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 [email protected]
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.
Session Outline & Presentations
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
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。
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。
“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。
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。
“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。
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。
- 开发用于降解HBV cccDNA的治疗方法；
- 开发预防cccDNA转录和HBV DNA整合的治疗方法。继续开发阻止病毒复制周期中其他关键步骤的方法，这些方法可以纳入HBV治愈的联合策略中；
- 增加政府、私人资助机构以及慈善捐助者对个人以及合作性治愈研究项目的投资。应考虑建立国际研究联盟，如由美国国立卫生研究院（NIH）管理的关注艾滋病治疗研究的马丁德莱尼合作实验室（Martin Delaney
- 世界卫生组织消除乙肝战略（WHO Hepatitis Elimination Strategy）应得到充足的资金支持，应特别注重普及新生儿出生时接种首针疫苗，显著增加HBV研究资金，改善即时诊断，促进疾病治疗与治愈；
- 专注于发现干预策略，永久减少产毒性感染的细胞数量，或永久抑制这些细胞中的cccDNA, 并诱导HBV特异性T细胞激活与中和抗体的产生，防止病毒扩散到其他细胞，模拟急性乙肝病毒感染后的自发性病毒清除；
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.
- ICE-HBV Media Advisory & Speakers Biographies
- ICE-HBV Press Release
- Global Scientific Strategy to Cure Hepatitis B
- Press Conference Webcast (on https://ilc-congress.eu/)
- Opinion Piece on HBV cure Preparedness
- The push is on to cure hepatitis B, a long-overlooked scourge of millions (by Jon Cohen from Science)
- About ICE-HBV
On the opening day of the EASL International Liver Congress taking place in Vienna, Austria, the International Coalition to Eliminate HBV (ICE-HBV), a global group of researchers, patient representatives and health organisations, will launch a Global Scientific Strategy to Cure Hepatitis B. The Strategy will be published simultaneously in The Lancet Gastroenterology & Hepatology and webcast live at https://ilc-congress.eu/
What: Launch of the ICE-HBV Global Scientific Strategy to Cure Hepatitis B at the European Association for the Study of the Liver (EASL) The International Liver Congress
Where: Press Conference Room, (Lehar 1), Ground floor, Reed Messe Wien Congress and Exhibition Center, Trabennstraße 7, 1020 Vienna, Austria
When: 11:30 CEST, Wednesday, 10th April
• Professor Peter Revill, ICE-HBV Chair at the Doherty Institute, Melbourne, Australia
• Professor Anna Suk-Fong Lok, Alice Lohrman Andrews Research Professor in Hepatology at the Department of Internal Medicine at the University of Michigan Health System in Ann Arbor, MI., USA
• Dr Mark Bulterys, Team Leader, Global Hepatitis Programme, World Health Organization, Geneva, Switzerland
• Dr Su Wang, President-Elect, World Hepatitis Alliance, Board Member, Hepatitis B Foundation, New York, USA
• Professor Markus Cornberg, Scientific Committee member, European Association for the Study of the Liver (EASL), Hannover, Germany
• Professor Fabien Zoulim, ICE-HBV Deputy Chair & Vice-President of the scientific advisory board and head of the HBV cure programme, French Agency for Research on AIDS and Viral Hepatitis (ANRS), Paris, France.
Below you will find summaries of recently announced opportunities from the United States (US) National Institutes of Health (NIH). Also note that there have been announcements, and we expect there to be additional ones, of research support for HBV and HCC from the US Department of Defense’s Peer Reviewed extramural program (search for CDMRP and PRMRP). This information is also available on the Hepatitis B Foundation website.
|Please be sure to review the key dates, especially the expiration date as some of these announcements are set to renew.
*UPCOMING SBIR Contract in FY2020– Antiviral Drugs To Cure Chronic Hepatitis B Virus Infection. NIAID topic for NIH SBIR contract solicitation.
