Management of hepatitis C virus infection in the Asia-Pacific region: an update

Lim, Seng Gee; Aghemo, Alessio; Chen, Pei‐Jer; Dan, Yock Young; Gane, Edward; Gani, Rino Alvani; Gish, Robert G.; Guan, R; Jia, Ji Dong; Lim, Kieron; Piratvisuth, Teerha; Shah, Samir; Shiffman, Mitchell L.; Tacke, Frank; Tan, Soek Siam; Tanwandee, Tawesak; Win, Khin Maung; Yurdaydın, Cihan

doi:10.1016/s2468-1253(16)30080-2

Cited by 49 publications

(48 citation statements)

References 81 publications

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“…Similarly, for patients with HCV, cheaper interferon-free direct-acting antiviral regimens that are included in reimbursement lists are urgently needed. 389,390 Future efforts to reduce hepatitis-related morbidity and mortality in China should focus on preventive strategies, safe blood practices, public education, and training health staff for large-scale HBV and HCV testing and treatment provision. 391 A strict action plan to reduce the harmful use of alcohol such as an excise tax on beer, wine, and spirits, and legally binding regulations on alcohol advertising should be implemented.…”

Section: Priorities To Address the Burden Of Liver Diseases In The Asmentioning

confidence: 99%

Liver diseases in the Asia-Pacific region: a Lancet Gastroenterology & Hepatology Commission

Sarin

Kumar

Eslam

et al. 2020

The Lancet Gastroenterology & Hepatology

365

303

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The Asia-Pacific region is home to more than half of the global population and accounted for 62·6% of global deaths due to liver diseases in 2015. 54·3% of global deaths due to cirrhosis, 72·7% of global deaths due to hepatocellular carcinoma, and more than two-thirds of the global burden of acute viral hepatitis occurred in this region in 2015. Chronic hepatitis B virus (HBV) infection caused more than half of the deaths due to cirrhosis in the region, followed by alcohol consumption (20·8%), non-alcoholic fatty liver disease (NAFLD; 12·1%), and chronic infection with hepatitis C virus (HCV; 15·7%). In 2015, HBV accounted for about half the cases of hepatocellular carcinoma in the region. Preventive strategies for viral hepatitis-related liver disease include increasing access to clean drinking water and sanitation. HBV vaccination programmes for neonates have been implemented by all countries, although birthdose coverage is extremely suboptimal in some. Availability of screening tests for blood and tissue, donor recall policies, and harm reduction strategies are in their initial stages in most countries. Many governments have put HBV and HCV drugs on their essential medicines lists and the availability of generic versions of these drugs has reduced costs. Efforts to eliminate viral hepatitis as a public health threat, together with the rapid increase in per-capita alcohol consumption in countries and the epidemic of obesity, are expected to change the spectrum of liver diseases in the Asia-Pacific region in the near future. The increasing burden of alcohol-related liver diseases can be contained through government policies to limit consumption and promote less harmful patterns of alcohol use, which are in place in some countries but need to be enforced more strictly. Steps are needed to control obesity and NAFLD, including policies to promote healthy lifestyles and regulate the food industry. Inadequate infrastructure and insufficient health-care personnel trained in liver diseases are issues that also need to be addressed in the Asia-Pacific region. The policy response of most governments to liver diseases has thus far been inadequate and poorly funded. There must be a renewed focus on prevention, early detection, timely referral, and research into the best means to introduce and improve health interventions to reduce the burden of liver diseases in the Asia-Pacific region. 168 www.thelancet.com/gastrohep Vol 5 February 2020The Lancet Gastroenterology & Hepatology Commission accounted for 108 276 (8·2%) of the total liver-related deaths in the region in 2015, compared with 929 (1·2%) of 72 437 in the USA and 4032 (0·3%) of 197 179 in Europe. Deaths in the Asia-Pacific region represented three-quarters of the global total number of deaths due to acute viral hepatitis. In 2015, the region accounted for three-quarters of the global total number of deaths related to acute HBV, almost two-thirds of those due to acute hepatitis A infection, and almost 80% of those due to acute hepatitis E infection. Of all deaths du...

