Hepatitis E affects millions globally, causing approximately 70,000 fatalities annually. Despite its significant impact, an approved vaccine or specific treatment has yet to be developed. However, the recent discovery of bemnifosbuvir, a compound exhibiting strong efficacy against hepatitis E viruses (HEV), may change that narrative.
A collaborative research effort involving teams from Bochum and Heidelberg in Germany, alongside researchers from Beijing, China, led to the identification of this drug during a screening of antiviral compounds. Bemnifosbuvir is classified as a nucleotide/nucleoside analogue, and its existing clinical trials for hepatitis C have fueled optimism about its potential repurposing for hepatitis E. The findings were published in the journal Gut on March 6, 2026.
Mechanism of Action
The research team began their investigation by examining a library of nucleotide/nucleoside analogues designed to mimic the components of genetic material. "These synthetically produced molecules are structured similarly to the building blocks of our genetic material and that of viruses," noted Dr. Mara Klöhn from Ruhr University Bochum.
To pinpoint viable candidates, the researchers tested around 500 compounds using a genetically modified hepatitis E virus that emits a fluorescent signal. They infected cell cultures with this virus and treated the cells with various compounds. The fluorescence tracking enabled them to swiftly ascertain whether the virus continued to replicate.
"With bemnifosbuvir, we observed that the virus ceased replication, while the treated cells remained healthy," reported Jungen Hu from Heidelberg University. Subsequent animal studies validated that the drug effectively reduced viral activity and liver inflammation.
"If the ongoing clinical trials of bemnifosbuvir for hepatitis C yield positive results, it could soon be available for off-label use against hepatitis E," stated Dr. Viet Loan Dao Thi and Professor Eike Steinmann.
The Challenge of Hepatitis E
The hepatitis E virus (HEV) is a prominent cause of acute viral hepatitis. While many infections resolve independently in individuals with robust immune systems, the virus can persist in those with compromised immunity, such as organ transplant recipients and individuals living with HIV. It also poses heightened risks during pregnancy.
Initially documented during a significant outbreak from 1955 to 1956, HEV has only recently gained attention in scientific research. Currently, there are no vaccines or targeted antiviral therapies available for this virus.
Collaborative Research Efforts
This groundbreaking research involved the Department of Molecular and Medical Virology at Ruhr University Bochum, the Dao Thi Lab at the Center for Integrative Infectious Disease Research (CIID) at Heidelberg University Hospital, and the Lin Wang Lab at Peking University in China. The study was supported by various funding entities, including the National Key Research and Development Program of China and the German Research Foundation.