In China universal vaccination program against hepatitis B virus (HBV)in newborns has led to a dramatic decline in HBsAg prevalence from 9.75%in 1992 to 7.18%in 2006.However,it is estimated that there are still around 90 million patients with chronic HBV infection,including 20-30 million with chronic hepatitis B (CHB).As recommended therapies,interferons and nucleos(t)ide analogues can effectively suppress HBV replication and thereby halt the progression of liver disease.Unfortunately,the current standard of care could not cure CHB in most cases.Developing direct antiviral agents targeting the specific steps of HBV life cycle or immunotherapy against the key steps of immune response to HBV infection will ultimately enable us to cure CHB.Chinese hepatologists have published more and more papers on HBV prevention and management,with the aim of optimizing current modalities and exploring new therapies.Adopting the public health policy to improve the accessibility and affordability of preventive and therapeutic drugs and increase the coverage of vaccination and standardized treatment is the most effective means to reduce the enormous health and socioeconomic burden of HBV-related diseases.

Chronic hepatitis B infection is a very important health problem in China, which is carrying an enormous economic and social burdens. The major routs of chronic hepatitis B infection in China are mother-infant vertical transmission and early childhood horizontal transmission. After more than 10 years implementation of universal vaccination against hepatitis B in newborns and safety injection in health care settings, the prevalence of HBsAg in general population has decreased from 9.75% to around 7%. In China, patients with hepatitis are cared by either hepatologists or physicians of infectious diseases. The Chinese Society of Hepatology, and Chinese Society of Infectious Diseases jointly issued an evidence-based guideline on the prevention and treatment of chronic hepatitis B in 2005. This guideline concisely describes the virology, epidemiology, natural history and prevention, as well as diagnosis and management of chronic hepatitis B. It also highlights the importance of active viral replication in disease progression in chronic HBV infection and explicitly states the necessity of antiviral therapy in patient care. The cornerstone of anti-hepatitis B therapy is optimal use of interferons or nucleos(t)ide analogs in those patients with active viral replication and elevated serum transaminase levels. Through an independent continue medical educational agency, a panel of selected speakers were trained to give well-formatted talks on the key points of the guideline in over 60 major cities across China. This educational campaign among health care providers has greatly improved the awareness and the stand of care for antiviral therapy.

Diagnostic Tests, Routine ; Humans ; Liver Cirrhosis ; diagnosis

In recent years,the basic research on liver fibrosis has been progressed rapidly.This article briefly reviews the cellular and molecular mechanisms of liver fibrosis,including the origin of myofibroblasts,immune regulation,autophagy,and epigenetic regulation,and introduces several new therapeutic targets.More and more evidences show that successful removal of causes is the most important antifibrotic therapy.At present,although the antifibrotic drugs acting on different targets have been emerging,most of them are still in the early stage of research and development,and well-designed clinical trials are needed to confirm their clinical efficacy.

Iron overload is a metabolic disorder characterized by excessive iron deposition in the liver,pancreas,heart,endocrine organs, etc.,resulting in structural damage and dysfunction.The liver is the primary organ for iron storage,and excessive iron deposition induces liver inflammation and fibrosis,which may progress to cirrhosis and even liver cancer,with a poor prognosis.Accurate evaluation and effec-tive treatment can reduce liver injury caused by iron overload and improve patients′survival.

Hepatitis C virus (HCV)infection is one of the most common causes of chronic hepatitis,liver cirrhosis,and hepatocellular car-cinoma.MicroRNAs (miRNAs),a class of small,non -coding RNA,are involved in a variety of physiological and pathological processes in human bodies.The mechanism by which miRNAs regulate HCV replication is described,and the effects of liver -specific microRNA -122 antagonists on hepatitis C antiviral therapy are discussed.Our study indicates that miRNAs play an important regulatory role in HCV ex-pression.Targeting miRNAs may be a potential therapeutic approach for treating HCV infection,but further studies are still in need.

Objective To investigate the changes in serum leptin and adiponectin levels and their significance in patients with chronic hepa-titis B virus (HBV)infection.Methods One hundred and twenty -five patients with chronic HBV infection (44 HBeAg -positive cases, 31 HBeAg -negative cases of chronic hepatitis B,23 chronic HBV carriers,and 27 inactive HBsAg carriers)were recruited in the present study.Fifty -five healthy people served as the control group.Blood samples were collected at 8 to 9 AMof the next morning after overnight fasting.Blood glucose,blood lipids,renal and liver function parameters,fasting insulin,serum HBV markers,and HBV DNA concentration were determined,and HOMA -IR was calculated.Serum levels of leptin and adiponectin were measured by ELISA.Continuous data were expressed as mean ±SD,and Student′s t -test,analysis of variance,linear regression analysis,and multiple regression analysis were ap-plied in the analysis of all experimental data.Results There were no significant differences in serum levels of leptin and adiponectin be-tween patients with chronic HBV infection and the control group (P =0.480;P =0.321),even after stratification by gender (males:P =0.210 /0.895;females:P =0.404 /0.066).After patients with chronic HBV infection were divided into subgroups by HBeAg status,HBV DNA,or ALT level,there were no significant differences in serum levels of leptin and adiponectin between groups (leptin:P =0.820 /0.296 /0.212;adiponectin:P =0.268 /0.760 /0.224).Conclusion For patients with chronic HBV infection,infection status and viral replication level are not significantly correlated with serum levels of leptin and adiponectin.

e scale clinical trials.

Humans ; Liver Cirrhosis ; Portal Vein ; Venous Thrombosis