Department of Medicine and Therapeutics, Institute of Digestive Disease, The Chinese University of Hong Kong, China.
J Gastroenterol Hepatol. 2011 Jan;26 Suppl 1:131-7. doi: 10.1111/j.1440-1746.2010.06544.x.
Chronic hepatitis B virus (HBV) infection is a major health problem in the Asia-Pacific region. In the past decade, much progress has been made in the understanding and management of this disease. The introduction of universal vaccination has significantly reduced the incidence of perinatal infection in most Asia-Pacific countries. As the majority of the adult population have not been immunized at birth, we are still facing a large population of young HBV-infected patients in the coming two decades. The study of long-term longitudinal databases has provided deeper insight into the clinical significance of HBV DNA suppression, hepatitis B e antigen (HBeAg) seroconversion and hepatitis B surface antigen (HBsAg) seroclearance in chronic hepatitis B. With a better understanding on the natural history of HBV infection, one can now stratify the risk of chronic hepatitis B patients for adverse clinical outcomes and use this to individualize management. The introduction of non-invasive assessment of liver fibrosis can potentially reduce the necessity of liver biopsy. There have also been great advances in the development of antiviral therapy in the past decade. However, the high cost of HBV antiviral drugs poses major challenges to health authorities in many Asia-Pacific countries. Properly performed cost-effective analysis and understanding on the best timing of stopping antiviral drugs will be important to facilitate the most appropriate allocation of resources.
慢性乙型肝炎病毒（HBV）感染是亚太地区的一个主要健康问题。在过去的十年中，人们对这种疾病的认识和管理有了很大的进展。乙肝疫苗的普及接种显著降低了大多数亚太国家围产期感染的发生率。由于大多数成年人在出生时未接种疫苗，我们在未来二十年仍将面临大量的年轻 HBV 感染患者。对长期纵向数据库的研究深入了解了 HBV DNA 抑制、乙型肝炎 e 抗原（HBeAg）血清学转换和乙型肝炎表面抗原（HBsAg）血清学清除在慢性乙型肝炎中的临床意义。通过更好地了解 HBV 感染的自然史，现在可以对慢性乙型肝炎患者的不良临床结局风险进行分层，并据此进行个体化管理。肝纤维化无创评估的引入可能减少肝活检的必要性。在过去十年中，抗病毒治疗也取得了重大进展。然而，HBV 抗病毒药物的高成本给许多亚太国家的卫生当局带来了重大挑战。进行适当的具有成本效益的分析，并了解停止抗病毒药物的最佳时机，对于促进最适当的资源分配非常重要。
