Management of chronic hepatitis B: experience from China
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Real-Time Polymerase Chain Reaction-Based Detection and Quantification of Hepatitis B Virus DNA
Published on: December 15, 2023
1Hepatology Unit and Key Lab for Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Insights
Chronic hepatitis B infection remains a global health challenge, particularly in China. Vaccination programs have reduced the hepatitis B virus (HBV) carrier population, improving outcomes and treatment accessibility.
Area of Science:
- Hepatology
- Virology
- Public Health
Background:
- Chronic hepatitis B infection poses a significant global health burden, with substantial mortality and socioeconomic impact in China.
- Hepatitis B virus (HBV) infection rates in China have decreased due to vaccination programs, transitioning the country from high to intermediate endemicity.
- Predominant HBV genotypes B and C in China may be linked to suboptimal responses to antiviral therapies.
Purpose of the Study:
- To review the current landscape of chronic hepatitis B management in China.
- To highlight China's contribution to global research and development of novel antiviral agents for hepatitis B.
- To discuss the future outlook for hepatitis B treatment accessibility and adherence in China.
Main Methods:
- Review of epidemiological data on chronic hepatitis B prevalence and mortality in China.
- Analysis of the impact of the national hepatitis B vaccination program.
- Examination of clinical trial participation and the development of antiviral therapies in China.
Main Results:
- A one-third reduction in the HBV carrier population since 1992, marking a significant public health achievement.
- Active patient and physician involvement in global and domestic clinical trials for various antiviral agents.
- Anticipation of future data from China's National Eleven Five Plan Project on Hepatitis Research to optimize antiviral efficacy.
Conclusions:
- China's progress in controlling hepatitis B is notable, with ongoing contributions to antiviral research.
- Economic development and healthcare reforms are enhancing the accessibility of antiviral treatments for Chinese patients.
- Improved access to antiviral agents will enable greater adherence to international and national treatment guidelines.
Abstract:
Chronic hepatitis B infection is a significant health problem throughout the world, and particularly in China. It is estimated that more than half a million Chinese people die annually from end-stage hepatitis B complications, which is associated with huge healthcare costs and a heavy socioeconomic burden. In China, the implementation of a hepatitis B vaccination programme has come into effect, and there has been a one-third decrease of the hepatitis B virus (HBV) carrier population since 1992. This great achievement changes China from a highly endemic area for HBV infection to an intermediate one. The predominant HBV genotypes in China are B and C, which might predispose patients to a poor antiviral response. Patients and physicians from China have been actively involved in the global research into and development of new antiviral agents. Patients have been recruited for global and domestic clinical trials on antiviral agents, including lamivudine, adefovir dipivoxil, entecavir, telbivudine and two pegylated interferon-alpha. In the future, more important data, focussing on optimization of the efficacy of antiviral agents, will be released from China, based on the newly launched National Eleven Five Plan Project on Hepatitis Research. Both economic development and healthcare system reform, including a new reimbursement policy, will make antiviral agents more accessible to Chinese patients. Ultimately, this will allow physicians greater opportunities to follow international and Chinese treatment recommendations.
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Assessment: