1.How far is the functional cure of chronic hepatitis B from complete cure?
Journal of Clinical Hepatology 2025;41(1):15-23
Functional cure is currently the ideal treatment endpoint for chronic hepatitis B (CHB) in China and globally. HBsAg seroclearance and HBV DNA that cannot be detected in peripheral blood for more than 24 weeks marks the regression of hepatitis B virus (HBV) infection. However, there is still a lack of systematic description of the characteristics of intrahepatic HBV markers after HBsAg seroclearance. This article elaborates on the issues including the latest definition of functional cure, the characteristics of intrahepatic virological markers after HBsAg seroclearance, the significance of ultrasensitive serum HBsAg detection, and antiviral therapy for CHB patients with a low level of HBsAg, so as to improve the understanding of functional cure among clinicians.
2.Update on the treatment navigation for functional cure of chronic hepatitis B: Expert consensus 2.0
Di WU ; Jia-Horng KAO ; Teerha PIRATVISUTH ; Xiaojing WANG ; Patrick T.F. KENNEDY ; Motoyuki OTSUKA ; Sang Hoon AHN ; Yasuhito TANAKA ; Guiqiang WANG ; Zhenghong YUAN ; Wenhui LI ; Young-Suk LIM ; Junqi NIU ; Fengmin LU ; Wenhong ZHANG ; Zhiliang GAO ; Apichat KAEWDECH ; Meifang HAN ; Weiming YAN ; Hong REN ; Peng HU ; Sainan SHU ; Paul Yien KWO ; Fu-sheng WANG ; Man-Fung YUEN ; Qin NING
Clinical and Molecular Hepatology 2025;31(Suppl):S134-S164
As new evidence emerges, treatment strategies toward the functional cure of chronic hepatitis B are evolving. In 2019, a panel of national hepatologists published a Consensus Statement on the functional cure of chronic hepatitis B. Currently, an international group of hepatologists has been assembled to evaluate research since the publication of the original consensus, and to collaboratively develop the updated statements. The 2.0 Consensus was aimed to update the original consensus with the latest available studies, and provide a comprehensive overview of the current relevant scientific literatures regarding functional cure of hepatitis B, with a particular focus on issues that are not yet fully clarified. These cover the definition of functional cure of hepatitis B, its mechanisms and barriers, the effective strategies and treatment roadmap to achieve this endpoint, in particular new surrogate biomarkers used to measure efficacy or to predict response, and the appropriate approach to pursuing a functional cure in special populations, the development of emerging antivirals and immunomodulators with potential for curing hepatitis B. The statements are primarily intended to offer international guidance for clinicians in their practice to enhance the functional cure rate of chronic hepatitis B.
3.Update on the treatment navigation for functional cure of chronic hepatitis B: Expert consensus 2.0
Di WU ; Jia-Horng KAO ; Teerha PIRATVISUTH ; Xiaojing WANG ; Patrick T.F. KENNEDY ; Motoyuki OTSUKA ; Sang Hoon AHN ; Yasuhito TANAKA ; Guiqiang WANG ; Zhenghong YUAN ; Wenhui LI ; Young-Suk LIM ; Junqi NIU ; Fengmin LU ; Wenhong ZHANG ; Zhiliang GAO ; Apichat KAEWDECH ; Meifang HAN ; Weiming YAN ; Hong REN ; Peng HU ; Sainan SHU ; Paul Yien KWO ; Fu-sheng WANG ; Man-Fung YUEN ; Qin NING
Clinical and Molecular Hepatology 2025;31(Suppl):S134-S164
As new evidence emerges, treatment strategies toward the functional cure of chronic hepatitis B are evolving. In 2019, a panel of national hepatologists published a Consensus Statement on the functional cure of chronic hepatitis B. Currently, an international group of hepatologists has been assembled to evaluate research since the publication of the original consensus, and to collaboratively develop the updated statements. The 2.0 Consensus was aimed to update the original consensus with the latest available studies, and provide a comprehensive overview of the current relevant scientific literatures regarding functional cure of hepatitis B, with a particular focus on issues that are not yet fully clarified. These cover the definition of functional cure of hepatitis B, its mechanisms and barriers, the effective strategies and treatment roadmap to achieve this endpoint, in particular new surrogate biomarkers used to measure efficacy or to predict response, and the appropriate approach to pursuing a functional cure in special populations, the development of emerging antivirals and immunomodulators with potential for curing hepatitis B. The statements are primarily intended to offer international guidance for clinicians in their practice to enhance the functional cure rate of chronic hepatitis B.
