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Hepatitis B is one of the world's top ten killer diseases. If left untreated, many with the disease will die of cirrhosis and cancer. Mala Maini explains how her team is tackling a deadly infection.
What is hepatitis B?
Hepatitis B is an infection of the liver caused by a virus that is spread through blood and body fluids.
Most adults infected with hepatitis B fully recover within a few months and keep traces of the virus under efficient lifelong control through their immune responses.
But for those who can't control the virus, there's a risk of developing life-threatening problems such as scarring of the liver (cirrhosis) or liver cancer.
One third of the world's population has been infected with hepatitis B. Around 240 million people have a long-term infection, causing over 700,000 deaths a year.
Our goal
Our goal is to develop new therapies for treating hepatitis B by harnessing the natural capacity of the body's immune respons to control this virus.
Our work is also directed towards advancing immunotherapy for liver cancer and providing new insights into local immune responses that could be applied to the treatment of other liver diseases.
How we work
New research techniques allow us to use small numbers of cells from patients' blood and liver to study their immune response in great detail. We work closely with hepatologists (liver physicians), oncologists (doctors specialised in diagnosing and treating cancer) and liver surgeons at the Royal Free Hospital.
I also work as a consultant physician in a viral hepatitis clinic. My research has always been closely informed by patients I see in my clinics and the samples they generously donate for our work.
Our progress so far
In patients with persistent infections like hepatitis B, the specific T cells become 'exhausted' - so stop working properly. By defining the mechanisms driving this, we try to identify ways to restore effective T-cell control.
One of the ways we can do this is by protecting T-cells from regulatory cells and signals that inhibit them. We can also boost T cells by giving them additional growth factors or nutrients they depend on. Saving T-cells in these ways supports their recovery and their response to hepatitis B.
This knowledge has informed the development of new therapies for liver diseases like hepatitis B.
Colorized 3D print imagery of hepatitis B virus (not to scale). Credit: NIAID
The IIT has saved my life and other patients like me by ensuring that the treatment and therapy match the patient. The research has enabled some 'incurable' conditions to be cured.
Jose Drabwell