Baraclude Treatment for Chronic Hepatitis B in Taiwan

Belantamab mafodotin treatment

1.
The patient has been a carrier of hepatitis B for over 5 years, with positive HBeAg and an HBV-DNA level of 911,500 IU/mL in March 2016.
In August 2016, the AST/ALT levels were 119/290, which is the highest recorded.
After half a month, the levels decreased to 48/103.
Based on these findings, the patient may meet the criteria for reimbursement for Baraclude (entecavir) treatment under the National Health Insurance in Taiwan.
2.
If the patient experiences a relapse after completing treatment, it is possible to re-initiate treatment with Baraclude, and the National Health Insurance may cover it again, depending on the specific circumstances and guidelines at that time.
3.
A report from Hospital A can be used at Hospital B to receive Baraclude treatment, provided that the receiving hospital accepts the documentation and the treatment plan aligns with their protocols.
Thank you.

tang, 30~39 year old female. Ask Date: 2016/09/12

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, sir.
① Generally, you can apply if the levels remain elevated for more than 3 months, with a doubling of values or jaundice greater than 2.
If the e-antigen is positive for more than 3 months, and you have been a carrier of hepatitis B for over 6 months, with a GPT increase of 5 times, you may also be eligible for medication.
② The National Health Insurance provides two opportunities for medication.
③ Yes, you can.
Changhua Hospital cares about your health.
Chen Shidian

Reply Date: 2016/09/12

More Info

In addressing your questions regarding Baraclude (entecavir) treatment for chronic Hepatitis B in Taiwan, it's essential to understand the context of your condition and the treatment guidelines established by health authorities.

1. Eligibility for Baraclude Treatment: In Taiwan, the National Health Insurance (NHI) provides coverage for antiviral treatments like Baraclude for patients with chronic Hepatitis B who meet specific criteria. Generally, these criteria include elevated liver enzymes (ALT/AST) and a significant level of HBV DNA (usually above 2000 IU/mL). Given your history of HBV-DNA at 911,500 IU/mL and elevated liver enzymes (GOT/GPT levels of 119/290), it appears that you would qualify for treatment under the NHI guidelines. However, the final decision rests with your healthcare provider, who will assess your overall health, liver function, and any potential complications.

2. Re-treatment After Relapse: If treatment with Baraclude is completed and there is a subsequent relapse (evidenced by elevated liver enzymes or increased HBV DNA), it is possible to re-initiate treatment. The NHI typically allows for re-treatment if the patient meets the criteria again. However, this may depend on the specific circumstances of your case, including the duration of the treatment-free interval and the reason for the relapse. It is crucial to maintain regular follow-ups with your healthcare provider to monitor your liver function and HBV status.

3. Transfer of Treatment Between Hospitals: You can generally transfer your treatment from one hospital to another in Taiwan, provided that the new hospital is equipped to manage chronic Hepatitis B and has the necessary protocols in place for administering antiviral therapy. It is advisable to bring your medical records, including previous test results and treatment history, to ensure continuity of care. Your new healthcare provider will review your history and determine the best course of action for your treatment.

Additional Considerations
Chronic Hepatitis B is a complex condition that requires careful management. Here are some additional points to consider:
- Monitoring: Regular monitoring of liver function tests (LFTs) and HBV DNA levels is crucial in managing chronic Hepatitis B. This helps in assessing the effectiveness of treatment and making necessary adjustments.

- Potential Side Effects: While Baraclude is generally well-tolerated, it is essential to be aware of potential side effects, including fatigue, headache, and gastrointestinal issues. Long-term use may also lead to resistance, so adherence to the prescribed regimen is vital.

- Lifestyle Modifications: Alongside antiviral therapy, adopting a healthy lifestyle can support liver health. This includes maintaining a balanced diet, avoiding alcohol, and engaging in regular physical activity.

- Vaccination: If you have not been vaccinated against Hepatitis A, it may be advisable to discuss this with your healthcare provider, as co-infection can complicate the management of Hepatitis B.

In conclusion, your eligibility for Baraclude treatment appears favorable based on your clinical data. Regular follow-ups and open communication with your healthcare provider will be essential in managing your condition effectively. If you have further questions or concerns, do not hesitate to reach out to your healthcare team for personalized advice and support.

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