Improved cure rate for patients with hep B

Professor Lim Seng Gee (at left) with Madam Ong Leng Mui, who has hepatitis C, and Mr Tan Koon How, a patient who has recovered from hepatitis B after participating in the clinical trial by NUH.
Professor Lim Seng Gee (at left) with Madam Ong Leng Mui, who has hepatitis C, and Mr Tan Koon How, a patient who has recovered from hepatitis B after participating in the clinical trial by NUH. PHOTO: LIANHE ZAOBAO

NUH trial involving combination of injection and oral medication yields 11% success rate

For more than 15 years, Mr Tan Koon How took a pill every day to suppress the hepatitis B virus in his body and prevent it from causing more damage to his liver.

But in 2014, the 57-year-old was cured of his disease after taking part in a 48-week clinical trial.

The treatment involved combining Interferon, an injection already used to treat hepatitis B, with Tenofovir, an oral medication Mr Tan took between 2012 and 2014 for the same disease.

The trial by the National University Hospital (NUH), which is ongoing, yielded an 11 per cent success rate. As of this year, 27 out of 260 patients from five hospitals here, including NUH, have been cured. They also showed no sign of the virus six months after the treatment ended.

In comparison, patients taking only Interferon have a 3 per cent success rate. The success rate was 2 per cent after six years of treatment with oral medication alone.

The patients in the study were regularly taking oral medication, some for more than 10 years, to keep their condition under control.

The study, which received a $25 million grant from the National Medical Research Council, was led by Professor Lim Seng Gee, senior consultant of gastroenterology and hepatology at NUH.

  • Fast facts: Hepatitis B and C

  • HEPATITIS B VIRUS

    •Nineteen acute cases so far this year, according to the Ministry of Health (MOH).

    •Transmitted through exposure to blood or body fluids of an infected person.

    WHO IS AT RISK?

    •People who frequently require blood or blood products (such as dialysis patients) or are exposed to them (such as healthcare workers).

    •People who share needles for recreational drugs.

    •People who have sexual contact with infected patients.

    WAYS OF PREVENTION

    •Vaccination and avoiding risk of exposure to the virus, such as safe handling and disposal of sharp objects.

    HEPATITIS C VIRUS

    •Eight acute cases so far this year, said MOH.

    •Transmitted through exposure to blood of an infected person.

    WHO IS AT RISK?

    •Similar to hepatitis B except it is not transmitted through sexual contact.

    PREVENTION

    •No vaccines available at the moment.

    •Avoid risk of exposure to the virus, such as safe handling and disposal of sharp objects.

    SOURCE: WORLD HEALTH ORGANISATION WEBSITE

It will be one of many presented at the fifth iteration of the Singapore Hepatology Conference, held today and tomorrow at Suntec convention centre.

This year, global medical experts and stakeholders - such as the World Health Organisation (WHO) as well as researchers from Asia - will discuss strategies to eliminate viral hepatitis, a disease causing inflammation or swelling of the liver.

WHO has set a target of a 90 per cent reduction in new cases and 65 per cent reduction in mortality to be achieved by 2030.

Some 3.6 per cent of the population in Singapore are infected with hepatitis B, the most common strain of the virus here. Hepatitis C, a strain which can also cause serious long-term health consequences like liver failure or cancer, affects 0.1 per cent of the population here.

Prof Lim told The Straits Times that Singapore has to take an active role in early detection and raising public awareness of the virus. He said hepatitis C is also a serious problem, though it is less common in Singapore.

Some 75 per cent of hepatitis C carriers are unaware they are infected until it reaches an advanced stage, like when symptoms of liver failure appear, he added.

Patients with hepatitis B or C usually present no symptoms.

Prof Lim said a new drug to treat hepatitis C was approved by the Health Sciences Authority in January.

The drug, Zepatier, will help cure patients like Madam Ong Leng Mui, who previously had no treatment available as existing drugs were not recommended for patients who, like her, also have kidney problems.

"I have not undergone any treatment because my condition was not bad enough yet, and there was no medication suitable," said Madam Ong, 62, who will be starting treatment with the new drug in two months' time.

Her doctor is applying for a subsidy as it costs $23,000 per month. Her daily treatment will run for between 12 and 16 weeks.

As for Mr Tan, he still routinely goes for a blood test every six months to rule out a relapse.

"Hepatitis has to be taken seriously. Just like some poisons which have no taste or smell, hepatitis is lethal and can kill," said Mr Tan.


Correction note: An earlier version of this story stated Madam Ong Leng Mui's age as 57. It should be 62. We are sorry for the error. 

A version of this article appeared in the print edition of The Straits Times on June 08, 2018, with the headline 'Improved cure rate for patients with hep B'. Print Edition | Subscribe