Significant reduction in end-stage liver diseases burden through the national viral hepatitis therapy program in Taiwan.

Abstract

UNLABELLED:

A national viral hepatitis therapy program was launched in Taiwan in October 2003. This study aimed to assess the impact of the program on reduction of end-stage liver disease (ESLD) burden. Profiles of national registries of households, cancers, and death certificates were used to derive incidence and mortality of ESLDs from 2000 to 2011. Age-gender-adjusted incidence and mortality rates of hepatocellular carcinoma (HCC) and chronic liver diseases (CLDs) and cirrhosis of adults ages 30-69 years were compared before and after launching the program using Poisson's regression models. A total of 157,570 and 61,823 patients (15%-25% of those eligible for reimbursed treatment) received therapy for chronic hepatitis B and C, respectively, by 2011. There were 42,526 CLDs and cirrhosis deaths, 47,392 HCC deaths, and 74,832 incident HCC cases occurred in 140,814,448 person-years from 2000 to 2011. Male gender and elder age were associated with a significantly increased risk of CLDs and cirrhosis and HCC. Mortality and incidence rates of ESLDs decreased continuously from 2000 to 2003 (before therapy program) through 2004-2007 to 2008-2011 in all age and gender groups. The age-gender-adjusted rate ratio (95% confidence interval; P value) in 2008-2011 was 0.78 (0.76-0.80; P < 0.001) for CLDs and cirrhosis mortality, 0.76 (0.75-0.78; P < 0.005) for HCC mortality, and 0.86 (0.85-0.88; P < 0.005) for HCC incidence using 2000-2003 as the reference period (rate ratio = 1.0).

CONCLUSIONS:

The national viral hepatitis therapy program has significantly reduced the mortality of CLDs and cirrhosis and incidence and mortality of HCC.

• Authors: Chun-Ju Chiang, Ya-Wen Yang, Jin-De Chen, San-Lin You, Hwai-I Yang, Mei-Hsuan Lee, Mei-Shu Lai, Chien-Jen Chen
• Journal: Hepatology (Baltimore, Md.) (Hepatology) Vol. 61 Issue 4 Pg. 1154-62 (Apr 2015) ISSN: 1527-3350 [Electronic] United States
• PMID: 25476749 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2014 by the American Association for the Study of Liver Diseases.

Topics

• Adult
• Aged
• Carcinoma, Hepatocellular (complications, epidemiology, prevention & control)
• Cost of Illness
• End Stage Liver Disease (complications, epidemiology, prevention & control)
• Hepatitis, Viral, Human (complications, drug therapy)
• Humans
• Incidence
• Liver Cirrhosis (complications, epidemiology, prevention & control)
• Liver Neoplasms (complications, epidemiology, prevention & control)
• Middle Aged
• National Health Programs
• Taiwan