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Thursday 24th May 2018

China battles Hepatitis B

14th May 2007

The Chinese authorities face a major public health problem in Hepatitis B, which is endemic in the country, with around 400 million people infected with the virus.


Almost one in every three people in the world infected with the virus (carriers) live in China - the country has 120 million carriers of the virus, and 30 million people who are chronically infected.

Over five years, between 10% and 20% of patients will go on to develop cirrhosis, and there are 300,000 deaths annually resulting from the disease.

The incidence of the virus increased from 21.9 in every 100,000 people in 1990 to 53.3 in 100,000 people in 2003.

Because a high viral load in patients is the main cause of hepatitis progression, the ultimate goal in treatment is to eradicate the virus before irreversible liver damage occurs.

Few drugs exist which can do that, however, as the virus is almost impossible to stamp out once tolerated by the body's immune system.

Some traditional Chinese herbs, such as kushenin and some complex prescriptions, have some efficacy as antivirals and in the protection of liver function, although the specific mechanism and components need to be identified.

The current treatment in China is the combination of antiviral agents (lamivudine, adefovir dipivoxil), immune modulators (interferon alfa, peginterferon alfa, thymosin), and hepatic protectors (such as glycyrrhizin, essentiale, glucurolactone).

This treatment plan carries costs of around 900 billion yuan (US$110,000 million) a year.

Patients and carriers are also frequently subjected to discrimination at a social level, even though such behaviour is not officially tolerated.

The government plans to fund a US$390 million research programme into hepatitis B over the next decade, looking at vaccinated populations, genetic variation in the virus itself, immune response and its role in liver failure, and research into the effects of traditional Chinese medicine compounds.

The authorities also plan to complete the vaccination programme, to develop molecular typing diagnostic kits to predict therapeutic response, new treatment plans and diagnostic kits for the early stages of liver cirrhosis, as well as the development of markers to predict recurrence and metastasis.

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