廖運範

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Taiwan leads global fight against hepatitisLiaw Yun-fan is one of Taiwan’s pioneers in treating hepatitis B. (Staff photos/ Chang Su-ching)

• Publication Date：07/07/2013
• Source：             Taiwan Today
• By  Rachel Chan
  

Taiwan’s achievements in hepatitis B prevention and treatment have long stood as a shining example for the rest of the world, underscoring the commitment and dedication of a group of outstanding local doctors and researchers.
Liaw Yun-fan, a distinguished chair professor and director of the Liver Research Unit at the Chang Gung University Medical College, is one of these global trailblazers in liver study.
On April 26, Liaw received the prestigious International Recognition Award from the European Association for the Study of the Liver in recognition of his 36-year contribution to viral hepatitis clinical research and developing practical treating strategies.
“This award is not a personal tribute but one representative of the entire team’s exceptional work,” Liaw said during a June 14 interview with Taiwan Today.
“I also dedicate this honor to my mentor Sung Juei-low, who passed away May 26 at the age of 96. He paved the way for my work in the field of liver disease research.”
Liaw, 72, published 459 papers with 18,958 citations worldwide pertaining to liver disease research. His main contribution was the characterization of the natural history of the infection in the 1980s, including the definition of clinic-pathological events associated with the chronic active hepatitis, the events preceding hemoglobin E seroconversion, and the clinical features of hepatitis B virus reactivation, according to Geneva-headquartered EASL.
“There are no fancy machines in my laboratory,” Liaw said. “What we do is study serum samples and biochemical test results from a very large number of patients.
“Our study has received international recognition because they are practical and effective in solving patients’ problems.”
Liaw said when he started practicing medicine, hepatitis B was a new area with physicians knowing nearly nothing about its origin of infection, clinical development and symptoms.
In those days, Taiwan had the highest chronic HBV rate in the world, with 20 percent of the local population carriers compared to 1 percent in the U.S., according to Liaw.
“Sung and his team pioneered studies of the disease and later indentified mother-to-infant transmission as one of the main reasons for such prevalence.”
Taiwan has since made headway in fighting HBV and related diseases, Liaw said, adding that a milestone was the 1984 implementation of the world’s first large-scale hepatitis B vaccination program, which helped slash the carrier rate in children from over 10 percent to less than 1 percent.
“I chose to focus my study on HBV and related diseases because I wanted to be able to tell my patients what they have and how I can help improve their lives,” Liaw said.
“The most frightening thing for patients is the unknown, and it is the doctor’s responsibility to answer questions and ease concerns.”
Liaw is the second Asian to receive the International Recognition Award by the European Association for the Study of the Liver.

In 1985, Liaw published a landmark paper in collaboration with a team led by Howard Thomas, emeritus professor of medicine at London’s Imperial College. The study detailed the characterization of different phases of hepatitis B: the immune tolerant phase, immunoactive phase, and the residual phase, or inactive carrier state.
These phases reflect the immunopathological mechanism of chronic HBV infection and are now classically recognized by all physicians managing hepatitis B patients.
Liaw’s extensive clinical studies of new antivirals and predictors of treatment outcome formed the basis of his first-of-a-kind hepatitis B treatment recommendations and guidelines published in 2000. Adopted by international liver societies and physicians, the guidelines were updated 2003, 2005, 2008 and 2012 under Liaw’s supervision.
Vaccination and treatment of HBV are key to reducing the spread of the virus and preventing patients with chronic hepatitis from progressing to liver cirrhosis or cancer, according to Liaw. “Hepatitis medicines such as interferon might be invented by others, but Taiwan physicians make the best use of it.”
In 2003, antiviral treatment of hepatitis B and C entered a new era in Taiwan with the National Health Insurance program initiating coverage for the use of related medicine.
“Taiwan is a global pioneer in the fight against hepatitis B,” Liaw said. “Our experience in HBV prevention and treatment can serve as great examples for other countries.”
With the World Health Organization’s Global Hepatitis Network established June 7 in Singapore, Liaw said Taiwan can look forward to playing a greater role in the field.
But there is more to be done in Taiwan, Liaw said, including lifting restrictions on NHI subsidies for a maximum of two three-year treatments per patient, and launching a national compulsory HBV screening program.
On clinical research, Liaw said he hopes to see more young doctors dedicated to HBV studies and development of new medicine. “My biggest medical achievement is that the findings of my studies are being used to improve patients’ lives.
“Sung taught me that good doctors should never stop caring for their patients and studying the unknown. I am proud to say that I have put that into practice with patients and families my biggest motivation.” (JSM)
Write to Rachel Chan at [email protected]

