Japan Digestive Disease Week 2025
Invited Lecture (JSH)
October 30, 9:00–9:30, Room 4 (Portopia Hotel South Wing Portopia Hall)
Invited Lecture-16
Universal HBV Vaccination and Antiviral Therapy for Eliminating Hepatitis B
- Hepatitis Research Center, National Taiwan University Hospital
Hepatitis B infections sharply declined since the implementation of unviersal HBV vaccination. In the vaccination population cohorts (born after 1990), acute HBV infections drops to one per 10,000 year in and chronic hepatitis B to around 0.5% in many countries. This is followed by a dramatic reduction (50-60%)of HBV-related end-stage liver diseases and liver-related HCC or death in this cohort. Therefore, the most important HBV control is to maintain a omprehensive HBV vaccinations worldwide for next devades.
For the pre-vaccination population, they still suffer a high HBsAg carrier rates (world-wide around 4%). About 20% of these carriers, if not treated, will progress into end-stage liver diseases. Long-term antiviral regimens (viral reverse transcriptase inhibitors) has shown effectively reduced the risk to ESLD (about 50% reduction) in the eligibale patients. Despite of these clinical benefits, only 10% of those CHB patients meeting current lhepatology-socity treatment guidlines received treatments. Not mentioning those beyond these guidelines are left without adequate care. Recognizing the gaping gap in untreated CHB patients, WHO released new guidlines in year 2024, aiming to simplify the guidlines and to expand the accessity so about 50% of CHB patients to be treated. This is a significant milestones in rolling out antivral therapy and deserves to be considered in areas when appropriate. Finally, the policy of universal anti-viral therapy for HIV-infected patients results in restoring their life expectancy equivalent to non-infected people, showing the value to universal treatment in fighting chronic viral infection. Recent studies also showed this policy useful and helpful in CHB in several countries.
In conclusion, a unviersal HBV vaccination and antiviral therapy policy emerges as the simple, accessible and probably most effective in controling hepatitis B in the world. It is imperative to collborate with public helath system, and physicians of other disciplines to convert HBV epidemic to a rare disease for future generations.
For the pre-vaccination population, they still suffer a high HBsAg carrier rates (world-wide around 4%). About 20% of these carriers, if not treated, will progress into end-stage liver diseases. Long-term antiviral regimens (viral reverse transcriptase inhibitors) has shown effectively reduced the risk to ESLD (about 50% reduction) in the eligibale patients. Despite of these clinical benefits, only 10% of those CHB patients meeting current lhepatology-socity treatment guidlines received treatments. Not mentioning those beyond these guidelines are left without adequate care. Recognizing the gaping gap in untreated CHB patients, WHO released new guidlines in year 2024, aiming to simplify the guidlines and to expand the accessity so about 50% of CHB patients to be treated. This is a significant milestones in rolling out antivral therapy and deserves to be considered in areas when appropriate. Finally, the policy of universal anti-viral therapy for HIV-infected patients results in restoring their life expectancy equivalent to non-infected people, showing the value to universal treatment in fighting chronic viral infection. Recent studies also showed this policy useful and helpful in CHB in several countries.
In conclusion, a unviersal HBV vaccination and antiviral therapy policy emerges as the simple, accessible and probably most effective in controling hepatitis B in the world. It is imperative to collborate with public helath system, and physicians of other disciplines to convert HBV epidemic to a rare disease for future generations.