scholarly journals Elimination of Hepatitis B in Highly Endemic Settings: Lessons Learned in Taiwan and Challenges Ahead

Viruses ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 815 ◽  
Author(s):  
Chun-Jen Liu ◽  
Pei-Jer Chen

Hepatitis B virus (HBV) infection and its related liver diseases are important health problems worldwide, particularly in the Asia-Pacific region. For the past 4–5 decades, Taiwan’s government and scientists have cooperated together to control this virus infection and its related liver diseases. These efforts and achievements have made progress toward the elimination of HBV. Taiwan’s government initiated the Viral Hepatitis Control Program (VHCP) in the1970s, and then launched the national vaccination program in 1984. This universal vaccination program effectively decreased the rate of hepatitis B carriage and the development of hepatocellular carcinoma (HCC) in the younger generation. Since 2003, approved anti-HBV treatments were reimbursed nationwide. This reimbursement program resulted in a higher uptake of anti-HBV treatments, which contributed to a decrease in liver-related disease progression and subsequently reduced attributable mortality in Taiwan. This experience can be shared by countries in other parts of the world regarding the control of chronic viral hepatitis B.

Blood ◽  
2010 ◽  
Vol 116 (16) ◽  
pp. 2875-2883 ◽  
Author(s):  
Vito Di Marco ◽  
Marcello Capra ◽  
Emanuele Angelucci ◽  
Caterina Borgna-Pignatti ◽  
Paul Telfer ◽  
...  

AbstractChelation therapy with new drugs prevents cardiac damage and improves the survival of thalassemia patients. Liver diseases have emerged as a critical clinical issue. Chronic liver diseases play an important role in the prognosis of thalassemia patients because of the high frequency of viral infections and important role of the liver in regulating iron metabolism. Accurate assessment of liver iron overload is required to tailor iron chelation therapy. The diagnosis of hepatitis B virus– or hepatitis C virus–related chronic hepatitis is required to detect patients who have a high risk of developing liver complications and who may benefit by antiviral therapy. Moreover, clinical management of chronic liver disease in thalassemia patients is a team management issue requiring a multidisciplinary approach. The purposes of this paper are to summarize the knowledge on the epidemiology and the risks of transmission of viral infections, to analyze invasive and noninvasive methods for the diagnosis of chronic liver disease, to report the knowledge on clinical course of chronic viral hepatitis, and to suggest the management of antiviral therapy in thalassemia patients with chronic hepatitis B or C virus or cirrhosis.


2009 ◽  
Vol 150 (1) ◽  
pp. 19-26 ◽  
Author(s):  
Alajos Pár

Mivel a hepatitis B- és C-vírus- (HBV-, HCV-) fertőzés döntő szerepet játszik a hepatocellularis carcinoma (HCC) keletkezésében, a HBV és HCV okozta hepatitis és cirrhosis megelőzése és kezelése egyben a HCC prevencióját is jelentheti. A HCC primer prevencióját képviseli a HBV elleni vakcináció és a donorok szűrése HBV- és HCV-markerekre. A szekunder prevencióhoz sorolható az interferonalapú és/vagy nukleozidanalóg anti-HBV- és anti-HCV-terápia, a cirrhosisos betegek HCC irányában történő alfa-foetoprotein + ultrahang szűrése, valamint a HCC kuratív reszekciója/ablatiója utáni adjuváns antivirális kezelés. Várható, hogy a HBV-vakcináció világszerte történő széles körű alkalmazása, továbbá az optimalizált individuális antivirális kezelésmódok, az új nukleozidanalógok és HCV-specifikus proteáz- és polimerázgátlók révén előrelépés történik nemcsak a vírushepatitisek megelőzésében és terápiájában, hanem a HCC prevenciójában is a nem túl távoli jövőben.


2000 ◽  
Vol 99 (3) ◽  
pp. 207-214 ◽  
Author(s):  
Michiko OKUBO ◽  
Goshi SHIOTA ◽  
Hironaka KAWASAKI

Thrombocytopenia in liver diseases is considered to be due to splenic platelet pooling and accelerated destruction. Since thrombopoietin (TPO), a regulator of thrombopoiesis, is produced mainly in the liver, decreased production of TPO may account for thrombocytopenia in liver diseases. To address this issue, we measured serum TPO, using a sensitive sandwich ELISA, in 108 patients with chronic viral hepatitis, which included chronic hepatitis (CH) and liver cirrhosis (LC), and hepatocellular carcinoma (HCC), and in 29 normal controls. TPO mRNA in 78 liver samples was examined by reverse transcription (RT)-PCR. Platelet counts in CH, LC, HCC and controls were 176±15×109/l, 81±8×109/l, 99±7×109/l and 234±9×109/l respectively. Serum TPO levels in CH, LC and HCC were 2.79±0.4 fmol/ml, 1.49±0.2 fmol/ml and 1.97±0.2 fmol/ml, and were higher than those of controls. Serum TPO levels were positively correlated with prothrombin time and serum albumin (P < 0.05, in each case), and negatively correlated with Indocyanine Green test and Pugh score (P < 0.01 and P < 0.05 respectively). However, RT-PCR and immunohistochemistry showed that expression of TPO mRNA and protein were similar in the different liver diseases, suggesting that serum TPO is a reflection of the total mass of functional liver. Platelet counts were negatively correlated with spleen index, but not with serum TPO. These results suggest that thrombocytopenia in liver disease is not directly associated with serum TPO but is associated with hypersplenism.


2015 ◽  
Vol 128 (17-18) ◽  
pp. 658-662 ◽  
Author(s):  
Enver Yüksel ◽  
Erdem Akbal ◽  
Erdem Koçak ◽  
Ömer Akyürek ◽  
Seyfettin Köklü ◽  
...  

2021 ◽  
Vol 2 (4) ◽  
pp. 1-8
Author(s):  
Gabriela Mitea ◽  
Marius Daniel Radu ◽  
Ana Maria Ionescu ◽  
Nicoleta Blebea

In infectious diseases, viral hepatitis has an increased incidence, being an important cause of morbidity and mortality, being a "sentinel" indicator of the socio-economic and hygienic-cultural standard of a geographical area. The World Health Organization (WHO) admits the following types of hepatitis viruses: A, B, B + D, C, E, F and G. Among the viral entities recognized by the WHO, a special importance in terms of incidence, evolution over time with the risk of chronicity and the therapeutic options are presented by hepatitis B and C. There is currently an effective vaccine as well as treatment for hepatitis B. There is no vaccine for hepatitis C, but in recent years considerable progress has been made in treating this disease. Also, the introduction of drugs known as direct-acting antivirals makes it possible to cure over 90% of patients within 2-3 months. But in many countries, current drug policies, regulations and prices keep treatment out of the reach of most people with hepatitis. Eradication of viral hepatitis is possible if greater emphasis is placed on prevention, diagnosis and treatment. Vaccination is very important, as it is possible for types A and B of hepatitis. Early diagnosis is also extremely important, given that there are currently very effective drugs that can prevent the development of liver cancer. The WHO also noted that about two million people worldwide become ill each year due to the reuse of syringes and stressed the importance of checking blood donors to see if they are not carriers of hepatitis B or C viruses. Therefore, the purpose of this article is to highlight the pharmacological treatment and the main therapeutic and prevention schemes currently used for patients with these liver diseases. The paper was based on the most popular methods of identification of the latest international information about the treatment of hepatitis (by electronic search using Pubmed, SciFinder, Scirus, GoogleScholar and Web of Science). We also consulted the global literature cited in the hepatitis database of the World Health Organization (WHO) updated frequent from the current literature on this topic.


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