1.Survey on the awareness and clinical application of guidelines for the prevention and treatment of chronic hepatitis B (2022 edition) among clinicians
Yuanyuan KONG ; Yujie GUO ; Yujuan GUAN ; Xuan LIANG ; Zhongjie HU ; Xiaobo LU ; Mingqin LU ; Yongfeng YANG ; Meifang HAN ; Hong YOU ; Zhiyun YANG ; Jidong JIA
Journal of Clinical Hepatology 2025;41(6):1068-1074
ObjectiveTo investigate the awareness and clinical practice of guidelines for the prevention and treatment of chronic hepatitis B (2022 edition) among clinicians. MethodsFrom July 19 to December 31, 2024, a self-designed electronic questionnaire was distributed via the WeChat mini program to collect related data from 1 588 clinicians nationwide, including their awareness and practice based on 18 questions regarding testing and referral, diagnosis and treatment, and follow-up. ResultsAmong all respondents, only 350 clinicians correctly understood all the updated key points of antiviral indications and treatment for special populations in the 2022 edition of guidelines for the prevention and treatment of chronic hepatitis B, with an overall awareness rate of 22.0%. Only 20% — 40% of the patients with positive HBV DNA and an age of >30 years receive antiviral therapy, while 80% — 100% of the patients with positive HBV DNA and a family history of hepatitis B cirrhosis or hepatocellular carcinoma receive antiviral therapy. The median follow-up rates at 1 year, 3 years, and 5 years were 67.5% 57.5% and 47.5%,respectively, showing a trend of gradual reduction, which might be associated with the influencing factors such as insufficient time for follow-up management by clinicians, insufficient awareness of the disease among patients, and poor adherence to follow-up. ConclusionThere is a gap between the awareness and practice of guidelines for the prevention and treatment of chronic hepatitis B (2022 edition) among clinicians. It is recommended to further strengthen training and focus on the whole process of “detection, diagnosis, treatment, and management” for patients with chronic hepatitis B in healthcare institutions, in order to promote the implementation of the guidelines.
2.Multidimensional analysis of diagnosis and treatment status of chronic hepatitis B
Ying TAN ; Bo LI ; Aiqi LU ; Lihua LIN ; Xiaoyuan CHEN ; Jianping LI ; Yujuan GUAN
Chinese Journal of Experimental and Clinical Virology 2025;39(4):449-453
Objective:The aim was to analyze key indicators for the diagnosis and treatment of chronic hepatitis B(CHB),including virus detection rate,standardized treatment rate,and loss to follow-up rate,in order to provide a basis for optimizing diagnosis and treatment plans,improve the diagnosis and treatment level of CHB,and improve patient prognosis.Methods:Patients with CHB admitted to the Guangzhou Eighth People′s Hospital Affiliated to Guangzhou Medical University from January 2024 to January 2025 were enrolled. The datas were collected and organized using Excel. Statistical analysis was conducted using SPSS 26.0 software,with a focus on evaluating core indicators such as virus detection rate,standardized treatment rate,and loss to follow-up rate.Results:The positive rate of hepatitis B surface antigen(HBsAg)in non-specific patients was 28.95%,the antiviral treatment rate in specialized patients was 90.78%,and the standardized antiviral drug conversion treatment rate in low-level viremia(LLV)patients was 61.45%. The standardized antiviral drug conversion treatment rates for high-risk patients with combined kidney/bone injuries were 72.75% and 74.40%,respectively. The overall dropout rate was 10.47%,with a dropout rate of 13.80% for LLV patients.Conclusions:The antiviral treatment coverage rates in CHB patients were over 90%,but in certain groups(such as LLV patients and those with kidney or bone injuries),the standardized treatment rates were still low and loss to follow-up rates were high,suggesting the need to improve HBV screening,treatment for special populations,and patient adherence.
