On May 18, 2024, the 6th Academic Conference on Clinical Cure of Chronic Hepatitis B was successfully held in Xiamen, Fujian Province! With the theme of "Gathering Chinese Wisdom and Drawing a New Blueprint for Clinical Cure of Chronic Hepatitis B", this conference brought together more than 1,000 experts and scholars in the field of liver disease to discuss the treatment strategy of chronic hepatitis B with the goal of clinical cure and prevention of liver cancer, focus on hot and difficult issues, share clinical practice, and look forward to the new blueprint.
The conference has received extensive attention from all walks of life, and more than 40 media such as People's Daily Health Client, Xinhua News Agency, Yulu Liver Lin, and Chinese Journal of Liver Disease have carried out publicity and reports, and the number of online live viewers has exceeded 100,000, and the response is enthusiastic and far-reaching!
The conference was co-sponsored by the China Foundation for Hepatitis Prevention and Control and the Liver Health Promotion Center of Zoomlion, and co-organized by Xiamen Tebao Bioengineering Co., Ltd. Professor Wei Lai from Beijing Tsinghua Changgung Hospital affiliated to Tsinghua University presided over the opening of the conference, and Wang Yu, Chairman of the China Hepatitis Prevention and Control Foundation, Academician Zhuang Hui of Peking University Health Science Center, Academician Wang Fusheng of the Fifth Medical Center of the PLA General Hospital, and Professor Xu Xiaoyuan of Peking University First Hospital made opening speeches respectively.
They said that this conference brings together many well-known liver disease experts in China, aiming to share new concepts, technologies and achievements of clinical cure, provide scientific methods and guidance for the clinical management of hepatitis B, and further promote the wide dissemination of clinical cure experience, which is conducive to improving the level of diagnosis and treatment of hepatitis B in mainland China and jointly promoting greater progress in the prevention and treatment of hepatitis B.
Professor Wei Lai
Chairman Wang Yu
Academician Zhuang Hui
Academician Wang Fusheng
Professor Xu Xiaoyuan
01
Chronic hepatitis B treatment strategies and prospects with the goal of clinical cure and prevention of liver cancer
Professor Wang Guiqiang
Clinical cure and prevention of liver cancer is the ideal goal and ultimate goal of chronic hepatitis B treatment, and clinical cure can minimize the risk of liver cancer in patients with chronic hepatitis B. Professor Wang Guiqiang from Peking University First Hospital pointed out that the evidence-based medical evidence for clinical cure of chronic hepatitis B is gradually enriched and improved, and the guidelines and consensus at home and abroad are constantly updated.
The research evidence for the high clinical cure rate of pegylated interferon α (PEG IFNα) based on nucleoside treatment, inactive HBsAg carriers, and children with chronic hepatitis B has gradually been consolidated, and more clinical cure studies focusing on different types of hepatitis B populations are also being actively explored and expanded, and many exciting interim data have been disclosed. In order to improve the clinical efficacy, various biological indicators and models for predicting clinical cure are becoming more and more abundant, and the popularity and depth are increasing year by year.
With the deepening of the exploration of clinical cure, more scientific questions are worth studying, and the persistence of clinical cure has received more attention, consolidation therapy and high levels of HBsAb are helpful to improve the durability of clinical cure, and the problem of poor persistence of new drugs can be improved by combining PEG IFNα therapy. The clinical cure of PEG IFNα retreatment in all types of patients with recurrence is also high. After clinical cure, intrahepatic cccDNA and integrated HBV DNA were significantly reduced, and some patients were even undetectable.
Professor Xie Qing
The ultimate goal of clinical cure for chronic hepatitis B is to reduce the risk of liver cancer, and the dual benefits will further enhance patients' willingness to be treated. Professor Xie Qing from Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, comprehensively discussed the progress of antiviral treatment strategies for patients with chronic hepatitis B with the ultimate goal of preventing liver cancer.
Nucleos(t)ide drugs (NAs) can reduce the risk of liver cancer in patients with chronic hepatitis B by about 50%, but the cumulative incidence of liver cancer in 5 years is still more than 7%. Patients can further reduce the risk of liver cancer by about 90% with PEG IFNα-based therapy, and the risk of liver cancer at 5 years can be less than 1%. The latest data from the Paradise study and the "Oasis" project have shown that the treatment strategy based on PEG IFNα can bring dual benefits to patients with chronic hepatitis B - clinical cure + prevention of liver cancer, and patients with chronic hepatitis B should actively adopt better antiviral treatment strategies to pursue higher treatment goals.
Academician Wang Fusheng
With the deepening of the clinical cure of hepatitis B, the clinical cure of chronic hepatitis B in children has received more attention. Academician Wang Fusheng of the Fifth Medical Center of the PLA General Hospital said that the efficacy of chronic hepatitis B meridian (PEG) IFNα treatment in children is excellent, and the lower the age, the higher the clinical cure rate. The newly released Expert Consensus on the Prevention and Treatment of Chronic Hepatitis B in Children this year has further optimized the treatment regimen and expanded the treatment indications. Children in the immunotolerant phase also have a high clinical cure rate after treatment with (PEG)IFNα. Therefore, children with chronic hepatitis B should be screened and treated early, and treatment and management should be standardized to reduce the risk of disease progression.
