Patterns of managing chronic hepatitis B treatment-related drug resistance: a survey of physicians in Mainland China, South Korea, Taiwan, and Thailand

被引：8

作者：

Chainuvati, Siwaporn

Cheng, Jun ^{[1
]}

Hou, Jin Lin ^{[2
,16
]}

Hsu, Chao Wei ^{[3
,17
]}

Jia, Ji Dong ^{[4
]}

Komolmit, Piyawat ^{[5
]}

Kwon, So Young ^{[6
]}

Lee, Chang Hong ^{[6
]}

Li, Hong ^{[7
]}

Li, Ying ^{[7
]}

Liu, Chun Jen ^{[8
]}

Neo, Boon Leong ^{[7
]}

Peng, Cheng Yuan ^{[9
]}

Tanwandee, Tawesak ^{[10
]}

Wongcharatrawee, Suchat ^{[11
]}

Wu, Jaw Ching ^{[12
]}

Yu, Ming Lung ^{[13
,14
]}

Zhang, Xin Xin ^{[15
]}

机构：

[1] Beijing Ditan Hosp, Beijing 100015, Peoples R China

[2] So Med Univ, Nanfang Hosp, Hepatol Unit, Guangzhou 510515, Guangdong, Peoples R China

[3] Chang Gung Mem Hosp, Dept Internal Med, Div Hepatogastroenterol, Liver Res Unit, Taipei 10591, Taiwan

[4] Capital Med Univ, Beijing Friendship Hosp, Beijing 100050, Peoples R China

[5] Chulalongkorn Univ, Div Gastroenterol, Dept Med, Fac Med, Bangkok 10330, Thailand

[6] Konkuk Univ, Sch Med, Dept Internal Med, Seoul 143701, South Korea

[7] Bristol Myers Squibb Co, Global Dev & Med Affairs, Asia Pacific, Singapore 428778, Singapore

[8] Natl Taiwan Univ, Grad Inst Clin Med, Taipei 100, Taiwan

[9] China Med Univ Hosp, Div Hepatogastroenterol, Dept Internal Med, Taichung 404, Taiwan

[10] Mahidol Univ, Siriraj Hosp, Div Gastroenterol, Dept Med,Fac Med, Bangkok 10700, Thailand

[11] Bristol Myers Squibb Thai Ltd, Bangkok 10110, Thailand

[12] Natl Yang Ming Univ, Sch Med, Taipei Vet Gen Hosp, Dept Med Res & Educ,Inst Clin Med, Taipei 112, Taiwan

[13] Kaohsiung Med Univ Hosp, Hepatobiliary Div, Dept Internal Med, Kaohsiung, Taiwan

[14] Kaohsiung Med Univ, Fac Internal Med, Coll Med, Kaohsiung 807, Taiwan

[15] Rui Jin Hosp, Dept Infect Dis, Shanghai 200025, Peoples R China

[16] So Med Univ, Nanfang Hosp, Inst Gastroenterol, Dept Infect Dis, Guangzhou 510515, Guangdong, Peoples R China

[17] Chang Gung Univ, Coll Med, Taipei, Taiwan

来源：

HEPATOLOGY INTERNATIONAL | 2009年 / 3卷 / 03期

关键词：

Chronic hepatitis B; Nucleoside/nucleotide analogs; HBV DNA; ALT; Antiviral resistance; Asia; VIRUS INFECTION; COST; MANAGEMENT; RECOMMENDATIONS; HBV;

D O I：

10.1007/s12072-009-9139-9

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

The emergence of antiviral resistance can negate the benefits of antiviral therapy in patients with chronic hepatitis B (CHB). This study aimed to assess how physicians in Asia manage suspected antiviral resistance. Randomly selected CHB-treating physicians in Mainland China, South Korea, Taiwan, and Thailand underwent a face-to-face interview. A standardized questionnaire was used to assess how physicians identify, monitor, and manage suspected resistance and its associated medical costs. We interviewed 575 physicians from January to May 2008. Most physicians preferred a "prevention-of-antiviral resistance" strategy over a "rescue-once-resistance-develops" strategy. Physicians had encountered lamivudine resistance most frequently (96-100% of respondents), followed by the resistance to adefovir (18-58%) and entecavir (3-7%). While physicians in South Korea and Taiwan have access to resistance testing, physicians in Mainland China and Thailand have limited access to resistance testing but rely on HBV DNA and alanine aminotransferase (ALT) tests to identify resistance. Once resistance is suspected, 60% of the physicians in Mainland China, South Korea, and Thailand monitored these patients quarterly and the remaining 40% opted for monthly follow-up. In comparison, 70% of the Taiwanese physicians monitored these patients monthly. The average total direct medical costs, excluding antiviral costs, to manage a patient during the first year after suspected resistance is identified ranged from USD $319 to USD $709. Limited access to HBV resistance tests causes physicians in Asia to manage suspected resistance by various HBV DNA assays and ALT tests. This raises concerns that resistance may not be detected early enough to be rescued efficiently.

引用

页码：453 / 460

页数：8

共 19 条

[1] Risk of hepatocellular carcinoma across a biological gradient of serum hepatitis B virus DNA level [J].