3.Construction and implementation of a new model for prevention and treatment of hepatitis B in communities in Guangzhou city
Bo LI ; Aiqi LU ; Ying TAN ; Lihua LIN ; Songlian LIU ; Ganqiu LIN ; Qikai NING ; Jiewei LIU ; Huanhui LIANG ; Jianping LI ; Yujuan GUAN
Chinese Journal of Experimental and Clinical Virology 2025;39(4):441-448
Objective:A novel grass-root community screening and management model of hepatitis B was developed in order to improve the diagnosis and treatment rate of hepatitis B in Guangzhou city.Methods:A three-tier collaborative framework[tertiary hospitals-center for disease control and prevention(CDC)-primary care clinics]implemented dual-track screening(fixed-site+mobile units)using rapid hepatitis B surface antigen(HBsAg)testing and structured surveys. Digital closed-loop management integrated screening,referral,and follow-up. Data were analyzed via SPSS 26.0.Results:Among 30 012 community-dwelling adults screened(Male∶Female=1∶1.68),overall HBsAg positive rate was 5.21%(1 565/30 012),peaking in the 50-59-year cohort( χ2=271.80, P<0.001). Hepatitis B knowledge awareness was critically low(39.24%). Of 140 referred HBsAg-positive individuals,15 chronic carriers required no immediate antiviral therapy per guidelines. Treatment linkage surged from 32.8%(41/125)to 86.4%(108/125)post-intervention. aMAP hepatocellular carcinoma(HCC)risk stratification(n=82)revealed low(36.6%),intermediate(32.9%),and high-risk(30.5%)profiles. Conclusions:This coordinated,digitally-enhanced strategy significantly improved hepatitis B detection and treatment access. However,persistent knowledge gaps underscore the imperative for targeted community education and adherence support.
4.Clinical research progress in different stages of recompensated cirrhosis
Yaping WANG ; Xiuhan YANG ; Haiyi CAI ; Pei ZHOU ; Xiaoping TANG ; Xiaoyuan XU ; Yujuan GUAN
Chinese Journal of Hepatology 2025;33(8):715-720
The 2021 version of the Baveno Ⅶ consensus on portal hypertension and the 2023 guidelines from the European Association for the Study of the Liver define recompensated cirrhosis as the restoration and stabilization of liver function, improvement of liver fibrosis, and absence of decompensated cirrhosis for a long time following effective treatment of the underlying etiology of cirrhosis. Recompensated cirrhosis has become an important research direction in the field with the gradually increasing number of these patients. Temporary recompensation, stable recompensation, and long-term recompensation are the three stages into which patients with cirrhosis are divided, based on varying recompensation stages. Clinical characteristics and prognosis are significantly different among different stages. Patients in the temporary compensation stage have significant fluctuations in their condition and poor stability, with a high risk of recurrent complications. The prognosis of patients in the stable recompensation stage is significantly affected by the cause and the type of initial decompensation event, while the condition of patients in the long-term recompensation stage is more stable, and the long-term prognosis is close to that of compensated cirrhosis. This article aims to summarize and explore the recompensation rates at different stages of liver cirrhosis, the occurrence risk of various complications and liver cancer, and long-term management and treatment following recompensation, providing new directions for future research in this field.
