8 ms·

I'm surprised that they're working on HB cures since there's been an HB vaccine for 40 years. I'd love to see more work done towards other incurable viruses li

by halapro 3mo ago

I'm surprised that they're working on HB cures since there's been an HB vaccine for 40 years. I'd love to see more work done towards other incurable viruses like HSV (no vaccine) and HPV (limited vaccine)

tfourb 3mo ago
There are > 800.000 yearly deaths due to hep b. https://en.wikipedia.org/wiki/Hepatitis_B https://en.wikipedia.org/wiki/Hepatitis_B Yes, there is an effective vaccine but not everyone has access to it for tons of reasons.
- chimeracoder 3mo ago
  > Yes, there is an effective vaccine but not everyone has access to it for tons of reasons. Also, about 3.5% of the world's population already has it. That's about 300 million people for whom a vaccine is pointless, and who are at dramatically higher risk of liver cancer (somewhere between 15-50% lifetime risk of an extremely deadly type of cancer), and for whom a cure would literally be life-changing, if available.
Centigonal 3mo ago
Herpes viruses like HSV are notoriously difficult to target with medication bc they encode themselves into DNA inside the nuclei of long-lived human nerve cells. Between outbreaks, they basically exist only as rogue DNA floating inside mostly-healthy cells in the nerve ganglia. At some point, something triggers the nerve cell to transcribe the rogue DNA, producing new viruses and beginning a new outbreak.
- mrtesthah 3mo ago
  IM-250 (Adibelivir) is a helicase-primase inhibitor that targets latent HSV so well it may actually permanently reduce the pool of viable latent HSV genomes.
  - shevy-java 3mo ago
    Nope - because it can not target the genome. So it is, by definition, not a permanent reduction. Any inhibitor is a protein; unless such a protein modifies the DNA, one only cures a symptom, not the cause, by definition. HAART with regards to the HI virus has a similar problem. Note that even on commercial sites they point this out: https://www.medchemexpress.com/im-250.html https://www.medchemexpress.com/im-250.html "Adibelivir (IM-250) is an orally active helicase-primase inhibitor. Adibelivir is effective against HSV infection and reduces reactivation of latent HSV." See the word "reduces". Nowhere does it insinuate "permanently"; besides, permanently is simply a misnomer here. Even "latent" is a misnomer; it simply is integrated DNA. The only way to get rid of it is to cut this DNA out. Which therapeutic does so with efficiency? Even CRISPR-Cas9 has off-target effects. There are no permanent cures, and insinuating otherwise by using "permanently", is simply and factually incorrect.
    - mrtesthah 3mo ago
      Technically they are circular episomes — not integrated into chromosomal DNA like HIV. And we do know that it’s possible to reduce the pool of reactivation-competent HSV genomes by the presence of IFNα during primary infection: https://pmc.ncbi.nlm.nih.gov/articles/PMC12764766/ https://pmc.ncbi.nlm.nih.gov/articles/PMC12764766/ This causes PML-NB formation → more viral genomes with H3K9me3 + ATRX → resists eviction by the H3K9me3S10ph “methyl/phospho switch” → stops Phase I HSV transcription (and VP16 expression). Who’s to say an HPI like IM-250 isn’t altering epigenetic markers in viral episomes in this way? Innovative Molecules’ own press release states that some sort of permanent or semi-permanent modification may take place: https://www.pharmaceutical-technology.com/analyst-comment/escmid-global-2026-adibelivir-emerges-as-potential-disease-modifying-therapy-for-hsv/ https://www.pharmaceutical-technology.com/analyst-comment/es... >Furthermore, testing in animal models showed that adibelivir affected the latent viral reservoir, suggesting that it has potential as a long-term curative therapy for HSV.
chimeracoder 3mo ago
It's estimated that 300 million people have HBV. HBV is currently incurable once acquired, at which point the vaccine is irrelevant. The HBV virus is also carcinogenic, which makes it unique[0] among the three big hepatitis viruses. Liver cancer is extremely aggressive and fast-killing, often reaching terminal stages before it is even detectable at all. It is one of the top three causes of cancer deaths worldwide. Aside from the sheer number of people affected by this, it is also a horrible thing to experience. I have watched someone die from liver cancer, and I would not wish it on anyone. Contrast to HSV, which is widespread (approximately half the population has at least one HSV latent infection) and causes very few problems beyond occasional irritation in virtually all cases that do not involve other comorbidities or immunocompromised status. HSV is also