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Editor's note
On the morning of April 27, the "WILLOW MEDICAL Conference (III) - Elimination of Hepatitis C Virus Infection" sponsored by the Journal of Clinical Hepatobiliary Diseases was successfully held in Beijing. This conference focused on the hot topics related to the progress of diagnosis and treatment of hepatitis C virus (HCV) infection in mainland China in the special issue of the fourth issue of 2024. The chair of the meeting is Professor Jia Jidong of Beijing Friendship Hospital affiliated to Capital Medical University, Professor Niu Junqi and Professor Gao Yanhang of the First Hospital of Jilin University, and the invited experts include Professor Chen Hongsong and Professor Rao Huiying of Peking University People's Hospital, Researcher Liu Zhongfu and Researcher Jin Cong of the Chinese Center for Disease Control and Prevention, Professor Wang Hao and Professor Zuo Li of Peking University People's Hospital, Professor Jin Xueyuan of the Fifth Medical Center of the PLA General Hospital, Professor Hu Peng of the Second Affiliated Hospital of Chongqing Medical University, Professor Ji Fanpu of the Second Affiliated Hospital of Xi'an Jiaotong University.
Professor Niu Junqi, editor-in-chief of the Journal of Clinical Hepatobiliary Diseases, delivered an opening speech, first of all, to express his warm welcome and gratitude to all the experts and colleagues on site and online! The magazine has created the IP brand "WILLOW MEDICAL" for related academic activities, "Willow Shade" aims to bring together well-known experts, and "Willow Bud" provides a stage for industry stars to jointly promote academic exchanges and scientific research innovation. Over the years, under the guidance of Academician Zhuang Hui, Professor Jia Jidong and many other experts, and with the support of colleagues, the Journal of Clinical Hepatobiliary Diseases has achieved leapfrog development and revival, won wide recognition and praise in the industry, and achieved excellent results in ranking 13th among more than 2,000 core journals of science and technology in China. In 2024, the Journal of Clinical Hepatobiliary Diseases will be carefully adjusted to give a new look, and each issue will be designed with a unique cover to complement the content of the article and highlight the high level of taste and positioning of the magazine. Regarding the theme of today's forum, editor-in-chief Niu Junqi said that HCV infection is still an important public health issue in the world, and he looks forward to discussing and in-depth exchanges with experts and colleagues to contribute wisdom and strength to the elimination of HCV infection.
Professor Jia Jidong, editor-in-chief of the Journal of Clinical Hepatobiliary Diseases, pointed out in his speech that the Journal of Clinical Hepatobiliary Diseases, founded by Professor Ye Weifa in 1985, is the earliest hepatobiliary journal in mainland China. In addition, editor-in-chief Jia Jidong highly affirmed the special issue of the fourth issue of 2024 hosted by Professor Chen Hongsong and Professor Rao Huiying. He stressed that, unlike the prevalent case of hepatitis B infection, HCV infection has a higher incidence in high-risk groups and a relatively low incidence in the general population. The theme of this special issue not only covers the hot issues in the clinical diagnosis and treatment of hepatitis C, but also involves the prevention and treatment of hepatitis C in special populations such as public health, maternal and child health, and hemodialysis patients.
Professor Chen Hongsong presided over the opening report, and Professor Rao Huiying introduced the current situation and elimination process of hepatitis C virus infection in mainland China. According to Professor Rao, the current global prevalence rate of HCV infection is 0.7%. In recent years, in order to achieve the strategic goal of eliminating the threat of viral hepatitis put forward by the World Health Organization, the mainland has gradually implemented relevant policies and actively promoted the prevention and treatment of hepatitis C. According to the experience of hepatitis C elimination and prevention in mainland China and the policy documents issued by the state, the screening of hepatitis C antibodies in hospitalized patients and the in-hospital management of positive patients can effectively accelerate the elimination of hepatitis C. According to different methods of hepatitis C prevention and treatment at home and abroad, it is possible to achieve micro-elimination of small or specific infected groups, establish multi-sectoral joint prevention and treatment of hepatitis C, cover the whole process of hepatitis C diagnosis and treatment, quickly and effectively screen HCV infected patients, and improve the management and treatment rate of infectious agents.
