Treatment of chronic Hepatitis B in resource-constrained countries: An economic solution is required

摘要

In this issue of JVH, we have published a series of articles describing some current practises in China where the majority of patients with CHB live. Professor Jia and most Chinese physicians acknowledge the fact that the use of the most potent drugs, tenofovir and entecavir, will minimize the risks of development of viral resistance, but these are expensive and not currently widely available in China. As a result, treatment has often been started with lamivu-dine or telbivudine which are less expensive. This has resulted in many patients developing viral resistance and recurrence of progressive liver disease within the first 5 years of treatment, in a disease where viral suppression is needed for many decades. Thus, although some patients with cirrhosis may derive clinical benefit initially, over the long term, the disease will progress with a return of significant risk of death from hepatic decompensation and HCC.