suppressible through antiviral treatment, making it generally untransmittable (if treated and suppressed) and unlikely to cause symptoms. Most people with HSV do not even bother to do this, which is if anything a testament to how little HSV affects their lives (most don't even know they have it, and there is no clinical justification for routine testing in otherwise healthy patients). Of all infections pathogens for which I could wish a cure into existence, HSV would be extremely low on my list. [0] While HCV can cause cancer if left untreated for a long time and if it causes cirrhosis, approximately one third of people clear HCV infection in the acute stages without any lasting ill effect. Of the remainder, it takes a long time for cirrhosis to develop, leaving plenty of time for treatment. First-line treatments are approximately 95-99% effective. So there is no clinical reason HCV needs to increase a person's risk for cancer, as long as they have access to medical care. The same is not true for HBV.
- NDlurker 3mo ago
  https://pubmed.ncbi.nlm.nih.gov/39956964/ https://pubmed.ncbi.nlm.nih.gov/39956964/ Link between HSV and dementia
  - dofm 3mo ago
    Yep — if this is properly verified it means HSV is one of the most consequential virus families in public health. For the same reason we should be hoping for a treatment that can rid the body of VZV (chickenpox/shingles) because it is absolutely clear that the shingles vaccine has some protective effect against dementia.
nomel 3mo ago
They didn't give it to males, and didn't let males get it, until recently.
- Gigachad 3mo ago
  Australia has been giving it to everyone for quite a while now. Last I saw, the virus is almost completely eradicated.
- cassepipe 3mo ago
  Aren't you confusing with HSV ?
  - sobjornstad 3mo ago
    HPV, not HSV. Acronym soup. * HBV - Hepatitis B * HSV - Herpes Simplex Virus (two strains, what most people call “herpes”) * HPV - Human Papillomavirus
- OneDeuxTriSeiGo 3mo ago
  You are confusing it with HPV (human papillomavirus). Hep B is a very different disease. The first Hep B vaccine in the US is given to all infants within 24 hours of birth (unless the child is already positive for Hep B or severely underweight). And then the second vaccine a month or so later and the third between ages 6 and 18 months old. Hep B vaccination is one of the most common vaccinations received in the US. And also as a fun little fact the first Hep B vaccine was given exclusively to gay men for a decent while until it was deemed safe enough for the general population. It was also manufactured from the blood of gay men and needle based drug users. The Hep B vaccine that came later was recombinant and that one was given to everyone from day 1 and that's the vaccine that's been more or less the main Hep B vaccine in use up to today. Recently there's at least one new one that has been approved but the original recombinant Hep B vaccine is still regularly given.
  - nomel 3mo ago
    That I am! My mistake.
Georgelemental 3mo ago
The HB vaccine unfortunately doesn't work that well, many people are still not fully immune even after several doses
- chimeracoder 3mo ago
  > The HB vaccine unfortunately doesn't work that well, many people are still not fully immune even after several doses This is incorrect. The HBV vaccine is one of the most effective vaccines available for any pathogen, providing full immunity to over 95% of healthy infants, children, and young adults, and with that immunity typical lasting for at least 30 years (and likely for life). If someone is one of the rare exception, tthat's easy to detect with blood titers, and the response is either to give them additional doses or to deliver an adjuvanted version (which is the same thing regularly done for other vaccines which are either less effective or primarily targeted at the elderly, who have weaker immune responses).
  - Georgelemental 3mo ago
    I work in healthcare. As a requirement for employment, I had to get tested for immunity to HBV. Even though I got the vaccine as is generally recommended for everyone, the test says I'm not immue. So now I have to get 3 additional doses, and apparently even with that it's not guaranteed sufficient for full immunity. And I know my case is not unusual at all
    - anakaine 3mo ago
      One 20 is not unusual. That said, that does not mean that the vaccine is not effective at being a vaccine. A vaccine isnt just about your immunity, but about herd immunity. When you create an inability for a virus to spread among the herd, you protect those who are unable to acquire immunity by inhibiting the viruses ability to move between hosts and persist in a population. Vaccines are not 100% effective for each individual.

