23 May 2016 | FOR IMMEDIATE RELEASE
NUHS Awarded $25M to Lead Research Studies to Eradicate Chronic Hepatitis B in Singapore
The National University Health System (NUHS), an Academic Regional Health System in Singapore, is engaging in research studies to better understand Chronic Hepatitis B (CHB) with hopes of discovering new drug targets and developing new treatments to eradicate CHB in Singapore.
Hepatitis B is a potentially life-threatening liver infection caused by the Hepatitis B Virus (HBV). In some people, HBV can cause a chronic liver infection which can later develop into liver cirrhosis or liver cancer. Not every person who has HBV develops liver problems. Some carriers of the virus are able to get rid of it. Under normal circumstances, those who have the virus for more than six months will be diagnosed as having CHB. CHB patients live with the virus in their liver and blood but can control and suppress the virus with long- term medication.
While previous studies have proven that CHB cure can occur over a span of 25 years, there is currently no treatment that can effectively get rid of the virus in the body. To date, vaccination remains the single most effective measure to prevent CHB. Though highly effective, vaccination cannot help patients who already have CHB. There is hence a need to better understand the disease and develop new treatment alternatives to eradicate the virus.
Researchers at the NUHS, together with a group of scientists from the Singapore Hepatitis B Consortium (SHBC), aim to meet these needs by engaging in a number of Hepatitis B related research studies. If successful, CHB patients will no longer have to be on long- term medication and will have a lower risk of developing liver problems or liver cancer.
The Consortium brings together 29 researchers and scientists from the NUHS, Agency for Science, Technology and Research, National University of Singapore, DUKE-NUS Graduate Medical School, National University Hospital, Singapore General Hospital, Tan Tock Seng Hospital and Changi General Hospital to tackle CHB through a comprehensive approach divided into three themes – Define, Discovery and Develop.
Theme 1, Define, is led byDrJohn E Connolly, Senior Principal Investigator of A*STAR’s Institute of Molecular and Cell Biology (IMCB). Under this theme, researchers aim to explore the genetic, immune and virus interactions to understand the mechanisms behind the Hepatitis B virus. Currently, it is unclear to what extent a person’s genes and immune system or the changes in the virus contribute to the activation or elimination of HBV. Theme 2, Discovery, led by Professor Hong Wanjin, Executive Director of IMCB, is a laboratory based project where researchers aim to look for potential targets that can get rid of the virus in liver cells, a crucial step in the discovery of new drugs to cure CHB patients. Lastly, theme 3, Develop, led by Prof Lim, aims to optimise existing treatments to improve patient outcomes.
One of the research studies, known as “HEAL”, which stands for Hepatitis B Eradication and Loss, aims to explore the interaction between the virus, genes and immune system of a CHB patient to understand the mechanism behind HBV. The study hopes to reach out to and follow up on 2,500 patients in Singapore for five years with intensive monitoring using blood test, ultrasound and a test for liver scarring or cirrhosis, to see to what extent a person’s genes and immune system or the changes in the hepatitis B virus contribute to the clearance of CHB.
Another study called “SWAP”, which stands for Switch or Add Peg-Interferon, examines existing and new treatments with the aim of improving patient outcomes. The study is currently looking at using interferon therapy, to help CHB patients to improve their chances of being cured. For this study, patients who are on long-term oral antiviral treatment are asked to either take interferon therapy as an additional treatment, or switch from their current medication to interferon therapy. The aim is to increase a CHB patient’s chances of being cured of the disease. Preliminary data from this study has shown that up to 12% of patients are able to do this.
Professor Lim Seng Gee, a Hepatology expert with the NUHS and the programme lead of the research studies, said, “Unlike other chronic diseases such as hypertension and diabetes, Chronic Hepatitis B can be cured. Up to now, however, there has been no comprehensive strategy or approach towards achieving a cure.”
“With the help of patients, our hepatologist experts, unique laboratory research models and state-of-the-art technology, we are now definitively poised to tackle the Hepatitis B Virus in Singapore and beyond and potentially eliminate it.”, he added.
CHB affects more than 300 million people globally1 and causes close to 1 million deaths per year2. In Singapore, an estimated 3.6% of the population has CHB3. It is the most common cause of liver cirrhosis and liver cancer here4.
In 2015, the Singapore National Research Foundation under its Translational and Clinical Research Flagship Programme administered by the Singapore Ministry of Health’s National Medical Research Council awarded the NUHS a $25 million grant to lead the eradication of hepatitis B.
Recruitment of volunteers
The studies are currently recruiting participants. Individuals who meet the following criteria and are interested to participate may contact the research team at 67724447 or 98894164 or email firstname.lastname@example.org
Criteria for HEAL study
- Age 18-65
- Known Chronic Hepatitis B patient
- Not on treatment now or previously
Criteria for SWAP study
- Age 21-70
- Chronic Hepatitis B patient on treatment (with oral antiviral therapy)
1 Lavanchy D. Worldwide epidemiology of HBV infection, disease burden, and vaccine prevention. J Clin Virol 2005;34
2 Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, Abraham J, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010.
3 Ang LW, Cutter J, James L, Goh KT. Seroepidemiology of hepatitis B virus infection among adults in Singapore: a 12-year review. Vaccine 2013;32:103-110.
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