Chronic HBV infects over 254 million people worldwide, causing about 1.1 million deaths annually, mainly from cirrhosis and hepatocellular carcinoma (HCC). Despite an effective vaccine for prevention, chronic infection remains prevalent, particularly in regions like Sub-Saharan Africa and East Asia. This highlights the need for a cure that could eliminate the virus and prevent progression to liver failure and cancer.2
Hepatitis D: A Co-Infection with HBV
HDV requires HBV for replication and can occur as a co-infection or superinfection. Co-infection with HBV and HDV is the most severe form of chronic viral hepatitis, leading to faster progression to cirrhosis and a higher risk of HCC. Nearly 5% of people with chronic HBV are also infected with HDV. The incidence of HDV has decreased since the 1980s, largely due to the global hepatitis B vaccination program.3
HDV is transmitted through blood, including through injection drug use, unsterile medical procedures, and, less commonly, mother-to-child transmission. Populations at higher risk include people who inject drugs, individuals with HIV or hepatitis C, and patients undergoing hemodialysis. Regions with higher prevalence include Mongolia, Moldova, and parts of Africa. Acute HDV infection can cause fever, fatigue, jaundice, and in rare cases, fulminant hepatitis. In chronic HBV patients, HDV superinfection accelerates disease progression, often leading to cirrhosis and HCC.3
What You Need To Know
nChroma Bio was formed through the merger of Chroma Medicine and Nvelop Therapeutics, securing $75 million to support its lead program, CRMA-1001, and other genetic therapies.
CRMA-1001 is an epigenetic editing therapy targeting chronic HBV and HDV, showing promise in preclinical studies for offering better functional cure rates than current treatments.
Chronic HBV and HDV remain major global health issues, and ongoing research, including CRMA-1001, is critical to advancing potential cures and improving patient outcomes.
The Path Forward: Research and New Therapies
A functional cure for HDV is difficult due to its reliance on HBV, limited treatment options, and immune clearance challenges. Chronic hepatitis B is linked to high mortality from cirrhosis and liver cancer, making a cure for HBV and HDV a critical health priority. Current strategies focus on expanding HBV vaccination and improving access to treatments for HDV.
In the press release, Chroma Medicine co-founder Luke Gilbert, PhD, associate professor, UCSF and core investigator, Arc Institute said, “We are just beginning to scratch the surface of epigenetic editing as a therapeutic approach. The continued engineering on both epigenetic editing cargo and extrahepatic delivery happening at nChroma have immense potential to create new medicines.”1
Overall, the $75 million funding will help nChroma advance CRMA-1001 into clinical trials in 2025. The company also plans to expand its pipeline with therapies targeting other tissues and diseases, leveraging its programmable, non-viral delivery platform for a range of conditions.
Ongoing research, including CRMA-1001, is key to advancing treatment options. CRMA-1001 offers hope for a cure by targeting HBV and HDV, potentially improving patient outcomes and reducing the burden of these infections.
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