4.Update on the treatment navigation for functional cure of chronic hepatitis B: Expert consensus 2.0
Di WU ; Jia-Horng KAO ; Teerha PIRATVISUTH ; Xiaojing WANG ; Patrick T.F. KENNEDY ; Motoyuki OTSUKA ; Sang Hoon AHN ; Yasuhito TANAKA ; Guiqiang WANG ; Zhenghong YUAN ; Wenhui LI ; Young-Suk LIM ; Junqi NIU ; Fengmin LU ; Wenhong ZHANG ; Zhiliang GAO ; Apichat KAEWDECH ; Meifang HAN ; Weiming YAN ; Hong REN ; Peng HU ; Sainan SHU ; Paul Yien KWO ; Fu-sheng WANG ; Man-Fung YUEN ; Qin NING
Clinical and Molecular Hepatology 2025;31(Suppl):S134-S164
As new evidence emerges, treatment strategies toward the functional cure of chronic hepatitis B are evolving. In 2019, a panel of national hepatologists published a Consensus Statement on the functional cure of chronic hepatitis B. Currently, an international group of hepatologists has been assembled to evaluate research since the publication of the original consensus, and to collaboratively develop the updated statements. The 2.0 Consensus was aimed to update the original consensus with the latest available studies, and provide a comprehensive overview of the current relevant scientific literatures regarding functional cure of hepatitis B, with a particular focus on issues that are not yet fully clarified. These cover the definition of functional cure of hepatitis B, its mechanisms and barriers, the effective strategies and treatment roadmap to achieve this endpoint, in particular new surrogate biomarkers used to measure efficacy or to predict response, and the appropriate approach to pursuing a functional cure in special populations, the development of emerging antivirals and immunomodulators with potential for curing hepatitis B. The statements are primarily intended to offer international guidance for clinicians in their practice to enhance the functional cure rate of chronic hepatitis B.
5.Effect of sex hormones on male osteoporosis: a review
GAO Zengjie ; ZHANG Wangming ; FAN Zhiliang ; LI Lailai ; CHAI Yihui
Journal of Preventive Medicine 2025;37(12):1239-1241
Abstract
The incidence of fragility fractures and related mortality caused by male osteoporosis (OP) are both higher than in females. Male bone health was regulated by a sophisticated network involving both androgens and estrogens. Androgens can directly promote bone formation and inhibit bone resorption through androgen receptors on osteoblasts and osteocytes. They can also be converted into estrogens via the action of aromatase and subsequently regulate bone metabolism through estrogen receptors. Declining sex hormone levels, an imbalance in the estrogen-to-androgen ratio, and the resulting disruption in bone metabolic pathways collectively contribute to the development and progression of male OP. Moreover, androgens cannot fully compensate for the bone metabolic imbalance induced by estrogen deficiency. This article reviewed research on the role and mechanism of sex hormones in male OP, as well as studies related to the risks of sex hormone therapy for OP, so as to provide the references for improving control and treatment strategies of male OP.
6.Expert recommendations on screening,testing and management for hepatitis B virus infection in adults
Society of Prevention and Control of Infectious Diseases of Chinese Preventive Medicine Association ; Working Committee of Promoting the Elimination of Viral Hepatitis of Chinese Preventive Medicine Association ; Bingliang LIN ; Fuqiang CUI ; Zhiliang GAO
Journal of Clinical Hepatology 2024;40(8):1543-1550
The prevalence of hepatitis B represents a significant public health concern with a heavy disease burden.In China,there is still a big gap between the current diagnosis and treatment rates of hepatitis B and the goal of eliminating viral hepatitis as a public health threat by 2030 set by the World Health Organization(WHO).In order to achieve the WHO goal and the goal of 2030 Healthy China Outline,the Chinese Preventive Medicine Association organized domestic experts in the fields of clinical medicine,public health and clinical laboratory medicine to develop the Expert Recommendations on Screening,Testing and Management for Hepatitis B Virus Infection in Adults after several rounds of discussion based on comprehensive review of relevant domestic and international guidelines and literatures,the purpose is to facilitate universal screening of hepatitis B virus(HBV)infection in adults and provide practical guidance on disease assessment,treatment and long-term follow-up management of people infected with HBV and vaccination for people susceptible to HBV infection,thus promoting the elimination of the threat of hepatitis B.
