Researchers from Duke and UNC team up to find an answer, with funding from the two institutions’ NIH Clinical and Translational Science Awards (CTSA).
For hundreds of millions of people around the world with chronic hepatitis B infection, anti-viral treatments do a good job of keeping the virus under wraps. Anti-viral treatments are essential in slowing damage to the liver, reducing the chance of liver cancer, and helping people live longer. But in the vast majority of cases, there is no end to the infection. If a patient stops medication for any reason, the hepatitis B virus (HBV) re-emerges. The cause of its resilience is circular bits of DNA, called covalently closed circular DNA, or cccDNA, that lurk in the liver cells of infected patients.
“Treatment blocks new viral replication,” said Lishan Su, a professor of microbiology and immunology at the University of North Carolina, Chapel Hill. “It doesn’t touch this cDNA.” When treatment stops, new virus is produced from these cccDNA templates, he continued. As a result, “you need almost lifetime (or very long-term) treatment.”
Liver cancer is one of the most common types of cancer worldwide, resulting in 800,000 lives lost each year. What many people don’t know is that a staggering 80% of deaths are caused by viral hepatitis, a disease that has preventative vaccines (hepatitis B) and a curative treatment (hepatitis C), meaning that over 600,000 liver cancer deaths each year are avoidable.
If the majority of these deaths are entirely preventable, why does liver cancer continue to claim the lives of so many? And how do we begin to count that in terms of children who have lost a parent, people who have lost a friend, societies that have lost a great mind? The answer is simple; 95% of people living with viral hepatitis are unaware of this, and of those who do know their status, less than 1% have access to life-saving medical interventions.
Last year, at the 69th World Health Assembly, 194 countries adopted the World Health Organization’s first-ever Global Health Sector Strategy for viral hepatitis, which presents a clear commitment to eliminate hepatitis B and C by 2030. Combatting these cancer-causing viruses by 2030 is also a target of the Sustainable Development Goals. If these commitments are upheld by governments, we can greatly reduce the number of cancer deaths globally.