral hepatitis deaths are due to chronic liver disease. Globally, in 2015, an estimated 257 million people were living with chronic HBV infection, and 71 million people with chronic HCV infection. Among the 36.7 million persons living with HIV in 2015, an estimated 2.7 million had chronic HBV infection and 2.3 million had been infected with HCV. Liver diseases are a major cause of morbidity and mortality among those living with HIV and coinfected with viral hepatitis as well as some key populations infected with viral hepatitis and at high risk of HIV infection, including people who inject drugs and prisoners.
The WHO 2019 report highlights the critical connections between efforts to achieve the global targets of elimination of viral hepatitis and reductions in HIV incidence and mortality. Service coverage of HBV and HCV testing and treatment needs to be rapidly scaled up. Hepatitis services need to be delivered through a public health approach to benefit all, including through strategic integration with HIV programming where it makes sense. Sustainable financing is required to enable universal health coverage. Innovations are also essential; new diagnostics, treatments, cure and vaccines are being developed. They should be tested and delivered urgently to transform the hepatitis response and attain the elimination targets.
– To highlight innovations in the viral hepatitis response that can have a wide public health impact and show how viral hepatitis elimination can contribute to Universal Health Coverage and to improving clinical outcomes for people living with HIV.
– To advocate for increased investments in viral hepatitis, including to achieve micro-elimination among people living with HIV and among key populations at risk of HIV, and beyond.
– To underline the feasibility of viral hepatitis elimination by looking at cost estimates, procurement systems and innovative financing. Due the existence of now affordable diagnostics and curative treatments for HCV, an effective and inexpensive HBV vaccine and the prospects for further innovations towards an HBV cure, enhanced investments made today can have a major impact on global health, within a short period of time.
Co-Chairs – Pr François Dabis, ANRS + Charles Gore, EndHep 2030 and Medicines Patent Pool
Speaker – Dr Benjamin Cowie, WHO Collaborating Centre for Viral Hepatitis at the Doherty Institute
The State of the Viral Hepatitis Epidemic – Success and Challenges
Speaker – Dr Yvan Hutin, WHO, Geneva – The Price Tag + Universal Health Coverage: integrated services delivery for HIV & hepatitis
Speaker – Dr. Christian Ramers, Senior Clinical Advisor on Viral Hepatitis, Clinton Health Access Initiative
