Innovative Efforts in Combating Chronic Hepatitis B in the Bay Area

Liver specialist Dr. Maurizio Bonacini from San Francisco is at the forefront of the quest to develop a cure for hepatitis B, one of the most prevalent infectious diseases worldwide and a leading cause of liver cancer. Despite the availability of vaccines and antiviral treatments, hepatitis B continues to spread globally, affecting over 2 million individuals in the United States alone.

The World Health Organization estimates that approximately one-third of the world’s population has been infected with hepatitis B, with a staggering 90% risk of developing chronic infection if contracted during infancy. If untreated, the virus can progress to liver cancer in about 25% of cases, leading to significant mortality.

In response, Bonacini has joined B-United, a comprehensive clinical trial involving 300 participants with chronic hepatitis B across 80 sites in 18 countries. His research location in San Francisco was the first to administer an experimental treatment aimed at curing the disease. Currently, patients with hepatitis B rely on lifelong antiviral medication to suppress the virus, which reduces cancer risk but can cause side effects and issues with drug resistance.

Bonacini explains that the current standard of care is like receiving a bronze medal—an important step but not a definitive solution. His goal is to discover a sterilizing cure that completely eradicates the virus, which would be a major breakthrough. Meanwhile, the trial involves monthly injections that inhibit production of surface antigens, a key marker of infection. Patients who respond well may eventually stop medication, a process that could be approved by the FDA around 2027.

The researcher emphasizes the importance of improved prevention and diagnosis. He has advocated for more rigorous screening and testing protocols, especially among primary care physicians, to identify infected individuals early. Current U.S. policies focus mainly on vaccination for immigrants, neglecting routine screening, which leaves many cases undiagnosed.

One participant in Bonacini’s study, a man who migrated from Southeast Asia and was vaccinated as a child, contracted hepatitis B beforehand and now faces complications like fatty liver and cirrhosis. Thanks to the ongoing trial, his hepatitis B DNA is undetectable, and he is effectively noncontagious. Despite the progress, he highlights the social stigma associated with the disease and the financial burden of ongoing testing and treatment.

Bonacini’s work offers hope that with the right drugs, a cure for hepatitis B could be achieved within the next few years, ultimately reducing the disease’s global impact. He continues collaborating with virologists and clinicians worldwide to tackle this persistent health challenge, emphasizing that a combination of better prevention, early detection, and innovative cures is essential in the fight against hepatitis B.