For millions of people living with chronic hepatitis B, long term treatment has been the only option. EU funded researchers are joining forces to develop combination therapy that could one day free patients from lifelong medication.<\/p>\n
Hepatitis B is a chronic infection affecting roughly 254 million people worldwide and causing about 1.1 million deaths each year, mainly from cirrhosis and liver cancer. Although a preventive vaccine has been available for more than 40 years, there is still no cure for people already living with the disease. Current antiviral medicines can suppress the virus, but cannot eliminate it.<\/p>\n
According to the\u00a0European Centre for Disease Prevention and Control (ECDC)<\/a>, around 3.6 million people in the 27 EU countries, Iceland, Liechtenstein and Norway are chronically infected with hepatitis B. Many do not realise they are infected until serious liver damage has already occurred, leaving them on lifelong treatment.<\/p>\n \u201cPeople think we have solved the problem because we have a preventive vaccine. But for the millions already living with chronic hepatitis B, that is simply not true,\u201d said Professor Ulrike Protzer, director of the Institute of Virology at the Technical University of Munich and Helmholtz Munich.<\/p>\n Now, however, Protzer and other researchers across Europe believe a functional cure may finally be within reach.<\/p>\n Protzer has spent more than two decades studying how hepatitis B evades the immune system, and developing new ways to help the body fight back.<\/p>\n \u201cI call hepatitis B the most frequent neglected disease in the world,\u201d said Protzer, who is leading an international team of researchers developing a new vaccine for people living with chronic hepatitis B.<\/p>\n Their work is part of the six\u2011year EU\u2011funded TherVacB research initiative that concludes at the end of 2026. While conventional hepatitis B vaccines prevent infection, this therapeutic vaccine is intended for people who are already chronically infected.<\/p>\n Rather than trying to attack the virus directly, Protzer\u2019s team is asking a different question: can the immune system itself be trained to regain control? The aim is to recreate the type of immune response seen in people who naturally clear hepatitis B after becoming infected later in life.<\/p>\n \u201cPeople who eliminate the virus develop strong antibody and T\u2011cell responses,\u201d said Protzer, referring to immune cells that detect and kill infected cells. \u201cWe designed our therapeutic vaccine to activate exactly those kinds of immune responses.\u201d<\/p>\n Early clinical studies in healthy volunteers showed the vaccine was well tolerated and successfully stimulated the expected immune response. Patient trials are now underway in Germany, Italy, Spain, the UK and Tanzania.<\/p>\n While the researchers caution that the work remains in its early clinical stages, they believe therapeutic vaccines could eventually become an important component of future combination treatments.<\/p>\n Cause for hope<\/p>\n The World Health Organization aims to eliminate viral hepatitis as a public health threat by 2030. Achieving that goal will require earlier diagnosis, wider vaccination and more effective treatments for people already living with chronic infection.<\/p>\n Growing optimism in recent years comes from a shift in scientific thinking. Rather than relying on a single treatment to eliminate the virus, researchers increasingly believe that a functional cure will come from combining therapies that work effectively together, allowing patients to keep the virus under control without continuous treatment.<\/p>\n \u201cWe are entering a very exciting time in hepatitis B research,\u201d said Dr Maria But\u00ed Ferret, a hepatologist with decades of experience treating patients with the disease.<\/p>\n \u201cMany new treatments are being developed, targeting different parts of the virus or helping the immune system fight it more effectively. The future will probably not come from a single treatment, but from combining different approaches that work together.\u201d<\/p>\n But\u00ed Ferret is a professor of medicine at the Universitat Aut\u00f2noma de Barcelona and a senior hepatologist at Hospital Universitari Vall d\u2019Hebron, one of Europe\u2019s leading liver disease centres.<\/p>\n For the past six years, she has been part of another international research team supported by the EU called IP\u2011cure\u2011B, which investigates whether scientists can restore the immune system\u2019s ability to control hepatitis B naturally.<\/p>\n Current antiviral medicines cannot remove the tiny viral reservoir that remains hidden inside liver cells. As soon as treatment stops, the virus often returns.<\/p>\n Researchers in IP\u2011cure\u2011B therefore explored whether they could \u201cwake up\u201d the body\u2019s own defences before stopping antiviral medicine. In this way, the immune system would be better prepared to keep the virus under control in the long term.<\/p>\n The project\u2019s Phase IIa clinical trial has now been completed, with researchers analysing whether this immune\u2011based approach can achieve a functional cure. Alongside the clinical trial, the team is also searching for biological clues in patients\u2019 blood and immune systems that could reveal who is most likely to benefit from future immune\u2011based treatments.<\/p>\n \u201cWhat we learn won\u2019t only be relevant for our own study,\u201d said project coordinator Fabien Zoulim, professor of medicine at Claude Bernard University Lyon 1, France, and one of Europe\u2019s leading experts on chronic hepatitis B.<\/p>\n \u201cIt could also help us understand which patients are most likely to respond to the new immune\u2011based treatments or direct acting antivirals that are now emerging.\u201d<\/p>\n Combining strengths<\/p>\n