Antiviral therapy for chronic hepatitis B in China

Zheng, Xin; Wang, Junzhong; Yang, Dongliang

doi:10.1007/s00430-014-0380-z

Cited by 28 publications

(26 citation statements)

References 34 publications

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“…It is estimated that 85% of HCC cases in China are HBV-related [3], and China accounts for half of the total number of liver cancer cases and deaths worldwide [4]. Five oral nucleot(s)ide analogs (NUCs), conventional interferon alpha (IFN-α), and two formulations of pegylated interferon alpha (PEG-IFNα) have been approved for treating chronic hepatitis B (CHB) infection in China [5]. Based on guidelines established by the Chinese Society of Hepatology and Chinese Society of Infectious Diseases, all NUCs are recommended as first-choice treatments [6].…”

Section: Introductionmentioning

confidence: 99%

“…On the other hand, according to the American Association for the Study of Liver Disease (AASLD) and several international guidelines, entecavir and tenofovir are recommended as the first-line of NUC therapy in the treatment of CHB [7,8]. Although randomized clinical trials have demonstrated that entecavir and tenofovir have low incidence of drug resistance and a potent antiviral effect [5], due to the high costs of these medications and inadequate medical insurance coverage, entecavir and tenofovir are not affordable or reimbursable for many Chinese patients. Therefore, low-to-moderate generic barrier drugs, including lamivudine, telbivudine, and adefovir dipivoxil are still commonly used in China [9,10].…”

Section: Introductionmentioning

confidence: 99%

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Adherence and perceived barriers to oral antiviral therapy for chronic hepatitis B

Liu

Farazi

et al. 2018

Global Health Action

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Background: Globally, of the 248 million people chronically infected with the hepatitis B virus (HBV), 74 million reside in China. Five oral nucleot(s)ide analogs (NUCs) have been approved for the treatment of chronic hepatitis B (CHB) in China. Objectives: The aims of this study were to determine rates of adherence to NUC therapy in patients with CHB, to identify the self-perceived barriers to adherence, and to examine the factors associated with adherence. Methods: Questionnaire-based interviews were administered among Chinese patients with CHB at hepatology clinics of a tertiary hospital in the city of Wuhan, China. Adults aged 18 years or older prescribed with NUCs were recruited and interviewed to complete a 27-item questionnaire in a private setting, and adherence was measured using the Morisky Medication Adherence Scale (MMAS-8). Results: Among 369 participants, only 16.5% had high adherence (score of 8), 32.2% had medium adherence (score of 6 to <8), and 51.2% were measured with low adherence (score of <6). A logistic regression model was used to determine the factors associated with medication adherence. Significant predictors of high adherence consisted of urban residency, non-cirrhotic status, not using prescribed pills other than HBV medications, and reminders from family members. The five most common reasons for skipping NUCs were that medication(s) are expensive (48.7%), forgetfulness (45.1%), have experienced or worry about potential side effects (19.8%), do not want others to know about my medication(s) usage (18.5%), and ran out of pills and do not have time to refill (15.9%). Conclusions: This study revealed that adherence rates to oral antiviral therapy were far from optimal. This finding should generate public attention, and it would be beneficial for interventional programs to target Chinese patients from rural regions, as well as patients with low socioeconomic status, cirrhosis, and taking multiple medications.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Adherence and perceived barriers to oral antiviral therapy for chronic hepatitis B

Liu

Farazi

et al. 2018

Global Health Action

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“…Although the two forms of pegylated IFN-α produced by pharmaceutical companies are listed as first-line antiviral drugs for chronic hepatitis B treatment by AASLD and EASL [18], for most patients with chronic hepatitis B, especially for those in China, Pegasys or PegIntron are too expensive. Consequently, patients must choose conventional IFN-α with affordable prices.…”

Section: Discussionmentioning

confidence: 99%

Elimination of N-glycosylation by site mutation further prolongs the half-life of IFN-α/Fc fusion proteins expressed in Pichia pastoris