Professor Chen Xinyue
How to effectively maintain the durability of clinical cure of hepatitis B? Professor Chen Xinyue from Beijing You'an Hospital affiliated to Capital Medical University showed that higher HBsAb levels are closely related to lower HBsAg recurrence rates. The team has published several studies showing that hepatitis B vaccine injection not only increases HBsAb positivity in HBsAb clearance after (PEG) IFNα treatment, but also increases antibody levels. The vaccine group significantly increased the proportion of total B cells, class-switched memory B cells, plasma cells, Th2, Th17 and Tfh cells, and decreased the proportion of Breg cells, all of which were beneficial for HBsAb production. This provides scientific ideas and directions for further improving the durability of clinical cure.
The innovative outpatient clinic for special diseases has helped to improve the clinical cure rate of hepatitis B
02
Prof. Takashi
Standardized antiviral therapy is an important measure to delay the progression of the disease and reduce the incidence of liver cancer. Since its launch, the "Standardized Construction and Capacity Improvement Project of Outpatient Clinics for Clinical Cure of Hepatitis B" initiated by the Hospital Management Institute of the National Health Commission has adhered to the strategy of combining prevention and treatment and promoted the popularization of standardized antiviral treatment regimens to improve the clinical cure rate of patients with chronic hepatitis B.
Professor Gao Zhiliang from the Third Affiliated Hospital of Sun Yat-sen University said that the project helps more patients achieve clinical cure by providing a new model of hepatitis B diagnosis and treatment with "scientific management of the whole course of the disease", individualized diagnosis and treatment plans, and the establishment of a database of special diseases. At present, more than 200 "hepatitis B clinical cure clinics" have been set up nationwide, and it is planned to achieve wide coverage of hepatitis B diagnosis and treatment and clinical cure network to benefit more patients.
03
To eliminate hepatitis B, we are in action
Professor Lin Feng
Professor Gao Haibing
Professor Lin Zhixiang
Wang Yu, chairman of the China Hepatitis Prevention and Control Foundation, said that the action to eliminate the harm of hepatitis requires multi-party coordination and joint efforts, exploring innovative models led by the government, departmental cooperation and social participation, and establishing a collaborative mechanism for the prevention and treatment of viral hepatitis.
Professor Lin Feng from Hainan Provincial People's Hospital, Professor Gao Haibing from Mengchao Hepatobiliary Hospital of Fujian Medical University, and Professor Lin Zhixiang from Guangdong Provincial Bureau of Disease Control and Prevention were invited to share the prevention and treatment strategies and project progress of hepatitis B in various provinces, once again emphasizing the importance of early prevention, early screening, early diagnosis and early treatment of hepatitis B.
Coping with Chronic Hepatitis B – Situation, Philosophy, Hope
04
As we approach the goal of eliminating hepatitis B set by the WHO, what is the current status of chronic hepatitis B prevention and treatment in the mainland, and what is the way out in the future? Focusing on this hot topic, the meeting invited researcher Xiao Li from the China Health Education Center to chair the discussion, and Wang Junping, deputy editor-in-chief of the People's Daily Health Client, Luo Gang, executive director and deputy secretary-general of the China Health Promotion and Education Association, and Professor Zhang Hongfei, Professor Wan Mobin and Professor Xie Yao, clinical experts in liver disease, conducted in-depth exchanges.
At present, the understanding of hepatitis B among patients and doctors in mainland China is far from enough, and many patients still believe that chronic hepatitis B does not require treatment, which eventually leads to disease progression. With the development of the media age, various liver disease awareness days can be effectively raised to raise public awareness.
The current media communication needs to eliminate the discrimination of the public against hepatitis B patients on the one hand, and on the other hand, guide patients to actively seek relevant knowledge and improve health awareness. For patients with chronic hepatitis B, in order to reduce the risk of liver cancer, it is far from enough to pursue HBV DNA or HBeAg clearance, and only HBsAg clearance can minimize the risk of liver cancer in patients.
We need to build confidence that every patient can achieve a clinical cure, and the current clinical cure for hepatitis B is inseparable from a PEG IFNα-based treatment strategy. In the future, we hope that by expanding the number of people receiving antiviral treatment, we will achieve full treatment and health for all, and move towards a future without hepatitis B together.
05
Roundtable pie - new progress, new future
The exploration of clinical cure for hepatitis B has entered a stage of in-depth development, and a number of projects for different hepatitis B populations are constantly advancing. The conference invited Professor Lin Bingliang to chair the roundtable discussion, and Professor Geng Jiawei, Professor Song Jianxin, Professor Li Minghui, Professor Shang Jia, Professor Jiang Jiaji and Professor Dang Shuangsuo gave in-depth sharing.
Professor Dang Shuangsuo proposed that the project should unify the patient enrollment criteria before enrollment, and if the patient enters the plateau period during the treatment period, individualized treatment can be adopted.
