Liver disease in Viet Nam: Screening, surveillance, management and education: A 5‐year plan and call to action

Abstract

Despite a high prevalence of liver disease in Viet Nam, there has been no nationwide approach to the disease and no systematic screening of at-risk individuals. Risk factors include chronic hepatitis B (estimated prevalence of 12%), chronic hepatitis C (at least 2% prevalence), and heavy consumption of alcohol among men. This combination of factors has resulted in liver cancer being the most common cause of cancer death in Viet Nam. There is a general lack of understanding by both the general public and health-care providers about the major risk to health that liver disease represents. We report here the initial steps taken as part of a comprehensive approach to liver disease that will ultimately include nationwide education for health-care providers, health educators, and the public; expansion of nationwide screening for hepatitis B and C followed by hepatitis B virus vaccination or treatment of chronic hepatitis B and/or hepatitis C; education about alcoholic liver disease; long-term surveillance for liver cancer; reduction of infection transmission related to medical, commercial, and personal re-use of contaminated needles, syringes, sharp instruments, razors, and inadequately sterilized medical equipment; and ongoing collection and analysis of data about the prevalence of all forms of liver disease and the results of the expanded screening, vaccination, and treatment programs. We report the beginning results of our pilot hepatitis B screening program. We believe that this comprehensive nationwide approach could substantially reduce the morbidity and mortality from liver disease and greatly lessen the burden in terms of both lives lost and health-care costs.

High Prevalence and Significance of Hepatitis D Virus Infection among Treatment-Naïve HBsAg-Positive Patients in Northern Vietnam

“…Due to the late introduction of a HBV vaccination program in 2003, more than 9.5 million people are estimated to be chronically infected with HBV with 10.7% of the general population being HBsAg-positive [29,30], while HBV-related mortality may increase to 40.000 individuals in 2025 [31]. HBV infection is therefore a major public health burden in Vietnam.…”

Mortality measures from sample-based surveillance: evidence of the epidemiological transition in Viet Nam

“…Furthermore, although liver cancer is a leading cause of death in both males and females, chronic hepatitis B among adults probably accounts for a large proportion of liver cancers in Viet Nam. 24 Although these mortality indicators suggest that Viet Nam is experiencing an epidemiological transition, the country's current mixed burden of communicable and non-communicable diseases, as well as injuries, illustrates that the country's health sector priorities cover a broad range.…”

Sociodemographic Characteristics, Knowledge and Prevalence of Viral Hepatitis Infection Among Vietnamese Americans at Community Screenings

“…In Vietnam, the estimated prevalence of chronic HCV ranged from 1% in the low risk general population to 87% in the high risk drug injection population (5), which showed the importance of assessing the prevalence of HCV infection among immigrants from Vietnam. However, there are only a few studies that have examined the prevalence of hepatitis C virus (HCV) infection among Vietnamese Americans (VAs), with the prevalence ranging from 2.2% to 15.4% (6,7).…”