|
|
|
|
|
 |
|
 |
|
|
|
| |
|
| |
S3-1
Advances in the treatment of chronic hepatitis B and C in Taiwan
Chia-Yen Dai M.D., PhD.
Professor, Department of Internal Medicine
Kaohsiung Medical University Hospital, Kaohsiung Medical University
|
Hepatitis B (HBV) and C virus (HCV) infection may result in long-term liver complication including cirrhosis or hepatocellular carcinoma. Taiwan is an endemic country with 12-18% in adults and 3-4% of prevalence of HBsAg and anti-HCV, respectively. With the launch of the universal HB vaccination since 1985, the prevalence of HBsAg decreased to less than 1%. The prevalence of HCV infection varies geographically with some hyperendemic area with prevalence of anti-HCV more than 20%identified in Taiwan.
The goal of treatment of HBV and HCV-infected patients is to eradicate or suppress the viral replication, which may reduce the all-cause mortality and liver related health adverse consequences, including end-stage liver disease and hepatocellular carcinoma.
For CHB, the finite interferon and long-term nucleo(t)side analogues (NUCs) are the current effective therapy. The endpoint is loss of HBsAg which is not common achieved. By the suppression of HBV DNA, reversion of the inflammation and fibrosis become achievable. The Taiwanese National Health Insurance has reimbursed the interferon and NUCs regimen with different duration according to the clinical parameters. New medications are necessary to achieve cure of CHB. With developed regimens for CHC, a high SVR rate was achieved by the pegylated interferon/ribavirin therapy, particularly in Taiwan. Currently all oral DAA therapy achieved a very high sustained virological response (SVR) rate with fewer adverse effects than IFN. New generation pan-genotypic DAAs has become the major regimens for CHC. Further refining the individualized therapy seems necessary after the all oral DAA therapy or the new generation DAAs are available for patients. The Taiwanese National Health Insurance has reimbursed all-oral DAA regimens for HCV since 2017 for the patients with advanced fibrosis and cirrhosis. The very high SVR rate is achieved with less adverse effects. Careful evaluation of the patients’ conditions before and after therapy is mandatory. Elimination of HCV infection by 2030 is the major task supported by WHO. The war against HCV infection has a quite good success now and keeps going which needs the team work of all the professionals, government and non-government organizations. |
|
|
|
|
| |
|
|
 |
|
