Aligos Therapeutics is a clinical-stage biotechnology company focused on improving patient outcomes through best-in-class therapies for liver and viral diseases. The company is dedicated to educating patients, providers, and others on new findings in chronic hepatitis B virus (HBV) infection.
Chronic HBV infection is the most common viral infection in the world with nearly 300 million carriers worldwide and 1.5 million new infections each year. Complications from chronic HBV infection include scarring and inflammation of the liver, liver failure, and liver cancer, which collectively resulted in approximately 1.1 million deaths in 2022, according to the World Health Organization.
HBV has powerful effects on infected patients, including suppression of the immune system, and even integration of the viral DNA into the patient’s chromosomes. These processes work collectively to damage healthy livers and promote cancer.
Standard of care
The primary goal of therapy is to slow the progression to end-stage liver disease and liver cancer. Studies have demonstrated that reducing HBV DNA in the blood to undetectable levels is associated with normalization of liver tests, slowing of liver damage, and lowers the risk of developing liver cancer. Current therapy with nucleoside analogs for chronic HBV infection is life-long treatment and does not eliminate the virus in a meaningful number of patients.
Long-term treatment can lower the amount of HBV DNA in systemic circulation, resulting in improvements in long-term disease outcomes, but virological relapse is common when treatment is stopped. In addition, certain patients continue to progress to liver disease while on treatment.
In recent years, the importance of treating all patients, even those with asymptomatic disease, has been gaining prominence. The reason for this change is that all patients, regardless of disease state, can progress to liver failure and even liver cancer. Moreover, recent studies have demonstrated that while patients treated with nucleoside analogs have a reduced risk, they can still progress to end-stage liver disease and liver cancer.
Next-generation treatment options
Progress has been made with new modalities to treat this insidious disease that can have a greater impact on disease outcomes. Some of these new modalities include blocking HBV gene expression with RNA therapeutics, immune-activators, and molecules targeting the viral capsid, which results in inhibition of multiple steps of the HBV lifecycle (capsid assembly modulators (CAMs)).
CAMs are a new class of drugs that affect the HBV lifecycle differently than the currently approved drugs by acting on multiple steps that the virus uses to replicate and integrate its DNA into an infected individual’s genome. By blocking these key processes, CAMs have the potential to reduce HBV DNA integration and viral secretion, which may translate to clinical benefit for patients. Several CAM candidates are now being tested in clinical studies.
In early clinical testing, some of these candidates appear to show the potential for more rapid and complete viral suppression when compared to previously reported results for nucleoside analogs. Additionally, this class of next-generation CAMs also suggest suppression of viral markers that have been associated with patient immune suppression.
Ongoing testing will further explore these findings and determine the potential role of these next-generation therapies for the treatment of chronic HBV infection, including reductions of viral integration events.
To learn more, please visit www.aligos.com or email [email protected]
