Cost Assessment of Hepatitis B Virus-related Hepatitis in Bangladesh

Abstract

Hepatitis B virus (HBV) infection is endemic in Bangladesh. Studies have indicated that HBV is the major cause of chronic hepatitis B (CHB), liver cirrhosis (LC), and hepatocellular carcinoma (HCC) in this country. Recently, HBV-related acute on chronic liver failure (HBV-ACLF) has emerged as a serious and emergent medical problem in Bangladesh. To develop a strategy to address HBV-related problems and their influence on health care delivery system, proper understandings about extent of problems and nature of economic burden should be explored. Conservative estimates indicate that about 50 million or more of Bangladeshi have been infected by HBV at some point of their life. Out of the total Bangladeshi population, about 2 to 5% is chronically infected with HBV (about 3–8 million) (1–6%) and considerable number of these patients will eventually develop LC, HCC, or ACLF (about 1 million). Although proper statistics is lacking, it is estimated that HBV-related liver diseases account for a majority of hospital admissions and around 20,000 deaths every year in Bangladesh. In addition, complex clinical features of HBV-related liver diseases have been documented in Bangladesh that show similarity and differences from HBV infection in other Asian countries. Although vaccination against HBV and containment of horizontal transmission are in progress in Bangladesh for reduction of new HBV infection, there is a lack of national strategy for treatment of millions of chronic HBV-infected subjects. This paper will provide an insight regarding the economic impact of HBV in Bangladesh that may act as a primary impetus for developing national HBV eradication program, a goal set by World Health Organization (WHO).How to cite this articleAl Mahtab M, Chaudhury M, Uddin MH, Noor-E-Alam SM, Rahim MA, Alam MA, Moben AL, Khondaker FA, Choudhury MFI, Sarkar MJA, Poddar PK, Foez SA, Akbar SMF. Cost Assessment of Hepatitis B Virus-related Hepatitis in Bangladesh. Euroasian J Hepato-Gastroenterol 2016;6(2):163-166.

A meta-analysis on genetic variability of RT/HBsAg overlapping region of hepatitis B virus (HBV) isolates of Bangladesh

“…Patients harboring HBV infection showing false-negative diagnosis are more harmful and lead to the development of chronic carrier followed by HCC which demands the establishment of new diagnostic kits [40]. Around 2–5% of the total population in Bangladesh are suffering with chronic HBV infection which require extensive treatment cost [41]. The commonly anti HBV drugs used in Bangladesh are Lamivudine, Adefovir.…”

Five-year Follow-up of Chronic Hepatitis B Patients Immunized by Nasal Route with the Therapeutic Vaccine HeberNasvac

“…The present results are also in agreement with pre-clinical pharmacological studies in AAV-HBV transfected mice, demonstrating a high proportion of HBV-specific and multifunctional CD4+ T cells in the liver after repeated IN administration of HeberNasvac. 13 Phase I/ II study conducted in treatment naïve patients also evidenced that patients PBMC preferentially induced Th1 cytokines after IN immunization. 9…”

“…19-21 In addition, IN administration may offer qualitative advantages for active and specific therapeutic vaccinations. 13…”

“…Although major studies with HeberNasvac were conducted in treatment-naïve CHB patients immunized by both IN and SC routes, further studies in different patient groups pharmacological studies have shown that the nasal route deserves further attention 13 The present work describes the retrospective analysis of the virological, biochemical and serological variables of CHB patients during 5 years after only IN immunization with HeberNasvac.…”

Treatment by Transarterial Chemoembolization and Sorafenib for Hepatocellular Carcinoma vs Advanced Hepatocellular Carcinoma in Bangladesh: A Real-life Situation

“…6 Bangladesh is a country of about 170 million people with hepatitis B virus (HBV) carrier rate of 2-5% and hepatitis C virus (HCV) carrier rate of about 1%. 7 Although nation-wise epidemiological data are not available about prevalence of HCC in Bangladesh, there seems 1,3 to be several thousand patients with HCC in this country. However, a workable and standardized surveillance and management system of HCC is yet to be developed for Bangladesh.…”