The Taiwan Association for the Study of the Liver yesterday said that there are an estimated 1 million hepatitis B surface antigen (HBsAg) carriers who need medical treatment to prevent the progression of cirrhosis or liver cancer, but only about 170,000 people have accepted treatment.
Taiwan has a relatively high HBsAg-carrier rate of about 10 to 15 percent, said Chien Rong-nan (簡榮南), head of the association and deputy superintendent at Keelung Chang Gung Medical Hospital, adding that the disease is especially prevalent among people above 30 years of age, as hepatitis B vaccinations for newborns were launched in 1984.
“There are an estimated 2.6 to 3 million HBsAg carriers in Taiwan, among them about 1 million to 1.2 million, about 40 percent, are at higher risk of chronic infection and progressing of liver fibrosis, cirrhosis and cancer, so they are in need of medical treatment,” Chien said, adding: “However, medical records from the past 12 years show that only about 170,000 people have sought medical treatment.”
Hepatitis B is an infectious disease caused by the hepatitis B virus (HBV) that attacks the liver, triggering the body’s immune system to target the virus along with infected liver cells, or hepatocytes, thus causing inflammation in the liver, said Dai Chia-yen (戴嘉言), a physician at Kaohsiung Medical University Chung-ho Memorial Hospital.
Liver fibrosis occurs as a result of the repeated injury and repair of hepatocytes, and advanced liver fibrosis can lead to cirrhosis, liver failure or cancer, he said.
“However, because the liver does not contain nerve fibers that sense pain, it is often too late when people notice symptoms associated with liver disease, such as fatigue or nausea,” Dai said.
Statistics obtained through chronic HBV infection screening conducted by Taiwan Liver Research Foundation and the hospital showed that among people found to be hepatitis B carriers, only 43 percent were aware that they were carriers, he said, adding that having a liver examination via a blood test is the best way to prevent and treat the disease at an early stage.
Chien said that a study conducted between 2000 and 2011 on 14,395 chronic hepatitis patients showed that receiving continuous treatment can reduce the prevalence of chronic liver disease and cirrhosis by 22 percent, liver cancer by 14 percent and death from liver cancer by 24 percent.
“Oral medication needs to be taken daily for three years and can effectively suppress the virus, but the disease has a reoccurance rate of 20 to 50 percent after treatment ends,” Chien said, adding that weekly interferon injections for a year is another choice of treatment that can effectively terminate the virus, but might have side effects ,with symptoms similar to a cold.
Patients can discuss with doctors to find out which treatment is best for them, he said, adding that the most important thing is to have regular liver examinations, as well as follow-up examinations or treatment if they are HBsAg carriers.
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