by halapro 3mo ago

tfourb 3mo ago

There are > 800.000 yearly deaths due to hep b. https://en.wikipedia.org/wiki/Hepatitis_B https://en.wikipedia.org/wiki/Hepatitis_B Yes, there is an effective vaccine but not everyone has access to it for tons of reasons.

chimeracoder 3mo ago
> Yes, there is an effective vaccine but not everyone has access to it for tons of reasons. Also, about 3.5% of the world's population already has it. That's about 300 million people for whom a vaccine is pointless, and who are at dramatically higher risk of liver cancer (somewhere between 15-50% lifetime risk of an extremely deadly type of cancer), and for whom a cure would literally be life-changing, if available.

Centigonal 3mo ago

Herpes viruses like HSV are notoriously difficult to target with medication bc they encode themselves into DNA inside the nuclei of long-lived human nerve cells. Between outbreaks, they basically exist only as rogue DNA floating inside mostly-healthy cells in the nerve ganglia. At some point, something triggers the nerve cell to transcribe the rogue DNA, producing new viruses and beginning a new outbreak.

mrtesthah 3mo ago
IM-250 (Adibelivir) is a helicase-primase inhibitor that targets latent HSV so well it may actually permanently reduce the pool of viable latent HSV genomes.
- shevy-java 3mo ago
  Nope - because it can not target the genome. So it is, by definition, not a permanent reduction. Any inhibitor is a protein; unless such a protein modifies the DNA, one only cures a symptom, not the cause, by definition. HAART with regards to the HI virus has a similar problem. Note that even on commercial sites they point this out: https://www.medchemexpress.com/im-250.html https://www.medchemexpress.com/im-250.html "Adibelivir (IM-250) is an orally active helicase-primase inhibitor. Adibelivir is effective against HSV infection and reduces reactivation of latent HSV." See the word "reduces". Nowhere does it insinuate "permanently"; besides, permanently is simply a misnomer here. Even "latent" is a misnomer; it simply is integrated DNA. The only way to get rid of it is to cut this DNA out. Which therapeutic does so with efficiency? Even CRISPR-Cas9 has off-target effects. There are no permanent cures, and insinuating otherwise by using "permanently", is simply and factually incorrect.
  - mrtesthah 3mo ago
    Technically they are circular episomes — not integrated into chromosomal DNA like HIV. And we do know that it’s possible to reduce the pool of reactivation-competent HSV genomes by the presence of IFNα during primary infection: https://pmc.ncbi.nlm.nih.gov/articles/PMC12764766/ https://pmc.ncbi.nlm.nih.gov/articles/PMC12764766/ This causes PML-NB formation → more viral genomes with H3K9me3 + ATRX → resists eviction by the H3K9me3S10ph “methyl/phospho switch” → stops Phase I HSV transcription (and VP16 expression). Who’s to say an HPI like IM-250 isn’t altering epigenetic markers in viral episomes in this way? Innovative Molecules’ own press release states that some sort of permanent or semi-permanent modification may take place: https://www.pharmaceutical-technology.com/analyst-comment/escmid-global-2026-adibelivir-emerges-as-potential-disease-modifying-therapy-for-hsv/ https://www.pharmaceutical-technology.com/analyst-comment/es... >Furthermore, testing in animal models showed that adibelivir affected the latent viral reservoir, suggesting that it has potential as a long-term curative therapy for HSV.