5.A phase Ⅲ clinical study to evaluate the efficacy and safety profile of antaitasvir phosphate combined with yiqibuvir in the treatment of adults with chronic hepatitis C
Lai WEI ; Jia SHANG ; Xuan AN ; Guoqiang ZHANG ; Yujuan GUAN ; Hongxin PIAO ; Jinglan JIN ; Lang BAI ; Xingxiang YANG ; Daokun YANG ; Xinhua LUO ; Shufang YUAN ; Yingren ZHAO ; Yingjie MA ; Guangming LI ; Feng LIN ; Xiaoping WU ; Jiawei GENG ; Guizhou ZOU ; Jiabao CHANG ; Zuojiong GONG ; Xiaorong MAO ; Jing ZHU ; Wentao GUO ; Qingwei HE ; Lin LUO ; Yulei ZHUANG ; Hongming XIE ; Yingjun ZHANG
Chinese Journal of Hepatology 2025;33(6):560-569
Objective:To assess the efficacy and safety profile of antaitasvir phosphate combined with yiqibuvir in the treatment of chronic hepatitis C (CHC) of various genotypes, without cirrhosis or with compensated cirrhosis.Methods:394 cases with CHC from 22 centers were collected from October 2021 to April 2023. They were randomly assigned to receive either the experimental drugs (antaitasvir phosphate 100 mg+yiqibuvir 600 mg) or placebo treatment in a 3∶1 ratio. The patients were administered drugs once a day for 12 consecutive weeks, and then followed up for 24 weeks after treatment cessation. All subjects were unblinded at the four-week follow-up following drug discontinuation, with the experimental drug group continuing to complete subsequent post-discontinuation follow-up. The placebo group was switched to receive the experimental drugs for a repeated 12-week treatment period and followed up for another 24 weeks after discontinuation of the drug (placebo delayed treatment phase).The sustained virologic response rate (SVR12) was observed for subjects in the double-blind phase and the placebo delayed-treatment phase at 12 weeks after treatment cessation.Virological resistance analysis was performed on subjects who failed treatment. The primary efficacy endpoint was SVR12. The number and percentage of subjects who achieved "HCV RNA
6.Clinical features of hepatitis B virus-related early-onset and late-onset liver cancer: A comparative analysis
Songlian LIU ; Bo LI ; Yaping WANG ; Aiqi LU ; Chujing LI ; Lihua LIN ; Qikai NING ; Ganqiu LIN ; Pei ZHOU ; Yujuan GUAN ; Jianping LI
Journal of Clinical Hepatology 2025;41(9):1837-1844
ObjectiveTo compare the clinical features of patients with hepatitis B virus (HBV)-related early-onset liver cancer and those with late-onset liver cancer, to assess the severity of the disease, and to provide a theoretical basis for the early diagnosis and treatment of liver cancer. MethodsA retrospective analysis was performed for 695 patients who were diagnosed with HBV-related liver cancer for the first time in Guangzhou Eighth People’s Hospital, Guangzhou Medical University, from January 2019 to August 2023, among whom 93 had early-onset liver cancer (defined as an age of50 years for female patients and40 years for male patients) and 602 had late-onset liver cancer (defined as an age of ≥50 years for female patients and ≥40 years for male patients). Related clinical data were collected, including demographic data, clinical symptoms at initial diagnosis, comorbidities, smoking history, drinking history, family history, routine blood test results, biochemical parameters of liver function, serum alpha-fetoprotein(AFP), virological indicators, coagulation function, and imaging findings. The pan-inflammatory indices neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) were calculated, as well as FIB-4 index, aspartate aminotransferase-to-platelet ratio index (APRI), S index, Model for End-Stage Liver Disease (MELD) score, Child-Turcotte-Pugh (CTP) score, albumin-bilirubin (AIBL) grade, and Barcelona Clinic Liver Cancer (BCLC) stage. The independent-samples t test was used for comparison of normally distributed continuous data between two groups, and the Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test or Fisher’s exact test were used for comparison of categorical data between two groups. ResultsThere were significant differences between the two groups in the proportion of male patients and the incidence rates of diabetes, hypertension, and fatty liver disease (χ2=6.357, 15.230, 11.467, and 14.204, all P0.05), and compared with the late-onset liver cancer group, the early-onset liver cancer group had a significantly higher proportion of patients progressing to liver cancer without underlying cirrhosis (χ2=24.657, P0.001) and a significantly higher proportion of patients with advanced BCLC stage (χ2=6.172, P=0.046). For the overall population, the most common clinical symptoms included abdominal distension, abdominal pain, poor appetite, weakness, a reduction in body weight, edema of both lower limbs, jaundice, yellow urine, and nausea, and 55 patients (7.9%) had no obvious symptoms at the time of diagnosis and were found to have liver cancer by routine reexamination, physical examination suggesting an increase in AFP, or radiological examination indicating hepatic space-occupying lesion; compared with the late-onset liver cancer group, the patients in the early-onset liver cancer group were more likely to have the symptoms of abdominal distension, abdominal pain, and jaundice (all P0.05). Compared with the late-onset liver cancer group, the early-onset liver cancer group had a significantly larger tumor diameter (Z=2.845, P=0.034), with higher prevalence rates of multiple tumors and intrahepatic, perihepatic, or distant metastasis (χ2=5.889 and 4.079, both P0.05), and there were significant differences between the two groups in tumor location and size (χ2=3.948 and 11.317, both P0.05). Compared with the late-onset liver cancer group, the early-onset liver cancer group had significantly lower FIB-4 index, proportion of patients with HBsAg ≤1 500 IU/mL, and levels of LMR and Cr (all P0.05), as well as significantly higher positive rate of HBeAg and levels of log10 HBV DNA, AFP, WBC, Hb, PLT, NLR, PLR, TBil, ALT, Alb, and TC (all P0.05). ConclusionCompared with late-onset liver cancer, patients with early-onset liver cancer tend to develop liver cancer without liver cirrhosis and have multiple tumors, obvious clinical symptoms, and advanced BCLC stage, which indicates a poor prognosis.