et al. 2016

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BackgroundInterferon (IFN)-α has been commonly used as an antiviral drug worldwide; however, its short half-life in circulation due to its low molecular weight and sensitivity to proteases impacts its efficacy and patient compliance.ResultsIn this study, we present an IgG1 Fc fusion strategy to improve the circulation half-life of IFN-α. Three different forms of IgG1 Fc fragments, including the wild type, aglycosylated homodimer and aglycosylated single chain, were each fused with IFN-α and designated as IFN-α/Fc-WT, IFN-α/Fc-MD, and IFN-α/Fc-SC, respectively. The recombinant proteins were expressed in Pichia pastoris and tested using antiviral and pharmacokinetic assays in comparison with the commercial pegylated-IFN-α (PEG-IFN-α). The in vitro study demonstrated that IFN-α/Fc-SC has the highest antiviral activity, while IFN-α/Fc-WT and IFN-α/Fc-MD exhibited antiviral activities comparable to that of PEG-IFN-α. The in vivo pharmacokinetic assay showed that both IFN-α/Fc-WT and IFN-α/Fc-MD have a longer half-life than PEG-IFN-α in SD rats, but IFN-α/Fc-SC has the shortest half-life among them. Importantly, the circulating half-life of 68.3 h for IFN-α/Fc-MD was significantly longer than those of 38.2 h for IFN-α/Fc-WT and 22.2 h for PEG-IFN-α.ConclusionsThe results demonstrate that the elimination of N-glycosylation by mutation of putative N-glycosylation site further prolongs the half-life of the IFN-α/Fc fusion protein and could present an alternative strategy for extending the half-life of low-molecular-weight proteins expressed by P. pastoris for in vivo studies as well as for future clinical applications.Electronic supplementary materialThe online version of this article (doi:10.1186/s12934-016-0601-9) contains supplementary material, which is available to authorized users.

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“…China has been identified as a region with a high prevalence of HBV; based on the National Disease Supervision Information Management System of China, the mean reported incidence of HBV was 84.3 per 100,000 in China between 2005 and 2010 (2). Despite the reduction in the incidence of the HBV infection, there are ~93 million individuals chronically infected with HBV and ~20 million cases of symptomatic CHB in China currently (3). The high prevalence of CHB poses heavy social and financial burdens for China.…”

Section: Introductionmentioning

confidence: 99%

Hepatitis B patients exhibiting mild alanine aminotransferase elevation: A comparative analysis of treatment with and without Bicyclol tablets

et al. 2016

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Abstract. The aim of the present study was to analyze the medicinal effect of Bicyclol tablets on patients with chronic hepatitis B (CHB) and concomitant mild alanine aminotransferase (ALT) elevation (40-80 IU/l). A retrospective cohort study, which included patients from the hospital information system (HIS; established by the Chinese Academy of Medical Sciences) viral hepatitis database comprised of 18 third-grade class A hospitals in China, was performed. Patients were divided into an exposed group (administered with Bicyclol tablets) and a non-exposed group (no administration of Bicyclol tablets). The CHB patients that exhibited mild ALT elevation provided the curative effect analysis data set, and the patients with viral hepatitis who underwent more than two creatinine/hemoglobin/leucocyte examinations served as the safety analysis data set. The factors influencing ALT normalization rate were analyzed and the safety of Bicyclol tablets was assessed. In total, 82 pairs of patients were included in the curative effect analysis, and single factor analysis revealed that the ALT normalization rate of the exposed group was statistically significantly higher than that of the non-exposed group (P=0.040) for patients with mild ALT elevation. After adjusting for patient age, gender, baseline ALT levels, state of illness upon admission, pattern of hospitalization, hospitalization days and drug combination, the odds ratio (95% confidence interval) of the ALT normalization rate of the exposed group was 2.156 (1.103-4.215) when compared with the non-exposed group. During treatment, the occurrence rates of creatinine/hemoglobin/leucocyte level abnormalities of the exposed group, which were included in the safety analysis were statistically significantly lower than those of the non-exposed group (P<0.05). These findings indicate that Bicyclol tablets improve the ALT normalization rate of CHB patients exhibiting mild ALT elevation. IntroductionChronic hepatitis B (CHB), which is defined as persistence of hepatitis B surface antigen for six months or more, is a major public health problem. According to the World Health Organisation, there are an estimated 240 million chronically infected individuals worldwide, particularly in low-and middle-income countries (1). The major complications of CHB are cirrhosis and hepatocellular carcinoma (HCC). Between 20 and 30% of those who become chronically infected will develop these complications, and an estimated 650,000 individuals will succumb due to CHB annually (1). The majority of individuals are unaware of their hepatitis B virus (HBV) infection, and, therefore, often present at an advanced stage of the disease (1). China has been identified as a region with a high prevalence of HBV; based on the National Disease Supervision Information Management System of China, the mean reported incidence of HBV was 84.3 per 100,000 in China between 2005 and 2010 (2). Despite the reduction in the incidence of the HBV infection, there are ~93 million individuals chronically infected with HBV and ...

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Antiviral therapy for chronic hepatitis B in China

Cited by 28 publications

References 34 publications

Adherence and perceived barriers to oral antiviral therapy for chronic hepatitis B

Adherence and perceived barriers to oral antiviral therapy for chronic hepatitis B

Elimination of N-glycosylation by site mutation further prolongs the half-life of IFN-α/Fc fusion proteins expressed in Pichia pastoris

Hepatitis B patients exhibiting mild alanine aminotransferase elevation: A comparative analysis of treatment with and without Bicyclol tablets

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