Subsequently, under the chairmanship of researcher Liu Zhongfu, researcher Jin Cong gave a detailed elaboration on the laboratory detection methods and strategies of hepatitis C virus infection. Early diagnosis and prompt treatment of HCV infection are important means to stop the progression to cirrhosis and HCV-associated hepatocellular carcinoma. Laboratory testing for HCV infection is moving towards more sensitive, rapid, and accurate testing, but challenges remain. As the treatment of chronic HCV infection enters the pan-genotype era of direct antiviral drugs (DDA), and more than 95% of hepatitis C patients are cured, more new laboratory testing technologies and strategies will emerge in the future. At present, point-of-care nucleic acid testing technology can greatly reduce the turnaround time of testing, diagnose current HCV infection on the same day, and improve treatment compliance. Triggering testing can reduce the number of clinical visits, increase the chance of HCV infection to obtain nucleic acid testing, and detect HCV infection in time. Self-testing can help improve the willingness of the tested to take the initiative to test, expand the coverage of testing, and promote early diagnosis and early treatment of individuals. The prevention and testing of multiple diseases is the mainstream direction of follow-up development in the field of public health.
Chaired by Professor Jin Xueyuan, Professor Hu Peng elaborated on the research progress of hepatitis C virus infection and organ transplantation. Considering the significant incidence and mortality of HCV-related liver disease, liver transplantation remains the top priority for HCV treatment, the report notes. HCV was previously thought to have a negative long-term effect on both patients and graft survival in non-hepatic solid organ transplant recipients, but with the advent of the DAA era, liver and non-hepatic solid organ transplant recipients can be safely and effectively treated with new DAA regimens, which is expected to fundamentally eliminate the risk of hepatic and non-hepatic complications after hepatitis C transplantation. The use of anti-HCV-positive organs minimizes organ discarding and significantly expands the available donor pool, reducing the time on the transplant waiting list and increasing the chances of a waiter getting a transplant. It is critical to determine the ability to treat DAAs, post-transplant drug interactions, and ensure that patients fully understand the associated risks and transplant costs prior to transplantation.
Subsequently, chaired by Professor Gao Yanhang, Professor Ji Fanpu pointed out in his report on the management of hepatitis C in pregnant women and children that HCV infection is a global public health problem, and the emergence of DAA has brought a revolutionary breakthrough to the treatment of hepatitis C patients. However, there are still many challenges in the treatment of infants, adolescents and pregnant women, and there are still two unfinished pieces of the puzzle of "treatment of hepatitis C in young children under 3 years of age and pregnant women", which need to be further clarified. In addition, the treatment of hepatitis C in adolescents, especially in the presence of special comorbidities, should not be neglected. It is believed that with the gradual enrichment of evidence-based medical evidence, the puzzle of hepatitis C DAA treatment will finally be completed and the true "total treatment" will be realized.
The last report was chaired by Professor Wang Hao, who introduced the current situation and goals of eliminating hepatitis C virus infection in the hemodialysis population. The report notes that the global rate of HCV infection among hemodialysis patients is much higher than that of the general population. The number of patients with end-stage renal disease in mainland China has increased year by year, and by the end of 2022, the number of hemodialysis patients has reached 844,000. Epidemiological data on HCV infection in hemodialysis patients are still lacking in mainland China, and the infection rate of patients in some areas is 7.4%. Reducing the rate of HCV infection in hemodialysis patients is a challenge for nephrologists and hepatologists. In recent years, China has strengthened the quality control and improvement of blood purification, and issued relevant standards and norms. Under the situation of strict compliance with the regulations of hemodialysis centers to do a good job of prevention and screening, the HCV infection rate of hemodialysis patients in mainland China is declining, but there is still a gap from the 2030 target. In addition, DAA treatment is rarely used in hemodialysis patients, which needs to attract wider clinical attention. With the inclusion of DAA in medical insurance, the cooperation between nephrology and specialists will help it to be widely used, and it is expected that the goal of micro-elimination of HCV infection will be achieved as soon as possible in the mainland hemodialysis population.
Professor Niu Junqi and Professor Gao Yanhang, editors-in-chief of the Journal of Clinical Hepatobiliary Diseases, presided over the meeting. In the summary of the conference, the editor-in-chief Gao Yanhang sincerely thanked all the experts and the audience for their enthusiastic participation, and paid special tribute to Professor Chen Hongsong and Professor Rao Huiying, the executive editors of this issue, for their careful planning and manuscript formation, as well as the outstanding contributions of the authors. At the same time, I would like to express my sincere gratitude to Gilead for its public welfare support. More than 7,200 people participated in the online meeting, and the wonderful views and insights of the experts have been widely disseminated, and it is believed that it can play a positive role in promoting the elimination of hepatitis C in mainland China. The Journal of Clinical Hepatobiliary Diseases will continue to give full play to its own advantages, expand the academic influence of the journal, and make important contributions to the development of the field!
Moderator Expert
Source: Editorial Board of International Liver Disease