7.Multidimensional analysis of diagnosis and treatment status of chronic hepatitis B
Ying TAN ; Bo LI ; Aiqi LU ; Lihua LIN ; Xiaoyuan CHEN ; Jianping LI ; Yujuan GUAN
Chinese Journal of Experimental and Clinical Virology 2025;39(4):449-453
Objective:The aim was to analyze key indicators for the diagnosis and treatment of chronic hepatitis B(CHB),including virus detection rate,standardized treatment rate,and loss to follow-up rate,in order to provide a basis for optimizing diagnosis and treatment plans,improve the diagnosis and treatment level of CHB,and improve patient prognosis.Methods:Patients with CHB admitted to the Guangzhou Eighth People′s Hospital Affiliated to Guangzhou Medical University from January 2024 to January 2025 were enrolled. The datas were collected and organized using Excel. Statistical analysis was conducted using SPSS 26.0 software,with a focus on evaluating core indicators such as virus detection rate,standardized treatment rate,and loss to follow-up rate.Results:The positive rate of hepatitis B surface antigen(HBsAg)in non-specific patients was 28.95%,the antiviral treatment rate in specialized patients was 90.78%,and the standardized antiviral drug conversion treatment rate in low-level viremia(LLV)patients was 61.45%. The standardized antiviral drug conversion treatment rates for high-risk patients with combined kidney/bone injuries were 72.75% and 74.40%,respectively. The overall dropout rate was 10.47%,with a dropout rate of 13.80% for LLV patients.Conclusions:The antiviral treatment coverage rates in CHB patients were over 90%,but in certain groups(such as LLV patients and those with kidney or bone injuries),the standardized treatment rates were still low and loss to follow-up rates were high,suggesting the need to improve HBV screening,treatment for special populations,and patient adherence.
8.Construction and implementation of a new model for prevention and treatment of hepatitis B in communities in Guangzhou city
Bo LI ; Aiqi LU ; Ying TAN ; Lihua LIN ; Songlian LIU ; Ganqiu LIN ; Qikai NING ; Jiewei LIU ; Huanhui LIANG ; Jianping LI ; Yujuan GUAN
Chinese Journal of Experimental and Clinical Virology 2025;39(4):441-448
Objective:A novel grass-root community screening and management model of hepatitis B was developed in order to improve the diagnosis and treatment rate of hepatitis B in Guangzhou city.Methods:A three-tier collaborative framework[tertiary hospitals-center for disease control and prevention(CDC)-primary care clinics]implemented dual-track screening(fixed-site+mobile units)using rapid hepatitis B surface antigen(HBsAg)testing and structured surveys. Digital closed-loop management integrated screening,referral,and follow-up. Data were analyzed via SPSS 26.0.Results:Among 30 012 community-dwelling adults screened(Male∶Female=1∶1.68),overall HBsAg positive rate was 5.21%(1 565/30 012),peaking in the 50-59-year cohort( χ2=271.80, P<0.001). Hepatitis B knowledge awareness was critically low(39.24%). Of 140 referred HBsAg-positive individuals,15 chronic carriers required no immediate antiviral therapy per guidelines. Treatment linkage surged from 32.8%(41/125)to 86.4%(108/125)post-intervention. aMAP hepatocellular carcinoma(HCC)risk stratification(n=82)revealed low(36.6%),intermediate(32.9%),and high-risk(30.5%)profiles. Conclusions:This coordinated,digitally-enhanced strategy significantly improved hepatitis B detection and treatment access. However,persistent knowledge gaps underscore the imperative for targeted community education and adherence support.