*NIH/NIAID– Research to Advance HBV Cure: HIV/HBV Co-Infection and HBV Mono-Infection (RO1 Clinical Trial Not Allowed: The purpose of this Funding Opportunity Announcement (FOA) is to invite applications for support of innovative basic, translational, and clinical research to identify and address the challenges to achieving hepatitis B virus (HBV) cure in the presence or absence of human immunodeficiency virus (HIV). https://grants.nih.gov/grants/guide/pa-files/PAS-19-097.html
*NIH/NIAID– HIV and Hepatitis B Co-Infection: Advancing HBV Functional Cure through Clinical Research (R21): The purpose of this Funding Opportunity Announcement (FOA) is to fill scientific gaps needed to (a) inform HBV functional cure strategies by furthering our understanding of unique challenges impacting HBV and HIV co-infected hosts and (b) advance the discovery and development of novel HBV interventions that are safe and achieve a functional cure in HIV and HBV co-infected individuals. https://grants.nih.gov/grants/guide/pa-files/pa-17-278.html
*NIH/NCI– Epidemiologic Research on Emerging Risk Factors and Liver Cancer Susceptibility (R21 and R01 – Clinical Trial Not Allowed):The purpose of this concept initiative is to promote etiologic research investigating novel and innovative hypotheses on emerging risk factors (biological, environmental, and social) and their interplay with established risk factors (e.g., viral hepatitis) associated with the development of liver cancer (hepatocellular carcinoma and other histological subtypes) in the United States. https://grants.nih.gov/grants/guide/pa-files/pa-18-677.html
NIH/NIDA/NIAAA– Pilot and Feasibility Studies in Preparation for Drug and Alcohol Abuse Prevention Trials (R34 Clinical Trial Optional): This Funding Opportunity Announcement (FOA) for R34 applications seeks to support: (a) pilot and/or feasibility testing of innovative new, revised, or adapted prevention intervention approaches to prevent or delay the initiation and onset of drug and alcohol use, the progression to misuse or problem use or alcohol and other substance use disorder, reduce drinking and driving and deaths related to impaired driving, and the drug- or alcohol-related acquisition or transmission of HIV infection and viral hepatitis among diverse populations and settings; and, (b) pre-trial feasibility and acceptability testing for prevention services and systems research. It is expected that research conducted via this R34 mechanism will consist of studies that are a pre-requisite for preparing and submitting subsequent applications for larger scale drug or alcohol abuse prevention and/or drug- or alcohol-related HIV prevention intervention studies. This R34 FOA does not support applications for which the sole focus is development of intervention protocols, manuals, or the standardization of protocols. Any intervention development work must be embedded within a pilot/feasibility study. Of particular interest is prevention research that addresses current public health priorities and priority settings and systems. https://grants.nih.gov/grants/guide/pa-files/pa-18-775.html
NIH/-NICHD– Advancing Understanding, Prevention, and Management of Infections Transmitted from Women to their Infants (R01 Clinical Trial Optional): The purpose of this funding opportunity announcement (FOA) is to stimulate investigations including translational, epidemiologic and clinical studies and trials that improve the understanding, prevention and clinical outcomes of non-HIV infections transmitted from women to their offspring during pregnancy, labor and delivery, and breastfeeding. NICHD is committed to supporting research that will increase scientific understanding of and treatments for high-priority perinatal infections. https://grants.nih.gov/grants/guide/pa-files/PA-18-031.html
*NIH/NIMHD/NIAAA/NCI– Mechanisms of Disparities in Chronic Liver Diseases and Cancer (R21)- The purpose of the initiative is to support multidisciplinary innovative exploratory and developmental research to understand the underlying etiologic factors and the mechanisms that result in disparities in chronic liver diseases and cancer in the US. This FOA utilizes the Research Project Grant (R21) mechanism, and is suitable for early phase, pilot, or exploratory/developmental projects. Investigators who are interested in proposing larger scale, later phase projects based upon substantial preliminary data should submit applications to the companion FOA PAR-17-151 of identical scientific scope which uses the NIH (R01) grant mechanism. https://grants.nih.gov/grants/guide/pa-files/PAR-17-150.html
In 2019, the IAS Towards an HIV Cure initiative, in collaboration with the International Coalition to Eliminate Hepatitis B (ICE-HBV), will organize a 1.5 day HIV & HBV Cure Forum on 20 & 21 July 2019, immediately preceding the 10th IAS Conference on HIV Science (IAS 2019).
