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Abstract:
This TWiV Special podcast episode, recorded at the 2024 International Hepatitis B Virus meeting in Chicago, features Rich Condit interviewing Dr. Thomas Tu, an Associate Professor from the Westmead Institute in Sydney. Dr. Tu shares his unique perspective as both a Hepatitis B (HepB) researcher and a patient diagnosed with chronic HepB at age 15. He discusses his personal journey into science, driven by his diagnosis, and his experiences living with the virus, including the initial feelings of shame and isolation, the importance of family history and transmission (primarily mother-to-child at birth), and the lifelong nature of the condition requiring monitoring and antiviral treatment. Dr. Tu recounts publicly disclosing his status at a scientific meeting, the positive reception, and how it spurred him to create the online support forum hepcommunity.org. His research focuses on understanding HBV persistence (towards a cure) and the mechanisms by which HBV DNA integration leads to liver cancer. He emphasizes the need for translational research, integrating patient perspectives, and advocates strongly for increased awareness, testing, vaccination, and significantly more research funding for HepB, highlighting the disparity compared to viruses like HIV despite HepB's higher global prevalence.
A Scientist and Patient's Perspective on Hepatitis B
0:10 Introduction: Rich Condit interviews Dr. Thomas Tu at the 2024 International HBV meeting in Chicago.
0:28 Guest Introduction: Dr. Thomas Tu is an Associate Professor at the Westmead Institute for Medical Research in Sydney, Australia.
1:07 Path to Science: Dr. Tu initially aimed for medical school but entered biomedical science. His personal diagnosis with Hepatitis B at age 15 (1:47) led him to specialize in HepB research at the University of Adelaide, followed by postdocs in Sydney and Heidelberg.
3:13 Current Role: He co-leads a viral hepatitis pathogenesis group, collaborating closely with a clinician (Prof. Mark Douglas) to ensure research is clinically relevant.
4:55 Personal Diagnosis & Impact: Diagnosed at 15, Dr. Tu experienced isolation and shame due to the stigma associated with HepB, despite its high global prevalence (300 million chronic infections).
6:52 Transmission & Family: He likely acquired the virus from his mother at birth (perinatal transmission), a common route. He notes the emotional burden this can place on families. Newborn vaccination is crucial and highly effective (12:26).
8:48 Testing & Asymptomatic Nature: Discusses risk-based testing (e.g., origin from high-prevalence areas) and the shift towards universal screening, as chronic HepB is often asymptomatic for decades (10:10) while slowly causing liver damage.
11:08 Personal Management: Dr. Tu is generally asymptomatic but undergoes regular monitoring (blood tests every 6 months) and takes lifelong antiviral medication (11:51) as there is currently no cure.
12:57 Transmission Routes: While perinatal is primary for chronic cases, blood-borne transmission (e.g., tattooing, shared needles, inadequate sterilization in procedures) is possible. Nursing is considered safe.
14:24 Public Disclosure ("Coming Out"): Dr. Tu publicly shared his HepB status for the first time at the 2019 HBV meeting community forum (14:44), finding it nerve-wracking but ultimately relieving and impactful for his peers.
17:17 Founding HepCommunity.org: Inspired by the response and contacts from others living with HepB after his disclosure, he started the online forum hepcommunity.org (17:30) to connect patients, scientists, and clinicians.
18:38 Research Focus: Dr. Tu's lab investigates two key areas: 1) Mechanisms of HBV persistence in the liver (aiming for a cure) and 2) How HBV DNA integrates into the host genome early in infection and contributes to liver cancer development decades later (19:09).
20:48 Integrating Roles & Activism: He sees himself as an activist (21:30), bridging patient experience, molecular research, clinical needs, and social science to improve care and understanding.
22:50 Call for Funding & Awareness: Dr. Tu highlights the critical underfunding of HepB research compared to HIV (23:03), despite affecting 10 times more people globally. He calls for greater activism, awareness, and funding parity to combat the virus effectively.