How to improve access to therapy in hepatitis B patients

Abstract

Despite the availability of a preventive vaccine and active antiviral treatments that stop disease progression and reduce the risk of hepatocellular carcinoma, hepatitis B is still a major public health problem. Only an estimated 10% of the 257 million people living with HBV have been diagnosed and as few as 1% are being adequately treated. Barriers to diagnosis and treatment include: (i) limited awareness and lack of knowledge about HBV infection and HBV‐related diseases; (ii) under‐diagnosis with insufficient screening and referral to care; (iii) limited treatment due to drug availability, costs, reimbursement policies and the need for long‐term or life‐long therapy. These barriers and the actions needed to improve access to treatment are strongly influenced by the prevalence of infection and affect middle‐high vs low‐middle income countries differently, where most HBV carriers are found. In high‐prevalence regions and low‐to middle‐income countries, the main challenges are availability and cost while in low‐prevalence regions and middle‐to high‐income countries low screening rates, public awareness, social stigma and discrimination play an important role. Overcoming these challenges on a global scale is a complex clinical and public health challenge and multilateral commitment from pharmaceutical companies, governments, funders and the research community is lacking. The new WHO 2016 Global Health Sector Strategy on viral hepatitis targets testing and treatment, suggesting that important but strong actions are needed from advocacy groups, scientific societies and funding agencies to foster awareness and access to cure.

 

KEYWORDS
access to treatment, chronic HBV infection, disease awareness, HBV screening, vaccine availability

 

About Speaker

Fabien ZOULIM

Professor of Medicine, Lyon University, Institut Universitaire de France // Medical Director, Hepatology Department at the Hospices Civils de Lyon, France // Scientific Director, Viral Hepatitis Research Laboratory, INSERM U1052, Cancer Research Center of Lyon, France

France

City: Lyon

Institution: Lyon University and INSERM

Contact: fabien.zoulim@inserm.fr


Biography of Fabien ZOULIM

Fabien Zoulim obtained his M.D. in Gastroenterology and Hepatology in Lyon Medical School in 1991. He has also obtained a PhD in Molecular and Cellular Biology and was trained as a post-doctoral researcher at Fox Chase Cancer Center in Philadelphia. He is Professor of Medicine at Lyon I University since 1997. He is currently Medical Director of the Hepatology Department at the Hospices Civils de Lyon, and Scientific Director of the Department of Immunology and Virology of INSERM Unit 1052 where he is leading the team on ‘Antiviral therapy of viral hepatitis’. Dr Zoulim has served as an Associate Editor for Journal of Hepatology and is currently Associate Editor for Gut. He also served as an expert in the microbiology study section of the INSERM and is currently head of the clinical viral hepatitis study section at ANRS. He served as a Governing Board member of the European Association for the Study of the Liver (EASL). Dr Zoulim received the William Prusoff award of the International Society for Antiviral Research. Furthermore, he has been the scientific coordinator of a European community-funded Network of Excellence on the management of antiviral drug resistance, and is currently head of the ANRS “HBV cure” program in France. Fabien Zoulim is a recognised expert in the field of viral hepatitis and antiviral therapy. He has published more than 350 articles (H index 63, Web of Science).

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