Abstract are accepted until 22 January 2019. Use the IAS 2019 system to submit.
Learn more about the Forum here.
Nature Reviews Commentary lays groundwork for the momentum behind hepatitis B cure research and the long-term implementation of HBV cure preparedness worldwide.
On the eve of World Hepatitis Day, the International Coalition to Eliminate HBV (ICE-HBV), a global group of researchers, patient representatives and health organisations, has called for the integration of a hepatitis B (HBV) cure in global plans to eliminate viral hepatitis.
More than 290 million people worldwide are chronically infected with the HBV, a viral infection that attacks the liver and can cause both acute and chronic disease. Last year, nearly 900 000 people died from the disease.
A safe and effective vaccine to prevent HBV infection has been available since 1982 and its universal delivery is essential for the elimination of HBV as a public health threat. Lifelong treatment is also needed for those already chronically infected but currently is only accessed by some five per cent of the people who need it.
“Some 900 000 people dying unnecessarily of hepatitis B every year is completely unacceptable,” said Associate Professor Peter Revill, ICE-HBV Chair and Senior Medical Scientist in the Royal Melbourne Hospital’s Victorian Infectious Diseases Reference Laboratory at the Peter Doherty Institute for Infection and Immunity (Doherty Institute).
“HBV cure research could make all the difference and prevent adverse outcomes in all people infected with HBV, allowing them to live treatment-free, fully productive lives and reduce the stigma associated with this chronic infection.”
Members of ICE-HBV stakeholders’ group argue in a commentary published today in Nature Reviews Gastroenterology and Hepatology that there is a need for appropriate cure research and preparedness to complement the World Health Organization´s global elimination strategy, the HBV vaccine and the well- tolerated but poorly accessed therapy.
“It is an ethical imperative that we rapidly scale-up diagnosis and treatment of these ‘missing millions’ and ensure that health systems engage them in order to provide equitable access to cure therapies once they become available,” said Dr Jeffrey Lazarus, an ICE-HBV member and head of the Health Systems Research Group at the Barcelona Institute for Global Health (ISGlobal) in Barcelona, Spain.
The current treatment regime helps keep HBV under control, but it is not a cure and must generally be taken for life. Even with ongoing treatment, people are still at a higher risk of developing liver cancer, particularly those with underlying cirrhosis due to chronic HBV. It raises issues of medication adherence and requires considerable investment for ongoing monitoring, adding to the challenges of achieving elimination.
Recent scientific progress and the momentum generated by the discovery of a cure for the hepatitis C virus (HCV) has created a sense of hope to find a cure for HBV. ICE-HBV is calling for increased investments in HBV cure research and cure preparedness to save the lives of the 290 million people living with chronic hepatitis B worldwide, most of whom are unaware of their infection.
ICE-HBV will launch a Global Scientific Strategy to Cure Hepatitis B immediately before the Liver Meeting® 2018 in San Francisco (8 November 2018). The scientific strategy aims to guide and accelerate research efforts globally, to ensure that the objectives outlined by WHO are sustainably met. ICE-HBV has already begun moving forward the most urgent research priorities such as developing reliable models and assays to study the impact of new curative treatments under development.
ICE-HBV strongly supports both the World Health Organization global health sector strategy on viral hepatitis and the World Hepatitis Alliance’s ‘Find the Missing Millions’ campaign. It urges a more universal health coverage approach to the hepatitis B response that has public health and research agencies go beyond the existing objectives and work together to discover and ensure access to curative treatment regimens for people living with HBV.