Drug combo may help cure hepatitis B

A combination of an antiviral drug and an anti-cancer drug has proved 100 per cent successful in eliminating hepatitis B virus (HBV) infections in preclinical models, scientists say.
Scientists from Melbourne's Walter and Eliza Hall Institute developed the combination treatment using birinapant, a drug developed by US biotech company TetraLogic Pharmaceuticals for treating cancer.
Dr Marc Pellegrini, Dr Greg Ebert and colleagues at the institute used their studies of the behaviour of hepatitis B virus in infected cells as a basis for the treatment.
Pellegrini said the treatment was successful in curing infections in preclinical models, leading to a human trial that began in December 2014.

"We were 100 per cent successful in curing HBV infection in hundreds of tests in preclinical models," Pellegrini said.
"Birinapant enabled the destruction of hepatitis B-infected liver cells while leaving normal cells unharmed. Excitingly, when birinapant was administered in combination with current antiviral drug entecavir, the infection was cleared twice as fast compared with birinapant alone.

"We are hopeful these promising results will be as successful in human clinical trials, which are currently underway in Melbourne, Perth and Adelaide," Pellegrini said.
The combination treatment, developed in collaboration with TetraLogic Pharmaceuticals based in Malvern, Pennsylvania, targets the cell signalling pathways that the hepatitis B virus uses to keep host liver cells alive.

Chronic infectious diseases such as HBV live within the host's cells, enabling them to persist within the body for many months or years, Pellegrini said.
"Normally, liver cells would respond to infection by switching on a signal that tells the cell to destroy itself 'for the greater good', preventing further infection," he said.
"However our research showed that the virus commandeers the liver cells' internal communications, telling the cells to ignore the infection and stay alive. Birinapant flips the cell survival 'switch' used by the virus, causing the infected cell to die," he added.
The research was published in the journal Proceedings of the National Academy of Sciences.