Leveraging rapidly falling commodity costs to improve clinical outcomes among people living with HIV and key populations through elimination of viral hepatitis.
Speaker – Jessica Hicks, Head of Programmes, World Hepatitis Alliance
Involving the affected community and civil society in innovative financing strategies
Speaker – Pr Massimo Levrero–Board member, International Coalition to Eliminate HBV
Collaborative Biomedical Innovations for Viral Hepatitis Elimination
全球治愈乙肝（Hepatitis B）的科学战略
2019年4月，国际消除HBV联盟（ICE-HBV）全球科学战略在《柳叶刀-胃肠病学和肝脏病学》（Lancet Gastroenterology and Hepatology）期刊上发表，为乙肝治愈研究和全球乙肝治愈准备奠定了基础。
乙肝是一种与结核病、艾滋病以及疟疾相同规模的全球公共卫生威胁。全球有超过2.57亿人长期感染乙肝病毒，2017年有近90万人死于该病。
ICE-HBV是由全球研究人员、患者代表和卫生组织所组成，其制定的全球治愈乙肝的科学战略（简称ICE-HBV战略），推动了全球乙肝病毒治愈工作。
在《柳叶刀-胃肠病学和肝脏病学》期刊发表的同时，于奥地利维也纳召开的欧洲肝脏研究协会（EASL）国际肝病大会（International Liver Congress）开幕当天也发布了这一战略并进行了网络直播。
乙肝是一种损害肝脏的病毒性传染病，可引起急性和慢性疾病。乙肝病毒通过与被感染者的血液或其他体液接触传播。今天，慢性乙肝（CHB）病毒感染导致的死亡人数已超出疟疾致死人数。
慢性乙肝还导致约40％的肝细胞癌，肝细胞癌则是全球癌症相关死亡的第二大原因。
“每年约有90万人死于乙肝相关疾病，这简直令人无法接受，” ICE-HBV主席以及多尔蒂研究所（Doherty Institute）皇家墨尔本医院高级医学科学家彼特·热维尔（Peter Revill）教授称。
“令人费解的是，虽然慢性乙肝造成了巨大的人员和经济损失，但乙肝研究仍资金不足，无异于被忽视的热带病。乙肝治愈研究可产生重大意义，防止所有乙肝病毒（HBV）感染者出现不良反应，使他们能够接受免费治疗，过上充实的生活，并减少与这种慢性感染有关的污名。”
如果有乙肝疫苗和治疗药物，为什么还需要研究其治愈方法？
虽然存在安全、有效、能预防HBV感染的疫苗且其全球供应，对于消除HBV这一公共卫生威胁至关重要，但那些已经长期感染的患者还需要终生治疗。而目前，在数百万需要终生治疗的人当中，只有大约8％的人能够获得终生治疗，部分原因是疾病监测的复杂性。ICE-HBV战略强烈呼吁进行适当的治愈研究和准备，来补充世界卫生组织（World Health Organization）的全球消除HBV战略、HBV疫苗和耐受性良好但难以获得的疗法。
目前的治疗方案有助于控制HBV，但无法治愈HBV，因为它无法将病毒从被感染的细胞中彻底清除。cccDNA（共价闭合环状DNA）是一种特殊的DNA结构，产生于HBV繁殖期间，并有可能永久存在于细胞核内。感染HBV后，cccDNA可在患者接受临床治疗后继续存在于肝细胞内，甚至可以重新激活。
即使进行持续治疗，被感染者患上肝癌的风险仍然较高，特别是那些因慢性乙肝而患有潜在肝硬化的人。这引发了药物治疗依赖性的问题，并需要大量投资进行持续监测，从而为实现乙肝消除的目标增加了挑战。
双管齐下
为了实现HBV治愈的目标，ICE-HBV战略提出并详细阐述了两种主要方法：一种是在不杀死被感染细胞的情况下治愈HBV；另一种是通过诱导免疫控制，安全地清除被感染细胞。ICE-HBV战略认为，其中任何一种方法都需要得到协调良好的临床研究的支持，才能推动HBV治愈目标的实现。
ICE-HBV战略还引用了新的证据，即乙肝“出现症状的时间”比先前认识到的更早，并且HBV DNA的整合与肝癌有关。因此，在比目前建议的治疗时间更早的阶段进行治疗或许是明智之举。
新的合作是关键
“治愈乙肝不是一个白日梦，也不应该被这么认为，”乙肝基金会（Hepatitis B Foundation）董事会成员兼世界肝炎联盟（the World Hepatitis Alliance）新当选主席Dr Su Wang称。
“我们当中的2.57亿个乙肝患者迫切希望实现治愈乙肝的目标，以结束不必要的痛苦和死亡。我们赞同ICE-HBV战略，认为它是努力扩大必要的研究和合作以实现HBV治愈目标的标志。”
“我们相信，如果能够给予乙肝研究与丙肝治疗研发同等的精力和投资，将可以大大推动HBV治愈目标的实现。ICE-HBV战略的重要性在于它详细阐述了如何采用病毒学和免疫学的方法多管齐下对抗和根除致命的HBV。”
“不仅如此，ICE-HBV还具有里程碑意义，因为它不仅包括知名科学家和临床医生，还重视HBV患者群体的贡献。HBV治愈关系着患者的切身利益，他们理应成为我们治愈HBV之路上的合作伙伴。”
普及全民医保
最近的科学进展以及发现丙肝病毒治愈方法带来的强劲研究势头为寻找HBV治愈方法带来了一线希望。
ICE-HBV 正呼吁增加HBV治愈研究和准备方面的投资，以挽救全球2.57亿慢性乙肝（CHB）患者的生命，他们当中大多数人并未意识到自己感染了这一病毒。
虽然ICE-HBV支持世界卫生组织（World Health Organisation）全球卫生部门病毒性肝炎战略以及世界肝炎联盟的“寻找失踪的百万人群”（Find the Missing Millions）运动，但它还敦促我们普及全民医保以应对HBV。
“我们强烈认为，公共卫生及研究机构需要突破现有目标，通力合作，为HBV患者找到治愈方法并确保他们能够接受治愈性治疗。” ICE-HBV委员会成员、北京生命科学研究所研究员李文辉博士称。
建议
ICE-HBV战略提出了一系列为应对HBV需要展开的重点研究领域，包括：
消除HBV：
HBV免疫调节
执行
Collaboratory)。各国的HBV计划都应将HBV治愈研究投资战略放在首位。