chimeracoder 3mo ago

It's estimated that 300 million people have HBV. HBV is currently incurable once acquired, at which point the vaccine is irrelevant. The HBV virus is also carcinogenic, which makes it unique[0] among the three big hepatitis viruses. Liver cancer is extremely aggressive and fast-killing, often reaching terminal stages before it is even detectable at all. It is one of the top three causes of cancer deaths worldwide. Aside from the sheer number of people affected by this, it is also a horrible thing to experience. I have watched someone die from liver cancer, and I would not wish it on anyone. Contrast to HSV, which is widespread (approximately half the population has at least one HSV latent infection) and causes very few problems beyond occasional irritation in virtually all cases that do not involve other comorbidities or immunocompromised status. HSV is also suppressible through antiviral treatment, making it generally untransmittable (if treated and suppressed) and unlikely to cause symptoms. Most people with HSV do not even bother to do this, which is if anything a testament to how little HSV affects their lives (most don't even know they have it, and there is no clinical justification for routine testing in otherwise healthy patients). Of all infections pathogens for which I could wish a cure into existence, HSV would be extremely low on my list. [0] While HCV can cause cancer if left untreated for a long time and if it causes cirrhosis, approximately one third of people clear HCV infection in the acute stages without any lasting ill effect. Of the remainder, it takes a long time for cirrhosis to develop, leaving plenty of time for treatment. First-line treatments are approximately 95-99% effective. So there is no clinical reason HCV needs to increase a person's risk for cancer, as long as they have access to medical care. The same is not true for HBV.

NDlurker 3mo ago
https://pubmed.ncbi.nlm.nih.gov/39956964/ https://pubmed.ncbi.nlm.nih.gov/39956964/ Link between HSV and dementia
- dofm 3mo ago
  Yep — if this is properly verified it means HSV is one of the most consequential virus families in public health. For the same reason we should be hoping for a treatment that can rid the body of VZV (chickenpox/shingles) because it is absolutely clear that the shingles vaccine has some protective effect against dementia.

nomel 3mo ago

They didn't give it to males, and didn't let males get it, until recently.

Gigachad 3mo ago
Australia has been giving it to everyone for quite a while now. Last I saw, the virus is almost completely eradicated.
cassepipe 3mo ago
Aren't you confusing with HSV ?
- sobjornstad 3mo ago
  HPV, not HSV. Acronym soup. * HBV - Hepatitis B * HSV - Herpes Simplex Virus (two strains, what most people call “herpes”) * HPV - Human Papillomavirus
OneDeuxTriSeiGo 3mo ago
You are confusing it with HPV (human papillomavirus). Hep B is a very different disease. The first Hep B vaccine in the US is given to all infants within 24 hours of birth (unless the child is already positive for Hep B or severely underweight). And then the second vaccine a month or so later and the third between ages 6 and 18 months old. Hep B vaccination is one of the most common vaccinations received in the US. And also as a fun little fact the first Hep B vaccine was given exclusively to gay men for a decent while until it was deemed safe enough for the general population. It was also manufactured from the blood of gay men and needle based drug users. The Hep B vaccine that came later was recombinant and that one was given to everyone from day 1 and that's the vaccine that's been more or less the main Hep B vaccine in use up to today. Recently there's at least one new one that has been approved but the original recombinant Hep B vaccine is still regularly given.
- nomel 3mo ago
  That I am! My mistake.

Georgelemental 3mo ago

The HB vaccine unfortunately doesn't work that well, many people are still not fully immune even after several doses

chimeracoder 3mo ago
> The HB vaccine unfortunately doesn't work that well, many people are still not fully immune even after several doses This is incorrect. The HBV vaccine is one of the most effective vaccines available for any pathogen, providing full immunity to over 95% of healthy infants, children, and young adults, and with that immunity typical lasting for at least 30 years (and likely for life). If someone is one of the rare exception, tthat's easy to detect with blood titers, and the response is either to give them additional doses or to deliver an adjuvanted version (which is the same thing regularly done for other vaccines which are either less effective or primarily targeted at the elderly, who have weaker immune responses).
- Georgelemental 3mo ago
  I work in healthcare. As a requirement for employment, I had to get tested for immunity to HBV. Even though I got the vaccine as is generally recommended for everyone, the test says I'm not immue. So now I have to get 3 additional doses, and apparently even with that it's not guaranteed sufficient for full immunity. And I know my case is not unusual at all
  - anakaine 3mo ago
    One 20 is not unusual. That said, that does not mean that the vaccine is not effective at being a vaccine. A vaccine isnt just about your immunity, but about herd immunity. When you create an inability for a virus to spread among the herd, you protect those who are unable to acquire immunity by inhibiting the viruses ability to move between hosts and persist in a population. Vaccines are not 100% effective for each individual.