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Frontiers of Medicine

Front. Med.    2014, Vol. 8 Issue (2) : 135-144     DOI: 10.1007/s11684-014-0331-5
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Chronic hepatitis B virus infection: epidemiology, prevention, and treatment in China
Rui Yu,Rong Fan,Jinlin Hou()
Hepatology Unit and Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
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Abstract

Chronic hepatitis B is a major health problem in China. The universal vaccination program since 1992 has changed the epidemiology of hepatitis B virus infection in China from highly to moderately endemic. The most prevalent hepatitis B virus strains in China are genotypes B and C, whereas those in western provinces are genotypes D and C/D hybrid. Chronic hepatitis B poses a heavy burden to the society in China. Different treatment strategies have been explored to improve patient outcomes in a cost-effective manner. However, antiviral drugs with a low genetic barrier to resistance are still extensively used because of the generally low income and limited resources in China. Individualized antiviral therapy is closely associated with translational medicine, which utilizes information from studies on genomics, immune biomarkers, and fibrosis. The results of these studies are crucial in further improving treatment outcomes.

Keywords chronic hepatitis B      epidemiology      prevention      treatment     
Corresponding Authors: Jinlin Hou   
Issue Date: 21 May 2014
 Cite this article:   
Jinlin Hou,Rui Yu,Rong Fan. Chronic hepatitis B virus infection: epidemiology, prevention, and treatment in China[J]. Front. Med., 2014, 8(2): 135-144.
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http://journal.hep.com.cn/fmd/EN/Y2014/V8/I2/135
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Fig.1  Distribution of antiviral drugs for chronic hepatitis B used in clinical practice in China. June 2012 to December 2013 (Data from 31905 patients enrolled in treatment survey in China Registry of Hepatitis B). CHB, chronic hepatitis B; NAs, nucleos(t)ide analogs. IFNs, interferons; LAM, lamivudine; ETV, entecavir; ADV, adefovir; TDF, tenofovir; LDT, telbivudine. a including hepatic protectant, immunomodulator, traditional Chinese medicine and drugs unknown.
Nucleos(t)ide analogsLamivudineAdefovirTelbivudineEntecavirTenofovir
HBeAg statusNPNPNPNPNP
Duration (year)35554b4b3577
HBV DNA<300–400 copies/ml (%)40NA533986.476.298949999
HBeAg seroconversion (%)/44a/30/53.2/23/40
HBsAg loss (%)NANA520.61.9NA1.4NA12
HBV resistance (%)NA71292015.918.81.2c00
Tab.1  Latest results of major clinical studies on the efficacy and drug- resistance of nucleos(t)ide analogs
Fig.2  Response-guided therapy for pegylated interferon treatment in patients with chronic hepatitis B.
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