Many hepatitis B cases go undetected

New global network launched to aid countries in drawing up battle plans

By Poon Chian Hui, The Straits Times, 8 Jun 2013

AS MANY as 160,000 people in Singapore are estimated to be infected with hepatitis B.

The life-threatening disease can cause liver cancer, but with symptoms rarely appearing, many do not know they have it till it is too late, said liver specialist Lim Seng Gee, director of hepatology at the National University Health System.

He is also chairman for the Asian Pacific Association for the Study of the Liver's (APASL) Liver Week conference, which began yesterday at Suntec City.

"The problem we have is a large, hidden burden of disease," said Professor Lim. "Screening is the first thing we need to do to identify patients. But there is no universal screening strategy."

Hepatitis B, an inflammation of the liver, can be spread by blood contact and sexual intercourse. Left untreated, it can result in cancer, cirrhosis and liver failure. But it can be managed with medication or injections.

Singapore does not have a national plan to eradicate hepatitis.

However, Health Minister Gan Kim Yong said yesterday that Singapore has had a "relatively successful" vaccination programme to prevent hepatitis B in children.

Since 2005, more than 95 per cent of young children have been vaccinated and the disease has hit only 0.4 per cent of those aged between five and 17, he said.

At the conference yesterday, the World Health Organisation (WHO) launched a new global network to better coordinate the fight against hepatitis B.

WHO's Professor Hande Harmanci said the network will unite research institutes, universities, medical associations, patient groups and non-governmental organisations around the world.

It will enable members to meet and share information and to avoid duplication of efforts, said the medical officer of the global hepatitis programme.

The Coalition to Eradicate Viral Hepatitis in Asia-Pacific and the APASL - both of which cover Singapore - have expressed an interest in joining the initiative.

Top of the network's agenda is to work with countries in drawing up national plans for the liver disease.

Said Prof Harmanci: "We hope that countries will have a comprehensive approach to hepatitis prevention and treatment."

This is all the more important in South-east Asia, given that an estimated 100 million people in the region are living with chronic hepatitis B, going by WHO figures. Some 65 per cent of them are unaware of their infection.

Study aims to get patients off medication

MANY people with hepatitis B have to take tablets for life to prevent serious liver ailments. But a new study set to start next month seeks to wipe out the virus for good.

The two-year study, involving about 310 patients, will examine if a combination of tablets and injections can achieve it, said National University Health System's (NUHS) Professor Lim Seng Gee, who is leading it.

"I have patients who have been on tablets for more than 10 years. They keep asking, when am I getting cured?" said the hepatology director.

Long-term management of hepatitis B can be tricky, with a previous NUHS study showing 67 per cent of patients with chronic hepatitis B do not show up for follow-up consultations.