Treatment of chronic hepatitis B in Asia-Pacific countries: Is the Asia-Pacific consensus statement being followed?

Joseph J.Y. Sung, Deepak Amarapurkar, Henry L.Y. Chan, Jun Cheng, Jia Horng Kao, KwangHyub Han, Teerha Piratvisuth

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: The Asia-Pacific consensus guidelines for the management of chronic hepatitis B state that the principal indicators for starting therapy are increased HBV DNA levels (≥20,000 IU/ml for hepatitis B e antigen [HBeAg]-positive status and >2,000 IU/ml for HBeAg-negative status) and alanine aminotransferase (ALT) levels >2x the upper limit of normal. We aimed to determine whether clinicians in the Asia-Pacific region are treating patients with chronic hepatitis B according to the Asia-Pacific consensus statement on the management of chronic hepatitis B. Methods: An online survey of chronic hepatitis B treatment practices was prepared, consisting of 14 questions grouped into seven categories: patient statistics, treatment statistics, treatment decision, first-choice treatment, treatment duration, future directions and patient preference. Results: In total, 124 respondents from 12 countries completed the survey. Most respondents indicated that detectable HBV DNA was either the first or second most important factor when deciding whether to initiate therapy. Many physicians were unsure about initiation of treatment in patients >40 years of age when ALT levels were within the normal range. Oral antiviral drugs were the most frequently used medication because of their effectiveness, safety and ability to provide sustained viral suppression. Conversely, the most important reasons for selecting interferon therapy were effectiveness, fixed duration of treatment and lack of drug resistance. Criteria for stopping treatment generally followed the recommendations included in the guidelines. Conclusions: These data suggest that clinicians from the Asia-Pacific region use criteria beyond those advocated in treatment guidelines when deciding whether to initiate treatment in HBV-infected patients.

Original languageEnglish
Pages (from-to)607-616
Number of pages10
JournalAntiviral Therapy
Volume15
Issue number4
DOIs
Publication statusPublished - 2010 Sep 24

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Chronic Hepatitis B
Therapeutics
Hepatitis B e Antigens
Guidelines
Alanine Transaminase
Patient Preference
DNA
Drug Resistance
Interferons
Antiviral Agents
Reference Values

All Science Journal Classification (ASJC) codes

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

Cite this

Sung, J. J. Y., Amarapurkar, D., Chan, H. L. Y., Cheng, J., Kao, J. H., Han, K., & Piratvisuth, T. (2010). Treatment of chronic hepatitis B in Asia-Pacific countries: Is the Asia-Pacific consensus statement being followed? Antiviral Therapy, 15(4), 607-616. https://doi.org/10.3851/IMP1561
Sung, Joseph J.Y. ; Amarapurkar, Deepak ; Chan, Henry L.Y. ; Cheng, Jun ; Kao, Jia Horng ; Han, KwangHyub ; Piratvisuth, Teerha. / Treatment of chronic hepatitis B in Asia-Pacific countries : Is the Asia-Pacific consensus statement being followed?. In: Antiviral Therapy. 2010 ; Vol. 15, No. 4. pp. 607-616.
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abstract = "Background: The Asia-Pacific consensus guidelines for the management of chronic hepatitis B state that the principal indicators for starting therapy are increased HBV DNA levels (≥20,000 IU/ml for hepatitis B e antigen [HBeAg]-positive status and >2,000 IU/ml for HBeAg-negative status) and alanine aminotransferase (ALT) levels >2x the upper limit of normal. We aimed to determine whether clinicians in the Asia-Pacific region are treating patients with chronic hepatitis B according to the Asia-Pacific consensus statement on the management of chronic hepatitis B. Methods: An online survey of chronic hepatitis B treatment practices was prepared, consisting of 14 questions grouped into seven categories: patient statistics, treatment statistics, treatment decision, first-choice treatment, treatment duration, future directions and patient preference. Results: In total, 124 respondents from 12 countries completed the survey. Most respondents indicated that detectable HBV DNA was either the first or second most important factor when deciding whether to initiate therapy. Many physicians were unsure about initiation of treatment in patients >40 years of age when ALT levels were within the normal range. Oral antiviral drugs were the most frequently used medication because of their effectiveness, safety and ability to provide sustained viral suppression. Conversely, the most important reasons for selecting interferon therapy were effectiveness, fixed duration of treatment and lack of drug resistance. Criteria for stopping treatment generally followed the recommendations included in the guidelines. Conclusions: These data suggest that clinicians from the Asia-Pacific region use criteria beyond those advocated in treatment guidelines when deciding whether to initiate treatment in HBV-infected patients.",
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Sung, JJY, Amarapurkar, D, Chan, HLY, Cheng, J, Kao, JH, Han, K & Piratvisuth, T 2010, 'Treatment of chronic hepatitis B in Asia-Pacific countries: Is the Asia-Pacific consensus statement being followed?', Antiviral Therapy, vol. 15, no. 4, pp. 607-616. https://doi.org/10.3851/IMP1561

