Monitoring inactive hepatitis B patients is cost-effective strategy for Shanghai

A novel study determined that monitoring inactive chronic hepatitis B (HBV) carriers is a cost-effective strategy for China. However, results published in Hepatology, a journal of the American Association for the Study of Liver Diseases, show that increasing treatment, monitoring and adherence to therapy are necessary to achieve significant health benefits at the population level.

The World Health Organization (WHO) estimates that roughly 2 billion individuals worldwide have been infected with HBV—a virus causing acute or that may lead to cirrhosis or (, HCC). WHO reports that 240 million are living with chronic HBV, with 1.4 million of those individuals in the U.S. according to estimates from the Centers for Disease Control and Prevention (CDC).

Previous research shows that 60% of the population in China has been infected with HBV and up to 10% are chronically infected, placing them at risk for life-threatening liver disease. In fact, medical evidence estimates that 500,000 Chinese die each year from HBV-related causes.

"China has the largest concentration of people infected with chronic HBV and understanding the health and economic impact is extremely important," explains Dr. Mehlika Toy from the Asian Liver Center at Stanford University School of Medicine who spearheaded the study while she was a Takemi Fellow at the Harvard School of Public Health in Boston, Massachusetts. "Our study is the first to analyze cost and cost-effectiveness of monitoring inactive CHB patients in Shanghai."

Using simulation models, the research team compared the current strategy of not monitoring inactive chronic HBV patients to a monitor and treat (M&T) strategy. The M&T strategy would include twice-yearly assessment of HBV and alanine transaminase (ALT) levels in patients with chronic HBV. For active HBV cases the researchers suggest treatment with entecavir, which evidence shows to be a cost-effective antiviral therapy in China.

Results show that there were 1.5 million adult carriers of HBV in Shanghai, with 63% of those hepatitis B virus e antigen (HBeAg) positive. The number of active cases of chronic HBV, were 258,139 HBeAg-positive group and 152,384 in the HBeAg-negative group. Researchers estimated that the M&T strategy would cost $20,730 (U.S.) and result in 15.45 quality-adjusted life-years (QALYs) per patient, compared to $20,455 and 15.35 QALYs for the current practice.

"Our findings suggest that monitoring of chronic HBV patients is cost-effective, but relies on identifying more cases of HBV infection, and increasing treatment, monitoring, and antiviral adherence to achieve health gains," concludes Dr. Toy. "We estimate that with adherence to monitoring and treatment, HCC could be reduced by 70% and mortality caused by chronic HBV by 83%."

More information: "Population Health Impact and Cost-Effectiveness of Monitoring Inactive Chronic Hepatitis B And Treating Eligible Patients In Shanghai, China." Mehlika Toy, Joshua A Salomon, Jiang Hao, Gui Honglian, Hui Wang, Jiangshe Wang, Jan Hendrik Richardus and Qing Xie. Hepatology; (DOI: 10.1002/hep.26934).

add to favorites email to friend print save as pdf

Related Stories

Men-only hepatitis B mutation explains higher cancer rates

Oct 17, 2013

A team of researchers has identified a novel mutation in the hepatitis B virus (HBV) in Korea that appears only in men and could help explain why HBV-infected men are roughly five times more likely than HBV-infected women ...

Recommended for you

Ebola death toll passes 7,500

4 hours ago

More than 7,500 people have now died from the Ebola virus, as the number of cases climbs towards 20,000, the World Health Organization said Monday.

Ebola-infected Italian doctor 'recovering'

4 hours ago

An Italian doctor who contracted Ebola in west Africa is recovering but is still in an isolation unit, the specialist clinic in Rome treating him said Monday.

Restrictions lifted at British bird flu farm

Dec 21, 2014

Britain on Sunday lifted all restrictions at a duck farm in northern England after last month's outbreak of H5N8 bird flu, the same strain seen in recent cases across Europe.

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.