国际消除HBV联盟（ICE-HBV）简介
ICE-HBV是一个国际研究型平台，正在努力协调、促进及建立公私合作伙伴关系，以加快慢性乙肝（CHB）治愈方法的发现。其目标是促进发现一种安全、有效、经济实惠且可扩展的治愈方法，使所有CHB患者，包括儿童与合并感染丙型肝炎、丁型肝炎和艾滋病病毒（HIV）的人都能受益。ICE-HBV试图促进CHB这一公共卫生威胁的消除。ICE-HBV是一项非营利性倡议，最初于2016年由来自法国国家艾滋病与病毒性肝炎研究署（ANRS）、彼得·多尔蒂感染与免疫研究所（Peter Doherty Institute for Infection and Immunity）和国际乙型肝炎病毒会议（International HBV Meeting）的学术研究人员制定。ICE-HBV的成员（包括个人和机构）数量日增，现已遍布全球各地。
HBV is a global public health challenge on the same scale as tuberculosis, HIV, and malaria. More than 257 million people worldwide are chronically infected with HBV and nearly 900,000 people died from the disease in 2017.
During this session, panelists discusssed the International Coalition to Eliminate HBV (ICE-HBV) and how a global scientific strategy lays the groundwork for the momentum behind hepatitis B cure research and the long-term implementation of HBV cure preparedness worldwide.
Professor Anna Lok presenting current data on HBV cure endpoints.
Hepatitis B cure is the next frontier in both liver disease and infectious diseases, and it is getting closer.
Cautious optimism is allowed as many new drugs are entering the pipeline and investments are growing since the entry receptor for HBV was discovered in 2015.
Still, many of these regimens might only induce remission as they might not eliminate viral cccDNA (covalently closed circular DNA – a special DNA structure that arises during the propagation of HBV in the cell nucleus and may remain permanently there).
Almost 500 packed the auditorium for the Think Tank, with the main topics of discussion including endpoints of cure, novel biomarkers, current immunology and virology-based approaches for cure, and considerations for combination therapies.
Professor Anna Lok (University of Michigan and ICE-HBV) gave a great summary of current data on HBV cure endpoints; Dr Barbara Testoni (Inserm Lyon and ICE-HBV) talked about how to impact cccDNA and Professor Mala Maini‘s talk (Imperial College London and ICE-HBV) focused on immunological strategies for HBV cure.
Better in vitro and in vivo models are required to ensure that a cure is soon discovered.
ICE-HBV is supporting this by collaborating with NIAID on a future reagent’s repository of HBV materials and an open access protocols dabatase soon available on www.ice-hbv.org.
ICE-HBV will also hold a workshop on in-vivo models in Melbourne in October 2019, stay tuned!
You can find out more on the next steps towards a cure in the “Global Scientific Strategy for an HBV Cure” released by ICE-HBV following a two-year in depth consultation process with key experts from the field, patient representatives and other stakeholders of the response to the hepatitis B epidemic.
See the webcast from the announcement here.
