Antiviral therapy of chronic hepatitis B: Opportunities and challenges in Asia

[Guest guest]

Journal of Hepatology

Volume 51, Issue 2, August 2009, Pages 403-410

Review

Antiviral therapy of chronic hepatitis B: Opportunities and challenges in Asia

Yun-Fan Liaw, a,

aLiver Research Unit, Chang Gung Memorial Hospital, Chang Gung University

College of Medicine, 199 Tung Hwa North Road, Taipei, Taiwan

Associate Editor: M. Colombo. Available online 17 April 2009.

Asia comprises more than 40 countries encompassing a wide geographic area with a

very large population. Many of these countries have low-income economies

together with high endemicity of chronic hepatitis B virus (HBV) infection,

which is usually acquired perinatally or during early childhood. The well

elucidated natural history of chronic HBV infection, together with the extensive

research and the longest experience in the use of therapeutic agents in Asia

have provided a great opportunity for Asian patients to benefit from recent

advancements. However, treatment of chronic HBV infection is a complex task that

requires individualized assessment, thus representing a great challenge for

general physicians. The inherent problems of the drugs currently available,

together with a lack of awareness of the disease among patients, government, and

healthcare practitioners are obstacles to proper management of HBV. The most

critical challenge and obstacle is the high cost of medical care and antiviral

drugs. Lack of adequate reimbursement for treatment and diagnostic testing makes

adherence to treatment guidelines impossible. Hence lamivudine is still widely

used in Asia. To address these challenges, the ongoing awareness campaigns,

active screening programs, educational activities are needed but must be

enhanced. Cost-cutting measures and international support are essential to

improve the difficult situation in this part of the world.

[Guest guest]

Journal of Hepatology

Volume 51, Issue 2, August 2009, Pages 403-410

Review

Antiviral therapy of chronic hepatitis B: Opportunities and challenges in Asia

Yun-Fan Liaw, a,

aLiver Research Unit, Chang Gung Memorial Hospital, Chang Gung University

College of Medicine, 199 Tung Hwa North Road, Taipei, Taiwan

Associate Editor: M. Colombo. Available online 17 April 2009.

Asia comprises more than 40 countries encompassing a wide geographic area with a

very large population. Many of these countries have low-income economies

together with high endemicity of chronic hepatitis B virus (HBV) infection,

which is usually acquired perinatally or during early childhood. The well

elucidated natural history of chronic HBV infection, together with the extensive

research and the longest experience in the use of therapeutic agents in Asia

have provided a great opportunity for Asian patients to benefit from recent

advancements. However, treatment of chronic HBV infection is a complex task that

requires individualized assessment, thus representing a great challenge for

general physicians. The inherent problems of the drugs currently available,

together with a lack of awareness of the disease among patients, government, and

healthcare practitioners are obstacles to proper management of HBV. The most

critical challenge and obstacle is the high cost of medical care and antiviral

drugs. Lack of adequate reimbursement for treatment and diagnostic testing makes

adherence to treatment guidelines impossible. Hence lamivudine is still widely

used in Asia. To address these challenges, the ongoing awareness campaigns,

active screening programs, educational activities are needed but must be

enhanced. Cost-cutting measures and international support are essential to

improve the difficult situation in this part of the world.