Immunotherapy Shows Promise for Hepatitis B and D

Researchers from Sweden’s Karolinska Institutet report promising animal model results for a new immunological treatment against hepatitis B and D viruses. The findings raise hopes for better treatments for chronic infections with hepatitis B virus (HBV) and hepatitis D virus (HDV), which are major causes of severe liver damage and liver cancer.

Though a vaccine against hepatitis B exists, over 250 million people worldwide currently have chronic infections. The available treatment rarely leads to the complete disappearance of the infection, which means that the risk of liver damage remains. And current treatment for chronic hepatitis D infection only cures about a quarter of patients.

The treatment under development at Karolinska Institutet consists of two components designed to affect the immune system in different ways. First, a DNA-based vaccine is administered that activates the production of neutralizing antibodies and T-cells against both viruses. Then, repeated doses of a protein-based vaccine are given to reinforce the activation of the immune system.

The study, published in the journal Gut, shows that the treatment can protect cultured cells against HBV and HDV infection. When the treatment was given to mice carrying parts of the hepatitis B and D virus, which resembles a chronic HBV infection, the animals produced the desired antibodies and T-cells at high levels. Antibodies from treated mice were also able to protect mice carrying human liver cells against simultaneous infection with HBV and HDV. In addition, these antibodies were able to protect mice with chronic HBV infection against HDV infection. This is of particular importance because patients with chronic HBV infection are at risk of serious illness if infected with HDV.

“These are promising results,” says Matti Sällberg, professor at the Department of Laboratory Medicine at Karolinska Institutet. “The study shows this is a viable route and encourages us to continue developing this treatment for use in humans. We are now optimizing the protein-based part to enable large-scale production to pharmaceutical standards, and then doing the final safety studies before we can apply for our first study with human subjects.”

The tests in cell culture were done in collaboration with Heidelberg University in Germany and the experiments in mice carrying human liver cells were done in collaboration with Ghent University in Belgium.