At present, there are only 2 kinds of drugs against chronic hepatitis b marketed internationally (note that there are 2 kinds but not 2 kinds), one is the nucleoside analogues that interfere with the reverse transcription process of HBV (entecavir, tibivudine, TAF, tenofovir, lamivudine, etc.), and the other is the immune modulator interferon (IFN).
Clinical trials of the two drugs, as well as studies since their release, have shown that they both have good virus-inhibiting effects and can significantly reduce the incidence of cirrhosis and liver cancer.
However, it is very rare for oral antiviral drugs to achieve HBsAg reversal, which is referred to as “winning the gold medal” by comrades, with an annual incidence of only 1-2%.
So patients who take these drugs often have to take them for a long time or even for life.The effect of IFN in reducing HBsAg is relatively good, but the effect is poor in some patients, and the side effects are very large.
Dual mechanism antiviral drugs
In this case, national experts have been looking for other kinds of drugs that can target the HBV infection and replication process.Last November, a new drug was discovered, Evans blue, which can be antiviral by a dual mechanism.
Let’s start with the first level mechanism.Before HBV enters a liver cell, the virus first recognizes the liver cell (HBV does not infect other cells, such as nerve cells), and then the liver cell opens a channel for it to enter the cell.This process mainly relies on HBsAg of HBV and the specific receptor NTCP on liver cells.The combination of the two ACTS as identification before HBV can enter the liver cells to complete the infection.Evans blue inhibits HBV infection of liver cells by inhibiting this process.
The second antiviral mechanism.After the virus enters the cell and replicates, it also needs to assemble various viral proteins.Evans blue inhibits the generation of progeny HBV by blocking the assembly process.Evans blue inhibited capsid assembly at micropolar concentrations by reducing the cytoplasmic calcium concentration.
In the cell experiment, Evans blue showed outstanding performance, which can effectively reduce the infection rate of HBV.And, because it ACTS on host factors, it does not cause resistance problems.In cell experiments, Evans blue was found to be very little toxic to cells at effective concentrations.
Therefore, the authors predict that Evans blue is a promising new anti-hbv drug.
The right mindset for new drugs
There has been a shortage of new hepatitis b drugs in recent years, despite frequent news reports of new antiviral drugs.
Because it takes at least a few years for a drug to be discovered and marketed, there are a lot of clinical trials to go through.As a result, many new drugs die young.
Don’t be too surprised or worried about the news.Because, although process is difficult, I believe, always have the day that overcomes its second liver.
Before this, I hope you can keep a good attitude, positive antiviral, good health, rational view of the disease.