Chronic Hepatitis B: Treatment Options and Healthcare Access in Taiwan

Q: Chronic Hepatitis B: Treatment Options and Healthcare Access in Taiwan

Reply： Hello, 1. <br>Chronic hepatitis B carriers with GPT > 200 for more than six months and HBeAg positive are eligible to participate. <br>2. <br>Entecavir can suppress the virus but cannot eliminate it; however, it may lead to a conversion of HBeAg from positive to negative.

Regarding hepatitis B issues?

Hello, I am a carrier of hepatitis B.
I regularly undergo follow-up examinations.
I have a few questions I would like to ask:
1.
Currently, there is a strengthened chronic hepatitis B treatment pilot program under the National Health Insurance.
What are the eligibility criteria to participate? Or can any hepatitis B patient participate?
2.
When I visit the doctor, they tell me that hepatitis B is lifelong and cannot be cured.
However, I know that there are currently several treatment options available, such as interferon injections and oral medications like Tenofovir.
Is it true that there is no way to cure it, or is there a possibility for treatment? I am confused about these two questions.
I would appreciate your clarification.
Thank you.

A De, 20~29 year old female. Ask Date: 2005/04/08

Dr. Cai Zonglong reply Internal Medicine

Reply: Hello, 1.
Chronic hepatitis B carriers with GPT > 200 for more than six months and HBeAg positive are eligible to participate.
2.
Entecavir can suppress the virus but cannot eliminate it; however, it may lead to a conversion of HBeAg from positive to negative.
Interferon can eliminate the virus but has an efficacy of about 30% to 40% and significant side effects.
Thank you for consulting Dr.
Tsai Tsung-Long from the Internal Medicine Department.

Reply Date: 2005/04/08

More Info

Hello! Thank you for your questions regarding chronic Hepatitis B and the treatment options available in Taiwan. I understand that navigating through the complexities of Hepatitis B can be quite confusing, especially with the varying information regarding treatment and healthcare access. Let me address your concerns in detail.

1. Eligibility for the National Health Insurance (NHI) Chronic Hepatitis B Treatment Program: In Taiwan, the NHI has implemented a strengthened treatment program for chronic Hepatitis B. To qualify for this program, patients typically need to meet specific criteria, which may include elevated liver enzymes (such as ALT/GPT), evidence of active viral replication (often measured by HBV DNA levels), and the absence of other liver diseases such as Hepatitis C or autoimmune liver disease. Generally, patients with chronic Hepatitis B who exhibit significant liver inflammation or fibrosis are prioritized for treatment. It is essential to consult with a healthcare provider who can evaluate your specific situation and determine if you meet the necessary criteria for enrollment in this program.

2. Understanding Treatment Options for Chronic Hepatitis B: Chronic Hepatitis B is indeed a lifelong condition, but it is important to clarify that while there is currently no complete cure for the virus, there are effective treatment options available. The primary goal of treatment is to suppress the virus to undetectable levels, which can help prevent liver damage and complications such as cirrhosis or liver cancer.

The two main types of treatment for chronic Hepatitis B include:
- Interferon Therapy: This is an injectable medication that can help the immune system fight the virus. It is typically used for a limited duration (usually about 6 to 12 months) and can lead to a functional cure in some patients, meaning the virus remains inactive without ongoing treatment. However, not all patients are suitable candidates for interferon therapy due to potential side effects and contraindications.

- Oral Antiviral Medications: These include drugs like Entecavir (often referred to as "甘安能") and Tenofovir, which are taken daily and work by inhibiting the replication of the virus. These medications are generally well-tolerated and can effectively lower viral loads, reducing the risk of liver damage. Patients may need to remain on these medications long-term, as stopping treatment can lead to a rebound in viral activity.

It is crucial to understand that while these treatments can significantly improve the quality of life and reduce the risk of liver-related complications, they do not eliminate the virus from the body. Therefore, regular monitoring and follow-up with a healthcare provider are essential to manage the condition effectively.

In summary, while chronic Hepatitis B is a lifelong condition, there are effective treatment options that can help manage the virus and protect liver health. Participation in the NHI treatment program requires meeting specific criteria, and it is advisable to discuss your individual case with a healthcare professional who can guide you through the process. If you have further questions or need clarification on any points, please feel free to ask. Thank you for your inquiry, and I wish you the best in managing your health!

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