Hepatitis B feared, but is curable<\/p>\n
The World Health Organization estimates that 2 billion people are
\ninfected by Hepatitis B virus (HBV) and of that amount 400
\nmillion chronically infected, which left untreated could develop
\ninto cirrhosis or liver cancer.<\/p>\n
George K.K. Lau from the Hong Kong University said that 75
\npercent of the people with HBV were from the Asia-Pacific region.<\/p>\n
Indonesia ranks third after China and India. Hepatitis B
\ncauses extensive liver damage and is often transmitted through
\nmaternal-infant vertical transmission.<\/p>\n
\"It is very important to disseminate the information about
\nthis disease because it slowly transgresses, so many people will
\nnot able to detect it until it reaches an advanced stage. At
\naround 40 to 60 years, if left untreated, people will already
\nhave liver cancer or cirrhosis,\" he said.<\/p>\n
Indonesia with an estimated 11.6 million people with HVB, he
\nsaid, was only one tenth of the number that China dealt with,
\nwhich saw 120 million people.<\/p>\n
But Indonesia has the same problem as other countries in Asia
\nwhere many patients are left untreated, he added. It is
\nnecessary to reduce the risk of getting liver cancer if not
\nIndonesia, for example, faces the death of 50,000 people every
\nyear from this disease,\" Lau said.<\/p>\n
Stemming from this concern, Lau, who is a physician at the
\nQueen Mary Hospital in Hong Kong, conducted a study on the
\ntreatment of Hepatitis B along with a number of specialists from
\nthroughout the world. His study was published in the June edition
\nof The New England Journal of Medicine.<\/p>\n
The study itself was initiated in 1998 and was completed last
\nyear, involving 841 patients.<\/p>\n
\"Treatments for chronic hepatitis B are suboptimal. In the
\nsearch for improved therapies, we compared the efficacy and
\nsafety of pegylated interferon alfa or Pegasys plus lamivudine,
\npegylated interferon alfa without lamivudine and lamivudine alone
\nfor the treatment of hepatitis B e antigen (HBeAg) -- positive
\nchronic hepatitis B.<\/p>\n
Peginterferon alfa-2a or Pegasys works in two ways:
\nstimulating the immune system and inhibiting viral replication.
\nIt is taken once a week for 48 weeks.<\/p>\n
Lamivudine is an oral medicine that is taken once a day to
\ntreat chronic hepatitis B. The drug belongs to a class of
\nmedicine called \"nucleoside analogs.\" Patients typically have to
\nkeep taking this medicine indefinitely. In addition, long-term
\ntreatment may also result in drug resistance and as a consequence
\nthere will be progression of liver disease and liver damage.<\/p>\n
Current consensus guidelines from Asia, Europe and the United
\nStates recommend lamivudine, adevoir or conventional interferon
\nalfa for the treatment of chronic hepatitis B. Pegasys however,
\nhad been widely used in the treatment of hepatitis C.<\/p>\n
During the 48-week observation period, many patients tolerated
\nPegasys very well, Lau said, adding that there were expected side
\neffects like fatigue, headaches, myalgia and pyrexia.<\/p>\n
\"The number of those who got minor side effects is
\ninsignificant,\" he said.<\/p>\n
What is the clinical implication of Lau's study then?<\/p>\n
It was found that peginterferon alfa-2a alone or in
\ncombination with lamivudine resulted in higher rates of sustained
\nHBeAg HBsAg, virologic and biochemical response among patients
\nwith HBeAg-positive chronic hepatitis B than did lamivudine
\nalone.<\/p>\n
One example, he said, was a 44-year-old patient. This
\nunidentified patient was diagnosed with hepatitis B after his
\nbrother died of liver cancer. Amazingly, Lau said, this man could
\nachieve Seroconversion without a dose reduction in his 44-week
\nlong treatment using this new combination of Pegasys.<\/p>\n
Manufactured by Roche, Pegasys was already approved by
\nIndonesian's Food and Drug Agency (BPOM) last month, nine months
\nearlier than expected.<\/p>\n
In terms of cost, Lau said it would save much of the expenses
\nbecause of the finite treatment duration. -- Emmy Fitri<\/p>",
"url": "https:\/\/jawawa.id\/newsitem\/hepatitis-b-feared-but-is-curable-1447893297",
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