Release date: 2015-03-19
March 18, 2015 is the fifteenth National "Love Liver Day", the theme is to prevent hepatitis C, prevent problems before they happen.
Last week, WHO released the first ever chronic hepatitis B treatment guide. Chronic hepatitis B is a viral infection transmitted through blood and body fluids that damages the liver and is estimated to cause 650,000 deaths each year, most of which are in low- and middle-income countries.
According to the global situation, about 240 million people carry chronic hepatitis B virus, and the infection rate is highest in Africa and Asia. People with chronic hepatitis B infection are at higher risk of dying from cirrhosis and liver cancer.
There are already effective drugs that can prevent these diseases and prolong their lives, but most people who have the demand for such drugs are still unable to obtain drugs, or can only get non-standard treatment. One reason for this situation is the lack of clear evidence-based guidance for countries (especially low- and middle-income countries) on who should receive treatment and which medicines should be used.
“Determining who needs hepatitis B treatment depends on a number of factors,†said Dr. Stefan Wiktor, head of the WHO Global Hepatitis Program. “These new guidelines offer treatment recommendations based on simple, inexpensive testing that will help clinicians make the right decisions.â€
The WHO Guidelines for the Prevention, Care and Treatment of Chronic Hepatitis B Infections propose simplified methods for treating people with chronic hepatitis B infection, especially in resource-constrained settings.
This guidance document covers all treatments, from determining who needs treatment, to what medicine to use and how to monitor the infected person for long-term.
The main recommendations made are:
1. Use several simple, non-invasive tests to assess the stage of liver disease to assist in determining who needs treatment;
2. Focus on the treatment of patients with cirrhosis - the latest stage of liver disease;
3. Treatment of chronic hepatitis B with two safe and effective drugs, tenofovir or entecavir;
4. Conduct regular monitoring using a simple test for early detection of liver cancer to judge whether the treatment is effective and whether treatment needs to be stopped.
5. Special needs have also been considered for specific populations, such as people living with HIV, children and adolescents, and pregnant women.
Many countries currently have access to two recommended generic drugs that are relatively inexpensive and cost as little as $5 per person per month. “Because many people need lifelong treatment, it is important that patients get these drugs at the lowest possible price,†Dr. Wiktor said.
Several countries have begun to develop hepatitis B treatment plans, and the latest document also provides guidance on how to organize hepatitis care and treatment services. “For example, countries need to consider ways to improve access to medicines and how to best provide quality care based on existing health services and personnel,†said Dr. Philippa Easterbrook of the WHO Global Hepatitis Programme.
For people who have been infected with hepatitis B, treatment can prolong their lives, but it is equally important to focus on preventing new infections. WHO recommends that all children receive hepatitis B vaccination and receive the first dose of vaccine at birth. In particular, in some countries in Asia, the prevalence of hepatitis B infection in children has been reduced through universal immunization of children. The challenge now is to intensify efforts to ensure that all children around the world are protected from the virus.
Another route of infection is the re-use of medical equipment, especially syringes. WHO has recently launched a new injection safety policy that will also help prevent new infections in hepatitis B. This policy requires the use of “smart†syringes worldwide to prevent the re-use of syringes or needles.
The new guidelines for hepatitis B treatment have been developed since the publication of the first hepatitis C treatment guidelines by WHO last year.
Source: WHO
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