StephenW

台湾领导全球抗击肝炎
台湾领导全球打击hepatitisLiaw云帆是台湾治疗B型肝炎的先驱之一，（职员照片/张苏清）

    出版日期：2013年7月7日
    图片来源：台湾今天
    陈雷切尔

台湾B型肝炎的预防和治疗中所取得的成就早已站在世界的其余部分作为一个光辉的榜样，强调一组优秀的当地的医生和研究人员的承诺和奉献。

廖运风扇，特聘讲座教授和长庚大学医学院的肝病研究单位的主任，是这些全球性肝研究的开拓者之一。

在4月26日，廖久负盛名的国际认可奖从欧洲协会的肝脏，以表彰他36年的贡献病毒性肝炎临床研究和制定切实可行的治疗策略的研究。

“这个奖项是不是一个个人的敬意，但一名代表整个团队的出色工作，”廖说，采访期间，6月14日与台湾今天。

“我这个荣誉献给我的导师宋Juei低，5月26日去世，享年96。他对我的工作在肝病研究领域铺平了道路。“

廖，72岁，发表了459篇论文有18,958引文全球肝病研究有关。他的主要贡献是在20世纪80年代的感染自然史的表征，包括慢性活动性肝炎，血红蛋白E血清转换前的事件，和乙肝病毒再激活的临床特点与相关的临床病理事件的定义，根据总部设在日内瓦的EASL。

“有没有花哨的机器在我的实验室，”廖说。 “我们做的是研究血清样品和生化检查结果，患者从一个非常大的数目。

“我们的研究得到了国际的认可，因为他们是切实有效的解决患者的问题。”

廖说，当他开始行医时，几乎没有关于它的起源感染，临床发展和症状的医生知道乙肝是一个新的领域。

在那些日子里，台湾在世界上最高的慢性HBV率，有20％的当地居民到1％，在美国的运营商相比，根据LIAW。

“金日成和他的团队开创了疾病的研究，后来鉴定出母亲对婴儿的传输，这种患病的主要原因之一。”

台湾一直以来取得的进展在战斗乙肝和相关疾病，廖说，增加的一个里程碑，是在1984年实施世界第一大规模肝炎乙疫苗接种计划，这有助于大幅削减带菌率在儿童中超过10％的不到1％。

“我选择我的乙肝及其相关疾病的研究重点，因为我希望能够告诉我的病人，他们有什么，我怎么能协助他们改善生活，”廖说。

“患者最可怕的事情是未知的，这是医生的责任回答问题和担忧缓解。”

1

廖是得到国际承认由欧洲肝脏研究协会奖第二届亚洲。

廖于1985年，由霍华德·托马斯领导的团队，在伦敦帝国学院医学名誉教授合作出版了一本里程碑式的论文。该研究乙型肝炎免疫耐受期，免疫活性相和残留相位，或处于非活动状态的载流子状态的不同阶段详细的表征。

这些阶段反映慢性HBV感染的免疫病理机制和现在古典认可的乙肝患者管理所有医师。

廖广泛的临床研究的基础上形成新的抗病毒药物和治疗结果的预测他的首个一类B型肝炎的治疗建议和指导方针，在2000年出版的。通过国际的肝社会和医生的指引，2003年，2005年，2008年和2012年更新廖的监督下。

疫苗接种和治疗HBV减少病毒的传播和预防慢性肝炎患者的进展为肝硬化或癌症的关键，根据廖。 “肝炎的药物如干扰素可能会被别人发明的，但台湾医师善用它。”

在2003年，乙型和丙型肝炎的抗病毒治疗进入了一个新的时代在台湾的全民健康保险计划启动有关药品使用的覆盖。

“台湾是一个全球性的先锋打击乙肝，”廖说。 “我们的经验可以作为很好的例子，其他国家在乙肝预防和治疗。”

世界卫生组织的全球肝炎网6月7日成立，在新加坡，廖表示，台湾可以期待在现场发挥更大的作用。

但是，还有更多在台湾做，廖说，包括解除限制健保补贴，为最多两三年每名患者的治疗，并启动了国家强制性乙肝筛查方案。

在临床研究中，廖说，他希望看到更多的年轻医生致力于对HBV研究和开发新药。 “我最大的医疗成果是我的研究结果被用来改善患者的生活。

“崇教我，好医生应该不停地照顾他们的病人和研究未知。我很自豪地说，我已经把它列入我最大的动力与病人及家属的做法。“（JSM）

写陈嘉怡[email protected]

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