Professor Geng Jiawei shared with us the phased data of the "Set Sail" project: more than 40% of patients in the HBeAg-negative indeterminate phase were treated with PEG IFNα combined with NAs for 48 weeks, and more than 40% of the patients achieved HBsAg < 1500 IU/mL, and the hope of clinical cure was greatly improved.
Professor Jiang Jiaji mentioned that the ultimate goal of the treatment of hepatitis B is to reduce the occurrence of liver cancer, and the treatment strategy of PEG IFNα combined with NAs can enable more patients to achieve clinical cure and minimize the risk of HBV-related liver cancer.
Professor Li Minghui put forward four scientific questions to be solved about "clinical cure":1. how to further improve the clinical cure rate; 2. How to solve the problem of recurrence after clinical cure in a very small number of patients; 3. How to shorten the course of treatment for non-dominant patients; 4. How to convert non-dominant patients into dominant patients.
Professor Shang Jia added that how to achieve "treat all" still needs to be further explored, and more platforms should be built to expand the popularization of knowledge, so that everything should be known, tested and treated.
Professor Song Jianxin put forward five questions for patients with high levels of HBsAg:1. whether the risk of liver cancer is higher; 2. Whether the virus inhibition is sufficient, high-sensitivity DNA detection is required; 3. Whether there is a difference in the response to PEG IFNα; 4. Whether the immune response mechanisms are different; 5. What is the prognosis of treatment with NAs alone, and how many patients can be a dominant population without treatment with PEG IFNα.
06
Clinical Cure Forum for Dominant Populations with Low Level of HBsAg-Annual Meeting of the Starlight Program
The inactive HBsAg carrier population (IHC) belongs to the clinically cured advantage population due to the low level of HBsAg. Since its launch, the project has covered 408 hospitals across the country, and as of May 2024, 10,028 patients have been screened and 6,593 patients have been successfully enrolled. The phased data showed that the HBsAg clearance rate was more than 30% and the cumulative HBsAg clearance rate was greater than 70% for 48 weeks of treatment based on PEG IFNα in the IHC population, and good efficacy was achieved. In addition, the new specialized outpatient clinic for clinical cure of hepatitis B has helped promote the project and help more patients pursue clinical benefits.
07
To share the practical experience of clinical cure of chronic hepatitis B
In order to improve the clinical treatment skills of chronic hepatitis B and further improve the clinical cure rate of patients with chronic hepatitis B, a number of experienced clinical experts shared their experience on the key and difficult issues of chronic hepatitis B treatment.
Prof. Yao Xie, Prof. Yan Huang, Prof. Chao Wu, and Prof. Hongfei Zhang introduced in detail the treatment strategies and management experience of nucleoside-experienced patients, inactive HBsAg carriers, non-dominant populations, and children with hepatitis B. Professor Ren Hong proposed a new combination treatment plan to help clinical cure. Prof. Li Minghui and Prof. Guo Ying focused on patient communication and conducted in-depth discussions on the appropriate response to adverse effects of interferon.
Forum on Complex Liver Disease
08
Professor Dou Xiaoguang
The current treatment of chronic hepatitis B should expand the scope of treatment and increase the depth of treatment. In order to improve the diagnosis and treatment of complex liver diseases by clinicians, the conference invited many experts such as Professor Dou Xiaoguang, Professor Geng Jiawei, Professor Xiang Huiling, Professor Zhang Xinxin, Professor Fu Junliang, Professor Wu Xiaoping, Professor Yan Xuebing, Professor Lin Feng, Professor Su Zhijun, Professor Wang Xiaozhong and Professor Ding Yang to focus on the disease progression and treatment strategies of patients with hepatitis B cirrhosis, patients in the immunotolerant stage of chronic hepatitis B and patients with chronic hepatitis B complicated with other diseases, the impact of antiviral therapy on the integration of HBV DNA, The research status of immunotherapy for chronic hepatitis B and the special manifestations of serum markers in the treatment of chronic hepatitis B were analyzed in depth, and the discussion was lively on the spot.
09
summary
Professor Yang Xizhong
Professor Yang Xizhong, Vice Chairman of the China Foundation for Hepatitis Prevention and Control, summarized the meeting and congratulated the successful convening of the 6th Academic Conference on Clinical Cure of Chronic Hepatitis B!
Under the leadership of the CPC Central Committee and governments at all levels, and through the joint efforts of all health personnel and all sectors of society, the cause of hepatitis B prevention and treatment in the mainland has achieved remarkable results, but the stock of hepatitis B in the mainland is still huge, and there is still a long way to go in the prevention and treatment of hepatitis B.
This conference gathered many liver disease experts and was rich in content. It is hoped that this meeting can promote the progress of hepatitis B prevention and treatment in mainland China. Gather Chinese wisdom to draw a new blueprint for the clinical cure of chronic hepatitis B, and help build a "Healthy China" to achieve the ambitious goal of eliminating viral hepatitis by 2030 proposed by the World Health Organization.