title: Current challenges and the management of chronic hepatitis C in mainland China.
abstract: Despite decreasing prevalence, new cases of hepatitis C in China are increasing recently with growing percentage of patients who are with advanced disease, aging, or not eligible for interferon-based treatments. Hepatitis C infection represents a serious public health burden. This review was based on expert's consensus during a medical forum on hepatitis sponsored by the Beijing Wu Jie-Ping Medical Foundation. The literature searches were conducted in PubMed and critical publications in Chinese journals. Data on hepatitis C prevalence, risk factors, viral or host features, and treatment modalities were extracted and reviewed. Recent large-scale surveys reported reducing prevalence of hepatitis C to approximately 0.4% in China, partly because of regulation changes to safer medical practices and illegalizing commercial blood donations. Patient demographics evolved from being dominated by former paid blood donors to include intravenous drug users and others. Although hepatitis C genotype 1 is the most common, other genotypes are emerging in prevalence. The current standard of care is interferon-based without direct acting antivirals. However, many patients failed therapy because of high treatment costs, substantial needs to manage side effects, difficulties with treatment monitoring in the rural areas, and growing populations of elderly and cirrhotic patients. The lack of high efficacy therapies with good safety profile and low disease awareness in China resulted in increasing public burden of advanced hepatitis C disease. Despite significant reduction of hepatitis C prevalence, iatrogenic, nosocomial, and community transmissions are still significant. In addition to promoting disease awareness, interferon-free regimens are needed to reduce the public health burden.
authors.affiliation: *Artificial Liver Center, Beijing Youan Hospital †Division of Hepatology, Friendship Hospital, Capital Medical University ¶Department of Infectious Diseases, Peking University First Hospital #Hepatology Institute, Peking University People's Hospital **Department of Microbiology and Center of Infectious Disease, School of Basic Medicine, Peking University Health Science Center, Peking University, Beijing ‡Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China §Hepatitis Consulting at Nexus Development, Palo Alto, CA ∥Department of Medicine, Division of Gastroenterology, NYU Langone Medical Center, NYU School of Medicine, New York, NY.
authors.forename: Zhongping
authors.initials: Z
authors.lastname: Duan
authors.forename: Ji-Dong
authors.initials: JD
authors.lastname: Jia
authors.forename: Jinlin
authors.initials: J
authors.lastname: Hou
authors.forename: Lillian
authors.initials: L
authors.lastname: Lou
authors.forename: Hillel
authors.initials: H
authors.lastname: Tobias
authors.forename: Xiao Yuan
authors.initials: XY
authors.lastname: Xu
authors.forename: Lai
authors.initials: L
authors.lastname: Wei
authors.forename: Hui
authors.initials: H
authors.lastname: Zhuang
authors.forename: Calvin Q
authors.initials: CQ
authors.lastname: Pan
mesh_terms: D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002681:China / Q000453:epidemiology; D017281:Cost of Illness; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification*; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology; D006801:Humans; D015995:Prevalence; D011634:Public Health; D012307:Risk Factors
chemical_list: D000998:Antiviral Agents