Two Brazilian public universities, the University of São Paulo (USP) and the Federal University of Espírito Santo's teaching hospital, Hucam-Ufes, have joined a new global study led by the Johns Hopkins University School of Medicine in the United States that is searching for treatments and a cure for hepatitis B.
Johns Hopkins University School of Medicine, based in Baltimore, is one of the best-known centers for infectious disease research in the United States. USP, headquartered in São Paulo, is Brazil's largest public university, while Hucam-Ufes is the teaching hospital linked to the Federal University of Espírito Santo.
The consortium also brings together researchers from India, Senegal and Uganda. The goal is to observe, at the cellular level, how the virus behaves in patients from different countries and how their immune systems respond to infection.
The study will also examine people infected at the same time with hepatitis B and HIV.
Tânia Reuter, a professor at Hucam-Ufes, said the research aims to eliminate viral hepatitis and, in Brazil's case, to eliminate hepatitis B as a public health problem by 2030.
Tests under way in Brazil
The study began this year in Brazil and is expected to last about five years. According to Reuter, researchers will follow a total of 600 patients with hepatitis B, including those with hepatitis B and HIV coinfection, for around four and a half years each.
Of the total participants, 150 will come from each of the four countries involved in the study. In Brazil, 75 participants will be followed by Reuter's team at Ufes.
The research seeks to identify what causes the virus to evolve differently in each patient, which genetic traits may protect people from a faster progression of the disease, and which viral subparticles could serve as predictors of a cure or of successful treatment.
Reuter said she wants to find targets that could help manage a cure for hepatitis B, adding that any findings could become targets for drug development, whether immunostimulators or immunomodulators.
Recruitment of patients at Ufes has been under way since July and has reached 40 participants so far. The deadline set for the study is mid-2027, though Reuter said she hopes to complete her group of participants by the end of this year.
Understanding hepatitis B
Hepatitis B belongs to the group of viral hepatitis infections, inflammatory diseases of the liver caused by different viruses that can lead to serious complications such as cirrhosis and liver cancer.
It is a silent disease that chronically affects the liver of about 240 million people worldwide and can lead to cirrhosis, liver cancer and death. The illness can appear in acute or chronic form and spreads through contact with contaminated blood, unprotected sex, and from mother to child during childbirth. In Brazil, about 1.1 million people live with chronic HBV infection.
Among the different types of viral hepatitis, B and C cause the most concern because of their capacity to become chronic. In many patients, the infection stays active for years without symptoms that would prompt them to seek care. By the time a diagnosis is made, the liver may already show advanced fibrosis, cirrhosis or cancer.
Prevention and global targets
Brazil's Ministry of Health says the main form of prevention is vaccination, which is available free of charge through the country's public health system, the SUS, to anyone who has not yet been vaccinated, regardless of age.
The World Health Organization's global target is to eliminate HIV, viral hepatitis and sexually transmitted infections as public health threats by 2030. A WHO report released in July this year found that annual infections from viral hepatitis fell 32% worldwide since 2015, a decline the organization attributed to rising childhood vaccination rates.
