Treatment options for chronic hepatitisBMJ 1999; 319 doi: https://doi.org/10.1136/bmj.319.7213.799 (Published 25 September 1999) Cite this as: BMJ 1999;319:799
Antivirals look promising
- A J Zuckerman, director,
- D Lavanchy, chief
- World Health Organisation Collaborating Centre for Reference and Research on Viral Diseases, Royal Free and University College Medical School, London NW3 2PF
- Viral Diseases Division, Emerging and other Communicable Diseases Surveillance and Control, World Health Organisation, CH-1211 Geneva 27, Switzerland
Over two billion people alive today have been infected with the hepatitis B virus and over 350 million of them are chronically infected carriers, of whom more than 75% are from South East Asia and the Western Pacific region. Although not all carriers are infectious, they represent an important reservoir of infection. Persistent carriers are at high risk of long term complications of infection, including chronic hepatitis, cirrhosis, and hepatocellular carcinoma Hepatitis B infection claims the lives of 1-2 million people every year and thus represents an important public health challenge The recent licensing of a new class of drugs may offer much help to the infected populations of South East Asia, but it also poses a set of problems.
Hepatitis B vaccines, introduced in 1982 and incorporated into universal infant immunisation programmes, have proved successful in preventing infection and have reduced significantly the pool of carriers in several countries. Nevertheless, there remains a need for a treatment for persistent carriers to prevent them developing progressive liver disease. Cirrhosis and hepatocellular carcinoma are caused by active replication of hepatitis B virus in the hepatocytes. Hence, the primary goal of treatment is to eliminate the virus or stop its …