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Author Spotlight: Advancements and Challenges in Hepatitis B Virus Detection
Published on: December 15, 2023
Chronic hepatitis B virus in the Philippines
Robert G Gish1,2,3,4, Jose D Sollano5, Alex Lapasaran6
1Department of Medicine, Division of Gastroenterology and Hepatology, Stanford University, Stanford, California, USA.
Insights
Chronic hepatitis B (CHB) affects millions in the Philippines due to low vaccination and treatment access. Urgent, nationally supported programs are needed for screening, vaccination, and treatment to prevent severe liver disease and reduce societal costs.
Area of Science:
- Hepatology
- Public Health
- Infectious Diseases
Background:
- Chronic hepatitis B (CHB) infection shows a high prevalence in the Philippines, impacting both high-risk groups and the general population.
- Recent national data indicate an HBsAg seroprevalence of 16.7%, translating to approximately 7.3 million affected adults.
- Inadequate vaccination and limited treatment access contribute significantly to the high CHB burden and its severe health consequences.
Purpose of the Study:
- To highlight the critical need for comprehensive national strategies to combat the high prevalence of CHB in the Philippines.
- To emphasize the importance of addressing factors contributing to CHB transmission and progression.
- To advocate for expanded healthcare coverage and public education initiatives for hepatitis B.
Main Methods:
- Review of existing studies on CHB prevalence in the Philippines.
- Analysis of factors contributing to CHB infection and its sequelae.
- Assessment of current healthcare access and financial barriers to prevention and treatment.
Main Results:
- An estimated 7.3 million Filipino adults are living with CHB, with a national HBsAg seroprevalence of 16.7%.
- Significant gaps exist in vaccination coverage and access to medical monitoring and treatment for CHB.
- Without intervention, CHB carries a 25-30% risk of progression to liver failure and death, incurring substantial medical and societal costs.
Conclusions:
- There is an urgent need for a nationally supported program in the Philippines to address CHB.
- Key interventions include universal newborn vaccination, nationwide screening and vaccination, and accessible monitoring and treatment for CHB patients.
- Addressing transmission routes in healthcare settings, through drug use, and tattooing, alongside expanded government coverage for prevention and treatment, is crucial for mitigating the impact of CHB.
Abstract:
Multiple studies have shown a high prevalence of chronic hepatitis B (CHB) infection in the Philippines, not only in high-risk populations but also in the general population. The most recent national study estimated HBsAg seroprevalence to be 16.7%, corresponding to an estimated 7.3 million CHB adults. The factors underlying the high prevalence of CHB and its sequelae include the inadequate use of vaccination for prevention and the lack of treatment for many Filipinos. Because without medical monitoring and treatment of CHB the risk of progression to liver failure and death is 25-30%, the ultimate medical and societal costs will be very high if the Philippines fails to properly address hepatitis B infection. It will be very important to move forward with programs that can help to ensure universal vaccination of newborns, screening and vaccination nationwide, and monitoring and treatment for CHB persons. It will also be crucial to address transmission of HBV in the health-care setting (via contaminated needles and syringes and inadequately sterilized hospital equipment) and via injection drug use and tattooing. Because of the relatively low average per capita income and the lack of coverage by PhilHealth of outpatient visits and medications, there is an urgent need to move forward with a nationally supported program that includes education for both the general public and health-care workers on liver disease and screening for hepatitis viruses, followed by, as appropriate, vaccination or treatment, with expanded government coverage for these for all those who could not otherwise afford it.
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