A report back on Denise Hsu's, James McMahon's and Eugene Kroon's session - Progress in HIV Cure/Elimination
Denise Hsu introduced the topic with how the HIV reservoir can be measured in a number of ways including single copy assay showing the majority of individuals on ART with undetectable viral load on conventional assays will unsurprisingly retain detectable VL on single copy assay- the median level being 3.1 copies/ml. This most likely represents virus production from integrated provirus in reservoirs such as LN and the CNS as ART intensification does not reduce the number.
A report back on Peter Revill's session - Hepatitis B therapy pipeline for cure
40 % of all liver cancers are caused by Hepatitis B and this risk not eliminated by treatment. Worldwide there are 880,000 deaths annually from Hepatitis B. One barrier to achieving cure is the viral reservoir is complex consisting of covalently closed circular DNA in the nucleus, integrated DNA and cytoplasmic phases. Current treatments (Tenofovir,Entecavir) work in the cytoplasm but not in the nucleus. This cccDNA is retained even when “cured” and can reactivate in the future with eg chemotherapy .HBSAg loss +/- Hep B SAb associated with undetectable serum DNA occurs at a rate of 1-2 % per year either spontaneously or on current treatments.
(A report back from morning sessions on Australasian Viral Hepatitis Conference Day 2)
What an inspiring conference the 11th viral Hepatitis Australasian Conference has been. A quick recap of the highlights of Day 2 of the conference.