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For now all one can say is transmission is assumed to be dramatically reduced.

The bigger risk is likely that in some the suppression is temporary or transient flares of replication under some circumstances.

The other question is, does this avoid all the sequela of HBV. It seems to reduce risk of cirrhosis atleast.

For hiv, it took many decades to be able to make the clam undetectable = untransmittable using serodiscordant couple studies.

A patient that is functionally cured shouldn't pass on the disease. Since it is cleared from the blood and the viral DNA is undetectable, it is not replicating anymore, so it can't be transmitted. They risk is not absolute since the dormant virus is still genetically encoded in the liver.

(Meta note: This exposure scenario hinges on whether the second party has previously completed the HepB vaccine schedule. So, for those evaluating this risk equation, duly noted that a vaccine exists that the yet-uninfected party above could have received.)

I'm pretty sure that if the virus and its DNA are undetectable then you can't spread it. I believe that's how it works with HIV anyway.

Herpes viruses like HSV are notoriously difficult to target with medication bc they encode themselves into DNA inside the nuclei of long-lived human nerve cells. Between outbreaks, they basically exist only as rogue DNA floating inside mostly-healthy cells in the nerve ganglia. At some point, something triggers the nerve cell to transcribe the rogue DNA, producing new viruses and beginning a new outbreak.

There are > 800.000 yearly deaths due to hep b.

https://en.wikipedia.org/wiki/Hepatitis_B

Yes, there is an effective vaccine but not everyone has access to it for tons of reasons.

It's estimated that 300 million people have HBV. HBV is currently incurable once acquired, at which point the vaccine is irrelevant.

The HBV virus is also carcinogenic, which makes it unique[0] among the three big hepatitis viruses. Liver cancer is extremely aggressive and fast-killing, often reaching terminal stages before it is even detectable at all. It is one of the top three causes of cancer deaths worldwide.

Aside from the sheer number of people affected by this, it is also a horrible thing to experience. I have watched someone die from liver cancer, and I would not wish it on anyone.

Contrast to HSV, which is widespread (approximately half the population has at least one HSV latent infection) and causes very few problems beyond occasional irritation in virtually all cases that do not involve other comorbidities or immunocompromised status. HSV is also suppressible through antiviral treatment, making it generally untransmittable (if treated and suppressed) and unlikely to cause symptoms. Most people with HSV do not even bother to do this, which is if anything a testament to how little HSV affects their lives (most don't even know they have it, and there is no clinical justification for routine testing in otherwise healthy patients).

Of all infections pathogens for which I could wish a cure into existence, HSV would be extremely low on my list.

[0] While HCV can cause cancer if left untreated for a long time and if it causes cirrhosis, approximately one third of people clear HCV infection in the acute stages without any lasting ill effect. Of the remainder, it takes a long time for cirrhosis to develop, leaving plenty of time for treatment. First-line treatments are approximately 95-99% effective. So there is no clinical reason HCV needs to increase a person's risk for cancer, as long as they have access to medical care. The same is not true for HBV.

The HB vaccine unfortunately doesn't work that well, many people are still not fully immune even after several doses

They didn't give it to males, and didn't let males get it, until recently.

> For the American market and the October 2001 release, the cover art of Is This It was changed to a psychedelic photograph of subatomic particle tracks in a bubble chamber.

https://en.wikipedia.org/wiki/Is_This_It

Is This It

My sister, who is two years younger, was in 8th or 9th grade when this album came out. She's also a Weezer and Radio Head fan. Only a few years difference but I feel this genre came after me.

It helps to look at some figures to bring it into perspective instead of making off hand comments about how it's not a lot. Remember these are human lives!

After some searching, I found estimates ranging between 600 thousand to 1.6 million people living with Hepatitis B in the US.

If we can help 20% of those people, that means significant life improvements to somewhere between 120 thousand and 320 thousand people.

If we take the upper end, that's half the population of Wyoming.

19% vs 15% would be "not a lot". But this is 19% vs 0%!

Quote: "233 of 1220 people who had received bepi had functional cures—both undetectable HBV DNA and surface antigen—versus zero of 614 participants in the placebo arm."

This is a HUGE deal because low virality now doesn't mean low virality in the future.

> This will enable it to be supplied at a non-exploitative price to Africa and Asia.

It's millions of times easier to copy than to discover. Discovery needs paying for, and the places that don't discover aren't owed things by places that do.

They produce drugs whose patents have expired; drugs still under patent are something they mostly avoid. The term for 3rd party versions of these drugs are often referred to as `generics`, which sees the same drug, but a different name(names also have copyrights that seem to extend longer).

However, if they can tweak the drug and make it something that escapes the patent and still works then good for them and everyone else. Though mindful large pharma is rather tight and lawyer-heavy when it comes to protecting their IP.

As of now it is under patent that expires in 2032, and also not FDA approved, so with how long that process takes, either way, wont see it available anytime soon in drug regulated countries. But grey imports/black market trade in pharma drugs is not to be overlooked.