Chronic Hepa B patients know little about disease

HONG KONG — A commissioned medical survey showed that chronic hepatitis B (CHB) patients in the Philippines lack crucial information about the disease, hampering their treatment and even increasing the chances of passing the disease to others.

Dr. Nany Leung, founding head of Hong Kong-based Asiahep, said that despite the high prevalence of CHB in Asia, 87 percent of respondents admitted they knew very little about the illness at the time they were diagnosed.

"There are a lot of Asian people, walking around in the street, going on with their lives without realizing that they have the infection because the infection is really relatively silent," she added.

The survey found that only 13 percent of patients knew a "great deal" or at least an "average amount" of information about CHB.

The survey "Chronic Hepatitis B: The Patient’s Perspective — Uncovering the Opportunity for Better Management," was commissioned by pharmaceutical company GlaxoSmithKline.

It covered a total of 1,200 patients from the Philippines, South Korea, Taiwan, Hong Kong, Indonesia, Malaysia, Singapore, Thailand, Vietnam and China.

Around two billion people worldwide have hepatitis B, the most common serious liver infection across the globe.

Of this figure, 360 million people have chronic or lifelong infection and 78 percent, or 281 million, are in the Asia Pacific region. Every year, 10 million to 30 million new infections occur.

CHB is the leading cause of liver cancer, cirrhosis or liver scarring and epatocellular carcinoma.

Patients in the Philippines registered the second lowest percentage of knowledge at 79 percent, following Vietnam with 74 percent.

"Most survey participants (90 percent) had no idea they were carriers of hepatitis B virus. For them the diagnosis came rather by chance, mainly through a blood test or a routine medical checkup," the survey reported of Philippine patients.

The survey showed that a majority of patients "could not correctly identify the possible routes of transmission of the virus." Another indication that Philippine patients were poorly informed about CHB was seen in the high percentage of respondents who had "overly optimistic expectations of treatment."

When asked in the survey how treatment would affect their CHB, "in the Philippines, 66 percent answered ‘complete recovery’ and 33 percent said ‘cure CHB.’ But in reality, a cure is not possible for any patient and although some patients may be able to achieve close to a complete recovery, most will not."

Awareness was highest in Indonesia (95 percent), followed by South Korea (94 percent), Malaysia (93 percent), Thailand (92 percent) and Hong Kong and Singapore (both 91 percent).

Leung noted the low knowledge about hepatitis B might be due to the minimal time spent by doctors in explaining the illness to their patients.

But in the Philippines, consultation time is significantly longer than the regional average — 41 percent spent less than 10 minutes with their doctor (the regional average was 58 percent); 18 percent spent 10-20 minutes and 41 percent spent more than 20 minutes (the regional average was 15 percent).

"We do need to have more doctors and more health care people to try to get the patients to understand the disease so they’ll get proper treatment," she added.

Leung maintained that since patients tend to rely on doctors for treatment, physicians should be able to attend to them individually.

During the presentation, a patient identified as "Mr. Lai" recalled how his family was devastated by the liver ailment. Mr. Lai learned that he had cirrhosis when his brother tested positive for hepatitis B during a medical checkup for insurance 15 years ago. This prompted the whole family to undergo medical tests and other siblings were found to have the liver ailment. Mr. Lai underwent a liver transplant three years ago.

Leung said the best way to fight hepatitis B is by vaccinating newborn infants because the most common route of spreading the disease is through perinatal or mother-to-child transmission.

She added that around 70 percent of patients do not exhibit symptoms. Others experience occasional non-specific symptoms like fatigue, muscle or joint pain, loss of appetite, mild nausea and vomiting.

"Don’t wait for symptoms. If you’re Asian or you live in Asia, have your blood tested. Without blood testing, you would not know. If you detect the infection late, the consequence is death," Leung warned.

She added that over the past 20 years there has been progress in treating hepatitis B and people only need to "seize this golden opportunity."