9.Clinical research progress in different stages of recompensated cirrhosis
Yaping WANG ; Xiuhan YANG ; Haiyi CAI ; Pei ZHOU ; Xiaoping TANG ; Xiaoyuan XU ; Yujuan GUAN
Chinese Journal of Hepatology 2025;33(8):715-720
The 2021 version of the Baveno Ⅶ consensus on portal hypertension and the 2023 guidelines from the European Association for the Study of the Liver define recompensated cirrhosis as the restoration and stabilization of liver function, improvement of liver fibrosis, and absence of decompensated cirrhosis for a long time following effective treatment of the underlying etiology of cirrhosis. Recompensated cirrhosis has become an important research direction in the field with the gradually increasing number of these patients. Temporary recompensation, stable recompensation, and long-term recompensation are the three stages into which patients with cirrhosis are divided, based on varying recompensation stages. Clinical characteristics and prognosis are significantly different among different stages. Patients in the temporary compensation stage have significant fluctuations in their condition and poor stability, with a high risk of recurrent complications. The prognosis of patients in the stable recompensation stage is significantly affected by the cause and the type of initial decompensation event, while the condition of patients in the long-term recompensation stage is more stable, and the long-term prognosis is close to that of compensated cirrhosis. This article aims to summarize and explore the recompensation rates at different stages of liver cirrhosis, the occurrence risk of various complications and liver cancer, and long-term management and treatment following recompensation, providing new directions for future research in this field.
10.A phase Ⅲ clinical study to evaluate the efficacy and safety profile of antaitasvir phosphate combined with yiqibuvir in the treatment of adults with chronic hepatitis C
Lai WEI ; Jia SHANG ; Xuan AN ; Guoqiang ZHANG ; Yujuan GUAN ; Hongxin PIAO ; Jinglan JIN ; Lang BAI ; Xingxiang YANG ; Daokun YANG ; Xinhua LUO ; Shufang YUAN ; Yingren ZHAO ; Yingjie MA ; Guangming LI ; Feng LIN ; Xiaoping WU ; Jiawei GENG ; Guizhou ZOU ; Jiabao CHANG ; Zuojiong GONG ; Xiaorong MAO ; Jing ZHU ; Wentao GUO ; Qingwei HE ; Lin LUO ; Yulei ZHUANG ; Hongming XIE ; Yingjun ZHANG
Chinese Journal of Hepatology 2025;33(6):560-569
Objective:To assess the efficacy and safety profile of antaitasvir phosphate combined with yiqibuvir in the treatment of chronic hepatitis C (CHC) of various genotypes, without cirrhosis or with compensated cirrhosis.Methods:394 cases with CHC from 22 centers were collected from October 2021 to April 2023. They were randomly assigned to receive either the experimental drugs (antaitasvir phosphate 100 mg+yiqibuvir 600 mg) or placebo treatment in a 3∶1 ratio. The patients were administered drugs once a day for 12 consecutive weeks, and then followed up for 24 weeks after treatment cessation. All subjects were unblinded at the four-week follow-up following drug discontinuation, with the experimental drug group continuing to complete subsequent post-discontinuation follow-up. The placebo group was switched to receive the experimental drugs for a repeated 12-week treatment period and followed up for another 24 weeks after discontinuation of the drug (placebo delayed treatment phase).The sustained virologic response rate (SVR12) was observed for subjects in the double-blind phase and the placebo delayed-treatment phase at 12 weeks after treatment cessation.Virological resistance analysis was performed on subjects who failed treatment. The primary efficacy endpoint was SVR12. The number and percentage of subjects who achieved "HCV RNA

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