Treatment of Chronic Hepatitis B in Asia-Pacific Countries: Is the Asia-Pacific Consensus Statement being followed?

Abstract

These data suggest that clinicians from the Asia-Pacific region use criteria beyond those advocated in treatment guidelines when deciding whether to initiate treatment in HBV-infected patients.

Management of Chronic Hepatitis B: Knowledge and Practices of Physicians in Pakistan

“…In a survey from Singapore, 11 25.4-42.5% participants choose to initiate the treatment outside the APASL recommendation which was comparable to our study (22.9-59.2%). In another study, 12 about 89.5% respondents recommend treatment in patients with high ALT level which was consistent with our results. It should also be noted that almost up to 20% of participants answered "may be" when asked about the all four aspects of knowledge.…”

“…17 Additionally lower compliance rates with APASL recommendations regarding HBV treatment have been reported in two studies from Asia. 11,12 Moreover, 50% compliance with APASL recommendations for HBV treatment has been reported in one of these two studies. 11 However, no data is available from Pakistan regarding physician's practices in HBV management according to the guidelines.…”

“…10 The treatment for HBV infection depends upon certain parameters including severity of fibrosis, serum HBV DNA and alanine transaminase (ALT) levels and HBeAg status. Significant variability in treatment of CHB among physicians have been reported in various studies from Singapore, 11 Hong Kong, 12 China, 13 Spain, 14 US 15,16 and Canada. 17 Additionally lower compliance rates with APASL recommendations regarding HBV treatment have been reported in two studies from Asia.…”

Predictors of relapse in chronic hepatitis B after discontinuation of anti‐viral therapy

“…For HBeAg‐negative patients, the APASL consensus recommended stopping anti‐viral treatment when HBV DNA remained undetectable for three separate occasions 6 months apart 12 . In a survey among 124 gastroenterologists in 12 Asian‐Pacific countries, approximately 60% of them will stop anti‐viral treatment according to these criteria 21 . Nonetheless, approximately 25% to 50% of the patients may still develop hepatitis relapse after stopping anti‐viral therapy even if these recommendations are followed 15, 22–24 …”

“…12 In a survey among 124 gastroenterologists in 12 Asian-Pacific countries, approximately 60% of them will stop anti-viral treatment according to these criteria. 21 Nonetheless, approximately 25% to 50% of the patients may still develop hepatitis relapse after stopping anti-viral therapy even if these recommendations are followed. 15,[22][23][24] In this study, we aimed to investigate the factors that could predict the best timing of stopping anti-viral therapy.…”