Treatment of chronic hepatitis B in Asia-Pacific countries : Is the Asia-Pacific consensus statement being followed? / Sung, Joseph J.Y.; Amarapurkar, Deepak; Chan, Henry L.Y.; Cheng, Jun; Kao, Jia Horng; Han, KwangHyub; Piratvisuth, Teerha.

In: Antiviral Therapy, Vol. 15, No. 4, 24.09.2010, p. 607-616.

Research output: Contribution to journalArticle

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T1 - Treatment of chronic hepatitis B in Asia-Pacific countries

T2 - Is the Asia-Pacific consensus statement being followed?

AU - Sung, Joseph J.Y.

AU - Amarapurkar, Deepak

AU - Chan, Henry L.Y.

AU - Cheng, Jun

AU - Kao, Jia Horng

AU - Han, KwangHyub

AU - Piratvisuth, Teerha

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Y1 - 2010/9/24

N2 - Background: The Asia-Pacific consensus guidelines for the management of chronic hepatitis B state that the principal indicators for starting therapy are increased HBV DNA levels (≥20,000 IU/ml for hepatitis B e antigen [HBeAg]-positive status and >2,000 IU/ml for HBeAg-negative status) and alanine aminotransferase (ALT) levels >2x the upper limit of normal. We aimed to determine whether clinicians in the Asia-Pacific region are treating patients with chronic hepatitis B according to the Asia-Pacific consensus statement on the management of chronic hepatitis B. Methods: An online survey of chronic hepatitis B treatment practices was prepared, consisting of 14 questions grouped into seven categories: patient statistics, treatment statistics, treatment decision, first-choice treatment, treatment duration, future directions and patient preference. Results: In total, 124 respondents from 12 countries completed the survey. Most respondents indicated that detectable HBV DNA was either the first or second most important factor when deciding whether to initiate therapy. Many physicians were unsure about initiation of treatment in patients >40 years of age when ALT levels were within the normal range. Oral antiviral drugs were the most frequently used medication because of their effectiveness, safety and ability to provide sustained viral suppression. Conversely, the most important reasons for selecting interferon therapy were effectiveness, fixed duration of treatment and lack of drug resistance. Criteria for stopping treatment generally followed the recommendations included in the guidelines. Conclusions: These data suggest that clinicians from the Asia-Pacific region use criteria beyond those advocated in treatment guidelines when deciding whether to initiate treatment in HBV-infected patients.

AB - Background: The Asia-Pacific consensus guidelines for the management of chronic hepatitis B state that the principal indicators for starting therapy are increased HBV DNA levels (≥20,000 IU/ml for hepatitis B e antigen [HBeAg]-positive status and >2,000 IU/ml for HBeAg-negative status) and alanine aminotransferase (ALT) levels >2x the upper limit of normal. We aimed to determine whether clinicians in the Asia-Pacific region are treating patients with chronic hepatitis B according to the Asia-Pacific consensus statement on the management of chronic hepatitis B. Methods: An online survey of chronic hepatitis B treatment practices was prepared, consisting of 14 questions grouped into seven categories: patient statistics, treatment statistics, treatment decision, first-choice treatment, treatment duration, future directions and patient preference. Results: In total, 124 respondents from 12 countries completed the survey. Most respondents indicated that detectable HBV DNA was either the first or second most important factor when deciding whether to initiate therapy. Many physicians were unsure about initiation of treatment in patients >40 years of age when ALT levels were within the normal range. Oral antiviral drugs were the most frequently used medication because of their effectiveness, safety and ability to provide sustained viral suppression. Conversely, the most important reasons for selecting interferon therapy were effectiveness, fixed duration of treatment and lack of drug resistance. Criteria for stopping treatment generally followed the recommendations included in the guidelines. Conclusions: These data suggest that clinicians from the Asia-Pacific region use criteria beyond those advocated in treatment guidelines when deciding whether to initiate treatment in HBV-infected patients.

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