In this research summary of a recent study from Blizard Institute researchers Patrick Kennedy and Upkar Gill, we hear about the potential of liver cancer development in patients with ‘quiescent’ chronic hepatitis B, after the group extensively studied the liver compartment in a cohort of east London patients.
In this work, conceived by Professor Kennedy and international collaborators (Svicher & Salpini; Tor Vergata, Rome, Italy), they report on novel findings which challenge the concept that patients in the ‘quiescent’ phase of chronic hepatitis B (CHB) do not require treatment for prevention of disease progression. Blood and liver tissue from a cohort of Hepatitis B ‘e’ antigen (HBeAg) negative patients at the Royal London Hospital were analysed, to study the integration of HBV into the host genome and generate these new data. Current national and international treatment guidelines exclude certain HBeAg negative CHB patients from treatment, but these latest results challenge this approach.
In line with their previous data, (Kennedy et al., Gastroenterology 2012 and Mason et al., Gastroenterology 2016) the team observed that patients currently excluded from treatment in fact have evidence of immunopathology, by means of integrated HBV DNA as a precursor for the development of liver cancer and the potential for progressive disease. In short, their latest work highlights the complexity of CHB and the need to consider broadening treatment candidacy to offer antiviral therapy to those previously excluded based on national and international guidelines.
Research paper: Svicher V, Salpini R, Piermatteo L, Carioti L, Battisti A, Colagrossi L, Scutari R, Surdo M, Cacciafesta V, Nuccitelli A, Hansi N, Ceccherini Silberstein F, Perno CF, Gill US, Kennedy PTF. Whole exome HBV DNA integration is independent of the intrahepatic HBV reservoir in HBeAg-negative chronic hepatitis B. Gut. 2020 Dec 21:gutjnl-2020-323300. doi: 10.1136/gutjnl-2020-323300. Epub ahead of print. PMID: 33402415.