For Immediate Release

Linkage between screening and treatment needed to improve hepatitis care in China

CEVHAP research shows systemic gaps lead to misinformation, stigma and suboptimal treatment of people with hepatitis

Singapore (Wednesday, 22 July 2015) – Viral hepatitis screening in China needs to be linked to support, care and treatment programmes, according to a study released today by the Coalition to Eradicate Viral Hepatitis in Asia Pacific (CEVHAP), led by researchers from La Trobe University, Australia. Researchers found that the absence of this linkage has led many people with viral hepatitis to struggle alone with misinformation, stigma and despair.

The “Needs Assessment of People with Viral Hepatitis – China” adopts a qualitative, systematic research approach to gain an accurate picture of the country’s system for managing the chronic condition, with an aim of informing more effective policy development. The assessment identified common traits in the experience of living with chronic hepatitis B and hepatitis C in China. Researchers conducted in-depth interviews with 46 people living with chronic hepatitis B or hepatitis C in five locations ─ Beijing, Chongqing, Dongguan, Guangzhou and Shanghai ─ as well as 13 key informants, including clinicians. The report describes the social impact of the infection, and the analysis of interview findings was backed by a review of 82 peer-reviewed papers in existing literature.

Up to 150 million people in China are infected with chronic viral hepatitis ─ over 93 million people live with chronic hepatitis B, with estimates for hepatitis C ranging from 13 up to 44 million people. One-third of the global population infected with chronic hepatitis B live in China, with around 300,000 people dying each year from hepatitis B-related complications, including liver cancer and cirrhosis. China has the highest number of new cases of liver cancer as a result of hepatitis B and around 55% of global liver cancer deaths occur in China.

In China, many people are diagnosed with hepatitis through health checks conducted at schools or workplaces. The study showed that these health checks are primarily administered by staff who do not understand the clinical implications of the infection, have not been trained to protect patient confidentiality or to have information on where to seek medical care and treatment.

“As a result, people are not given accurate information about where to go to and how they should manage hepatitis. Prevailing stigma from poor awareness also means that people are often physically alienated from group activities or even laid off upon diagnosis of hepatitis,” said Professor Hou Jinlin, CEVHAP Executive Committee Member; Director and Professor of the Hepatology Unit and Department of Infectious Diseases, Nanfang Hospital, Southern Medical University; and President-elect of the Asian Pacific Association for the Study of the Liver (APASL).

Other gaps in the healthcare system from the point of diagnosis, to monitoring, care and treatment identified in the study include:

• Poor quality information in the public domain and misleading advertising cause significant misconceptions about the infection.
• Viral hepatitis infection in China occurs within a familial context where the diagnosis of one member often lead to the diagnosis of several other family members, but there is no institutionalized support for affected families.
• The high cost of medical treatments lead to decisions to opt for suboptimal medical care, or to not seek care at all, as families forgo care and treatment for other essential expenditure.

“What is clear from the report is that hepatitis infection can have grave personal, social and economic implications for people living with it,” said principal researcher of the study Jack Wallace, CEVHAP Executive Committee Member and Research Fellow at the Australian Research Centre in Sex, Health and Society, La Trobe University. “A coordinated national policy for hepatitis prevention, care, treatment, education and research ─ as being promoted by the World Health Organization ─ is important for coordinated national action and in particular the allocation of resources. Success, however, will hinge upon the implementation of a strong linkage between hepatitis screening and treatment.”

Linkage can be built into existing services and programmes, such as those already established for maternal and child health, HIV prevention and control, and non-communicable diseases. The study proposes a range of specific interventions for strengthening the linkage between hepatitis screening and treatment in China, including:

• Provide training to educational institutions, employers and healthcare professionals for the communication of accurate information about hepatitis and better protection of privacy.
• Develop effective models of care that can be instituted outside of Tier One cities.
• Establish a viable model to finance clinical management and treatment through public health care.
• Raise awareness of hepatitis through campaigns that convey the benefits of regular monitoring and dispel myths of hepatitis transmission.

The needs assessment can be downloaded from: https://www.cevhap.org/index.php/en/newsfooter-2/49-living-with-chronic-hepatitis-in-china-a-qualitative-assessment

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Attachment:
Life Stories ─ Living with Chronic Hepatitis in China: A Qualitative Assessment

About CEVHAP
The Coalition to Eradicate Viral Hepatitis in Asia Pacific (CEVHAP) is the first organization of its kind in the region, established as an independent, multidisciplinary body to advocate for public policy reform to reduce the burden of and ultimately eliminate viral hepatitis in Asia Pacific.

Incorporated in October 2010, CEVHAP membership is comprised of many world-renowned hepatitis experts, including people living with the infections, utilizing the collective expertise of its members to assist the region through partnership with a broad range of stakeholders, including government bodies in public policy formation and health education.

CEVHAP is working closely with the WHO, having assisted the WHO in launching its landmark Global Hepatitis Network in Singapore in June 2013, as well as having taken part in the WHO Global Partners’ Meeting on Hepatitis in March 2014. More recently, CEVHAP has contributed to the development of the Western Pacific Regional Action Plan for Viral Hepatitis. For more information, please visit www.cevhap.org, or follow CEVHAP on Facebook, Twitter, LinkedIn and Weibo.

References

All China statistical data and facts in the press release are obtained from “Needs Assessment of People with Viral Hepatitis – China” report.

Wallace, J., Pitts, M., Liu, C., Lin, V., Wei, L., Hajarizadeh, B., Richmond, J., Locarnini, S. Needs assessment of people with viral hepatitis – China. ARCSHS Monograph Series, (105). 2015. Available at: https://www.cevhap.org/index.php/en/news-footer-2/49-living-withchronic-hepatitis-in-china-a-qualitative-assessment

For more information, please contact:

Elizabeth Fung
T: +852 9311 9539
E: This email address is being protected from spambots. You need JavaScript enabled to view it.

Tzu Wong
T: +852 9388 5986
E: This email address is being protected from spambots. You need JavaScript enabled to view it.

Click here to download the complete document.