Hepatitis B in Asia-Pacific area: it’s time to address both clinical and public health issues
With the implementation of universal vaccination against hepatitis B virus (HBV) among infants, the prevalence of chronic HBV infection in young age group has declined remarkably in the world . However, most part of Asian-Pacific region still belongs intermediate to high endemic area of HBV infection and have a high disease burden of CHB. For example, in China, although the prevalence of HBsAg has declined from nearly 10% to around to 7%, the total number of persons with HBsAg positivity would still be over 90 million, with around 20 to 30 million of them being candidates of antiviral therapy. If left untreated, many of them will eventually progress to cirrhosis and even hepatocellular carcinoma. Therefore, the diagnosis and management of this huge number of chronically HBV infected persons pose a great challenge to the health care and reimbursement systems.
Currently, all the major international guidelines on the management of CHB recommend to treat chronic hepatitis B patients with high viral replication and active liver disease with pegylated interferons( PEG-IFN) or nucles(t)ide anologues (NAs). However, choosing PEG-IFN or NAs sometimes is an issue of decision-making process. Besides clinical evidence, doctors’ clinical experience, patients’ preference and their affordability also play an important role in the selection of therapeutic modalities. High antiviral efficacy, excellent tolerance, wide applicability and long-term benefit in clinical outcomes all make NAs of high potency and low resistance profiles the preferred choice for the management of CHB in most patients. But this principle is often compromised in resource-constrained countries or settings due to the higher price or limited reimbursement. As a result, in some countries of the Asia-Pacific region, multi-drug resistance caused by using suboptimal regimens with less potent and higher resistant agents has already become a critical issue in clinical practice, and may even become an emerging public health problem.
Thanks to the national major project on the scientific research for controlling infectious diseases, remarkable progress has been made in China. As of this year, the number of international publications from China on the prevention and treatment of viral hepatitis B and associated HCC has jumped to the second in the world. As an example, considering the pros and cons of IFNs and NAs, efforts have been made to explore the possible roles of de novo combination therapy, sequential therapy(switch-to or add-on) or even so-called nested therapy, with the aim of potentiate the efficacy of these 2 categories of antiviral treatment medications. Promising or encouraging results have been reported at international liver meetings, and the real benefits of these approaches yet to be confirmed by further studies and most importantly by real-world data. In response to this unmet need, CR-HepB(China Registry for Chronic Hepatitis B) was launched in 2012 and as of Oct 2014, more than 30 000 cases and nearly 300 000 follow-up visited have been input into this national platform of long-term follow-up and clinical research. We are confident that in the near future more and more high quality real-world data would be generated and used for evidence-based decision making in both clinical practice and public health domain.
Finally, to address the unmet needs of HBV prevention and treatment in Asia-Pacific region, national health care reform will offers great opportunity. As already demonstrated in the fields of HIV/AIDS and HCV, a greater success in prevention and control of CHB could be achieved through public health approach for massive price reduction of HBV drugs through governmental negotiation by means of tiered pricing, voluntary licensing or compulsory licensing.
At this great moment, the APASL STC on HBV 2014 in Guangzhou will set an excellent platform for hepatologists and scientists from Asia-Pacific and all of the world to communicate new advances, share knowledge and experiences, and explore future directions and opportunities, as well as build and strength personal friendship and collaborations. Therefore, I wholeheartedly wish this HBV conference a great success!
Jidong Jia, MD, PhD
Liver Research Center, Beijing Friendship Hospital, China
The Advisory Board Member of the Single Topic Conference on HBV 2014 in Guangzhou
Past president and current member of Steering Committee of APASL
APASL STC on HBV in China
Dates: December 12-14, 2014
City: Guangzhou, China
President: Dr. Jinlin Hou
Updated Information of APASL 2015 in Istanbul
APASL Future STCs in 2015
In 2015, we APASL will have following single topic conferences.
APASL STC on HCV in India
Date: August 21-23, 2015
City: New Delhi, India
Conference Patron: Dr. S K Sarin
Conference Chairman: Dr. B C Sharma
Conference Secretary: Dr. Manoj Kumar
APASL STC on HBV in Armenia
Date: October 3-5, 2015
City: Yerevan, Armenia
Chairman: Dr. Hasmik Ghazinyan
Website: To be announced.
APASL Future Annual Meetings
2017 APASL Annual Meeting: City: Guangzhou, China
2018 APASL Annual Meeting: City: New Delhi, India
It is our pleasure to inform you that we have elected a 2014 fellow successfully and now we are in preparation phase to offer the fellow the best placement for pursuing his career.
The objective of the fellowship is to foster career development by encouraging the beneficial experience of working in a different clinical or research environment in another country in the Asia-Pacific region. These fellowships provide for advanced training in health and medical research in any country in the Asia-Pacific region and enable fellows to work in a clinical environment or on a research project with nominated advisers. We appreciate your generous contributions and support for these APASL fellowships and look forward to a number of high-quality applications for a 2015 fellowship.
An application form can be downloaded by clicking here: http://www.apasl.info/applicationform-fellowship.docxPlease fill in and send to the APASL secretariat (email@example.com). We are looking forward to receiving your application.
There are no restrictions based on nationality. The sponsoring institution with the academic environment to provide adequate support for the proposed project might be suggested by APASL.
Application will be reviewed by APASL Committee members. The decisions of the Committee are final and not subject to appeal.