How to improve access to therapy in hepatitis B patients

Abstract

Despite the availability of a preventive vaccine and active antiviral treatments that stop disease progression and reduce the risk of hepatocellular carcinoma, hepatitis B is still a major public health problem. Only an estimated 10% of the 257 million people living with HBV have been diagnosed and as few as 1% are being adequately treated. Barriers to diagnosis and treatment include: (i) limited awareness and lack of knowledge about HBV infection and HBV‐related diseases; (ii) under‐diagnosis with insufficient screening and referral to care; (iii) limited treatment due to drug availability, costs, reimbursement policies and the need for long‐term or life‐long therapy. These barriers and the actions needed to improve access to treatment are strongly influenced by the prevalence of infection and affect middle‐high vs low‐middle income countries differently, where most HBV carriers are found. In high‐prevalence regions and low‐to middle‐income countries, the main challenges are availability and cost while in low‐prevalence regions and middle‐to high‐income countries low screening rates, public awareness, social stigma and discrimination play an important role. Overcoming these challenges on a global scale is a complex clinical and public health challenge and multilateral commitment from pharmaceutical companies, governments, funders and the research community is lacking. The new WHO 2016 Global Health Sector Strategy on viral hepatitis targets testing and treatment, suggesting that important but strong actions are needed from advocacy groups, scientific societies and funding agencies to foster awareness and access to cure.

Efficacy and safety of YinQiSanHuang-antiviral decoction on chronic hepatitis B: study protocol for a randomized, placebo-controlled, double-blinded trial

“…[ [7][8] It is estimated that in China there are 20-30 million people with CHB, 1 million with liver cirrhosis and 0.3 million with HCC caused by hepatitis B. [ 9] Deaths due to HBV-related liver diseases in China (0.308 million deaths per year) account for more than 30% of the global mortality from HBV (0.887 million deaths per year) [ 10] . The antiviral therapy is the primary link to slow the conversion of CHB into cirrhosis, which can effectively restore liver function and improve survival rate in patients with CHB.…”

“…The antiviral therapy is the primary link to slow the conversion of CHB into cirrhosis, which can effectively restore liver function and improve survival rate in patients with CHB. [1 [1][2][3][4][5][6][7][8][9][10][11][12] Currently, the US Food and Drug Administration (FDA) has approved two types of anti-hepatitis B virus drugs: interferon (IFN) and nucleos(t)ide analogs (entecavir, lamivudine, telbivudine, adefovir, and tenofovir), although nucleoside analogues are well tolerated and exhibit an early and potent antiviral effect, the selection of resistant mutants and nephrotoxicity during long-term therapy limit their use. [ [13][14] Chinese herbal medicine (CHM), as one of the most popular complementary and alternative therapies of CHB, a large number of studies have reported its anti-hepatitis B virus effect.…”

Low Testosterone Levels Predict Increasing Severity and Worse Outcomes of Hepatitis B Virus-related Acute-on-chronic Liver Failure in Males

“…It has become a major issue in the eld of hepatology due to its rising incidence and ultimate fatality [2]. Among Asian populations, the major underlying disease for ACLF is hepatitis B virus (HBV) infection [3], which is responsible for an estimated 887,000 deaths worldwide in 2015 [4] and ranks seventh in the top causes of mortality worldwide [5].…”

Selecting the Management of Patients With Chronic Hepatitis B After the Completion of the Long-Term Antiviral Therapy

“…В настоящее время недостаточно данных о дальнейшем течение заболевания после прекращения терапии при длительном использовании НА у пациентов с ХГВ HBeAg-негативным, в частности о частоте развития рецидивов и необходимости продолжения ПВТ [16,17].…”