When you say a person who seroconverted still needs to monitor with Ultrasound every 6 months... Do you refer to people above the age of 40? Or even young people should monitor? How likely it is that a person below 40 would develop HCC because of integrated cells? Some doctors even suggest to monitor only after a person who is hbsag positive only after the age of 40, are they all wrong?
Also, what do you think about DRACO that is developed by the MIT already 10 years, does it have the potential to be the next antibiotics for viruses? https://www.ll.mit.edu/news/DRACO.html
I just can't comprehend that you can't cleanse all the cells in the liver to get rid of the genetic material from the virus. Are you saying even Timothy Brown who got cured from hiv is still in higher risk of cancer because there is some latent virus in his immune cells? Well, technically our body might have many viruses like herpes, bar espstein, they all have potential to cause problems or cancer, but it's a question of how likely it is... and if there is a way to reduce the risk by doing something... Btw, if getting a new liver... Would that ensure you will have no virus anymore? Also, how safe is it to get a liver transplant, and how long can you live with it after the transplant has happened.
Even birinapant will not wipe out the last infected cell within the ten trillion cell liver.
in chimp studies it was demonstrated that a single hbv virion was able to start the infection.
We will have to rely on reinfection protection by the antibody and the immune surveillance by the class I t cells.
Birinapant holds the promise to eliminate large amounts of cells with integrated surface antigen gene fragments, often the starting point for HCC. Thus it should also have a great HCC prevention power, if it will ever make it to approval.
Also is there something that at least identifies the infected cells, like is there a double stranded RNA on every infected cell? Something that the DRACO drug was supposed to target and I believe biripriant too... Can you use some advanced imaging technique with contrast to be able to highlight the infected cells in an image? If such image could be produced could it be possible to direct drugs to attached only the highlighted zones? Something I believe scentists are trying to do with hiv latent cells (so the technology could be borrowed once completed)
That is a good question...
Even a combination of NAPS + Birinpant used i a sequential manner wouldnt represent a good chance of cccdna eradication?