World Hepatitis Day

28 July 2022 - King’s leading the way on clinical trials for Hepatitis B

Research

Today (28 July) is World Hepatitis Day, an opportunity to raise awareness of the impact of viral hepatitis globally. This year’s theme is ‘I Can’t Wait’, underscoring the fact that, with a person dying every 30 seconds from a hepatitis-related illness, we can’t wait to act on viral hepatitis.

Hepatitis B virus (HBV) has a global prevalence of 300 million, with south London seeing a higher than average number of cases. As such, King’s is the largest clinical service in Europe for HBV, and our liver research team is currently carrying out pioneering clinical trials and research projects in order to improve care for people with HBV and develop a functional cure.

HBV-associated liver disease, which is often described as silent as people may have no symptoms, may cause damage before symptoms arise, and long-term infection can lead to liver scarring (cirrhosis) which, in turn, can cause liver failure and liver cancer.

Current HBV treatments reduce the risk of complications but rarely lead to a cure. As such, curing new HBV treatments is a major focus of our clinical trials.

The King’s Hepatitis Research Team, led by consultant hepatologist Dr Kosh Agarwal in the Institute of Liver Studies, has recruited over 70 patients into the largest set of clinical trials in Europe aimed at curing HBV.

The trials can be split into two broad therapy areas: antivirals and immunomodulators.

Antivirals are drugs which disrupt the life cycle of the virus, often by preventing its replication within human cells and tissues. Examples of antivirals currently being trialled at King’s include ‘capsid inhibitors’, which prevent the virus from assembling its protective shell, ‘small interfering RNA (siRNA)’, which prevent viral replication, and entry inhibitors, which stop HBV entering human liver cells, preventing infection.

Alternatively, immunomodulators can be used to boost the immune system to stop infection with HBV. At King’s we are currently trialling various ways of doing this, for example using genetic material from HBV in vaccines so that the immune system can mount a stronger immune response against the virus, or by stimulating the immune system to release its own antiviral molecules - cytokines - in order to destroy the virus.

As a result of excellent teamwork, King’s is the global lead for three major HBV cure pipelines involving these methods, with most trials aiming to quickly get rid of the virus and then boost the immune system to prevent further infection – leading, hopefully, to a cure.

A patient who took part in one such trial a few years ago said: “I was lucky enough to meet Dr Kosh Agarwal and his team who offered to put me on a research trial at King’s College Hospital. This ultimately triggered the path of curing my HBV, and at the same time I was able to continue with my professional, personal and sports life (the gym six times a week!).

“Understanding of hepatitis B and the development of potential cures have improved significantly over the past few years. However, further research trials are needed so that more people can benefit,” he added.

We strive to achieve equity of access to our trials and therefore have a wide intake area. If you have been diagnosed with hepatitis B, live in Greater London or Kent and want to know more about the trials we are running, please email kch-tr.livertrials@nhs.net.