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Section: Priorities To Address the Burden Of Liver Diseases In The Asmentioning

confidence: 99%

Liver diseases in the Asia-Pacific region: a Lancet Gastroenterology & Hepatology Commission

Sarin

Kumar

Eslam

et al. 2020

The Lancet Gastroenterology & Hepatology

365

303

View full text Add to dashboard Cite

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“…The new direct‐acting antivirals (DAAs) represent a significant breakthrough in the HCV treatment paradigm . Sustained virological response (SVR) rates have been reported as high as 97% for certain patients . However, according to China’s HCV treatment guidelines published in 2014, the current standard of care for treating HCV has been the combination of pegylated interferon (Peg‐IFN) and ribavirin (RBV).…”

mentioning

confidence: 99%

The Burden of Chronic Hepatitis C in China From 2004 to 2050: An Individual‐Based Modeling Study

Zhou

et al. 2019

Hepatology

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The launch of new direct‐acting antivirals (DAAs) is expected to substantially reduce the burden of hepatitis C virus (HCV) in China. However, the effect of these changes has not yet been modeled in China. Therefore, we aim to predict the burden of HCV‐related diseases in China by simulating different scenarios that incorporate recent therapeutic advances of HCV and China’s current screening strategy. We developed an individual‐based microsimulation Markov model that simulated disease progression of HCV‐infected patients in China from 2004 to 2050. We simulated four scenarios with different assumptions about treatment, including a natural history scenario, a pre‐DAAs scenario, a DAA treatment for all patients with a METAVIR fibrosis score ≥F3 (DAAs [≥F3]) scenario, and a DAAs (≥F0) scenario. The introduction of DAAs is predicted to have great impacts on the burden of HCV in China, particularly under the DAAs (≥F0) scenario in which we rapidly expand DAAs to all HCV‐infected patients (≥F0) in 2021. Under this scenario, prevalence of chronic HCV is expected to peak at 10.75 million (95% confidence interval [CI], 8.30‐12.85) around 2020 and then decrease to 7.92 million (95% CI, 5.41‐10.08) in 2050. Conclusion: If the future increasing burden of HCV‐related diseases is to be averted, China needs to start launching the new DAA treatment and rapidly increase the number of patients treated. However, to maximize the benefits of new DAAs, expanded screening is necessary to identify more cases that require treatment in the short term. Without these changes, the HCV burden in China will remain high in the future.

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“…Given these findings, yimitasvir phosphate can be a suitable adjunct drug for DAA combination therapy. [30] In conclusion, our results showed that yimitasvir phosphate, a new inhibitor of NS5A complex, can be administered orally at daily dose of 100 mg and is well tolerated. Yimitasvir phosphate robustly reduced the HCV RNA level even after a single dose in genotype 1b patients.…”

Section: Discussionmentioning

confidence: 57%

“…Furthermore, yimitasvir phosphate exhibits additive or synergistic effects to NS5B and NS3 inhibitors in the replicon system (data not shown). Given these findings, yimitasvir phosphate can be a suitable adjunct drug for DAA combination therapy …”

Section: Discussionmentioning

confidence: 98%

Clinical evaluation of efficacy, tolerability and pharmacokinetics of yimitasvir phosphate in patients infected with hepatitis C virus

Zhang

Zhu

et al. 2018

Journal of Pharmacy and Pharmacology

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Management of hepatitis C virus infection in the Asia-Pacific region: an update

Cited by 49 publications

References 81 publications

Liver diseases in the Asia-Pacific region: a Lancet Gastroenterology & Hepatology Commission

Liver diseases in the Asia-Pacific region: a Lancet Gastroenterology & Hepatology Commission

The Burden of Chronic Hepatitis C in China From 2004 to 2050: An Individual‐Based Modeling Study

Clinical evaluation of efficacy, tolerability and pharmacokinetics of yimitasvir phosphate in patients infected with hepatitis C virus

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