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10 Oct 2019

2019 International Hepatitis B Meeting - Nadia Warner’s ‘Hep B Briefing’

Leading hepatitis B (HBV) experts converged on Melbourne for the International HBV Meeting. Here, senior scientist Dr Nadia Warner shares her insights on the final day of the meeting. 

The focus of the HBV meeting on the final day was ‘New antivirals and targets’, the real endpoint of HBV research, and I was honoured to co-chair the first session. The identification of the HBV receptor back in 2012 (NTCP, a bile-acid transporter) opened up a surge of research into HBV entry inhibitors. The first talk of the day was given by Professor Stephan Urban on his entry inhibitor Myrcludex, which in a clinical trial cured 50 per cent of people of their hepatitis delta virus (HDV) co-infection! Dr Alexander Koenig presented state of the art screening and development strategies to identify novel antivirals.

We heard exciting data from Professor Kiyoaki Ito about the use of bile-acid derivatives to prevent HBV infection by down-regulating the HBV receptor. Elegant work by Wakana Saso showed that blocking the interaction between NTCP and EGFR could block HBV entry, presenting a new drug target.

Another direct target is the HBV core protein, which has the potential to prevent cccDNA replenishment by blocking the intracellular conversion pathway (this means these drugs could possibly cure long-term existing infections).

We saw novel core-agonist screening systems from Professor Kenji Ogawas group, and very promising preclinical mouse studies from Professor Luca Guidotti.

There were more fantastic talks and posters on CRISPR, Immunotherapies, NAPs, miRNAs, delivery systems, T-cell targeting and a nice talk on promoting clearance of chronic hepatitis B using apoptosis inhibitor agonists by Dr. Greg Ebert at WEHI. These presentations really fuelled that hope that we can get a cure for HBV infection within the next ten years.

At the close of the meeting we had an announcement by Professor Sharon Lewin that there will be a new virology fellowship to be introduced at the Doherty Institute, The Professor Stephen Locarnini Fellowship, which will honour his lifelong contribution to the field of virology. Having worked for Stephen for many years, I personally think this is a wonderful thing to honour him as he is approaching retirement, and very exciting for the future of virology at the Doherty.

Following the close of the meeting, delegates could visit Australian wildlife at Healesville Sanctuary, or stay around for the HBV public forum. In this public session there was a focus on the importance of people living with HBV to tell their stories, as a way of advocating to inform government policies and increase funding, in the way the Hepatitis B Foundation in the US has successfully done for years. We heard a heartbreaking story from Sidney Vo, who was diagnosed with HBV in Australia and now faces deportation to Vietnam due to government policy. (If you have time please support her petition which ends in a few days).

Friend and HBV researcher Dr Thomas Tu also gave a powerful talk about his personal experience living with HBV (you can view his talk on the Doherty website). Having known Thomas since way back when he was an honours student and I was a PhD student, but only now learning of his HBV status, I felt moved to provide feedback to him and the audience. As a HBV lab-based researcher I am really passionate about virology and the tiny molecular details of the virus, but I realised that I personally don’t know anyone living with HBV (that I know of). For Thomas to openly reveal the worry and stigma his diagnosis forces him to live with gives me that extra reason to work harder, to work longer into the night on grant applications, to improve my science communication skills, advocate, all these things that get us closer to a cure, so that hopefully I can contribute to relieving that worry that Thomas has hanging over him. My scientist colleagues agreed with me, it gives us that extra motivation, so thank you Thomas and Sidney (and all HBV affected people), you guys inspire us. Speak up, keep advocating, we will get that cure for you.

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