7.Expert recommendations on hepatitis B vaccination in adults
Working Committee of Promoting the Elimination of Viral Hepatitis of Chinese Preventive Medicine Association ; Society of Prevention and Control of Infectious Diseases of Chinese Preventive Medicine Association ; Fuqiang CUI ; Zhiliang GAO
Journal of Clinical Hepatology 2024;40(8):1551-1556
In order to achieve the target of eliminating viral hepatitis as a public health threat by 2030 and to prioritize the role of hepatitis B vaccination in reducing new hepatitis B virus infections,the Chinese Preventive Medicine Association commissioned experts to develop the Expert Recommendations on Hepatitis B Vaccination in Adults to scientifically guide adult hepatitis B vaccination,build the herd immunity in population,and reduce the hepatitis B virus infection rate and incidence of hepatitis B.
8.Current Status and Research Progress of the Third Generation Domestic Left Ventricular Assist Device
Zhiliang GAO ; Hanwei TANG ; Jianfeng HOU
Chinese Circulation Journal 2024;39(8):822-827
Heart failure represents a significant public health challenge in China at present.The technology development of left ventricular assist device has become a therapy option for end-stage heart failure patients.The third generation left ventricular assist device has undergone significant improvements in its principle,structure,size,mechanical stability,biocompatibility,and many other aspects.In recent years,multiple products have been put into clinical application,meeting the need of heart failure patients with implantation indications.This article mainly reviews the technological development,clinical application,available domestic and abroad products,and future prospects of the third generation domestic left ventricular assist device.
9.Multi-omics combined test performance effectiveness on opportunistic screening of high-risk liver cancer population
Chan XIE ; Bingliang LIN ; Hong DENG ; Xiaohong ZHANG ; Qiyi ZHAO ; Zhiliang GAO
Chinese Journal of Hepatology 2024;32(2):140-147
Objective:To validate the performance of a multi-omics combined test for early screening of high-risk liver cancer populations.Methods:173 high-risk patients with liver cancer were prospectively screened in a real-world setting, and 164 cases were finally enrolled. B-ultrasound, alpha-fetoprotein (AFP), and HCC screens were conducted in all patients. A multi-omics early screening test was performed for liver cancer in combination with multi-gene methylation, TP53/TERT/CTNNB1 mutations, AFP, and abnormal prothrombin (PIVKA-II). Differences in rates were compared using the chi-square test, adjusted chi-square test, or Fisher's exact probability method for count data. A non-parametric rank test (Mann-Whitney) was used to compare the differences between the two groups of data.Results:The HCCscreen detection had a sensitivity of 100% for liver cancer screening, 93.8% for liver cancer and precancerous diseases, 34.1% for positive predictive value, 99.2% for negative predictive value, and 0.89 for an area under the curve (AUC). Parallel detection of AFP, AFP+B-ultrasound, and methylation+mutation had a sensitivity/specificity and AUC of 31.3%/88.5% (AUC=0.78), 56.3%/88.2% (AUC=0.86), and 81.3%/82.4 % (AUC=0.84). At the same time, the disease severity range was significantly correlated with the methylation+mutation score, HCCscreen score, or positive detection rate (PDR). There was no significant correlation between AFP serum levels and methylation+mutation or HCCscreen scores, while there was a significant linear correlation between methylation+mutation scores and HCCscreen scores ( r ?=?0.73, P ?0.001). Conclusion:In real-world settings, HCCscreen shows high sensitivity for screening opportunistic, high-risk liver cancer populations. Furthermore, it may efficaciously detect liver cancer and precancerous diseases, with superior performance to AFP and AFP+ultrasound. Hence, HCCscreen has the potential to become an effective screening tool that is superior to existing screening methods for high-risk liver cancer populations.
10.Predictive factors for HBsAg-negative seroconversion in chronic hepatitis B after antiviral therapy
Chinese Journal of Hepatology 2024;32(2):186-192
Hepatitis B surface antigen (HBsAg) negative seroconversion (HBsAg < 0.05 IU/ml) is research hotspot in the field of hepatitis at this stage, and patients who achieve HBsAg negative seroconversion have significantly fewer liver-related complications. Presently, there are many studies with regard to HBsAg-negative seroconversion, but there are still relatively few indicators used in clinical practice to predict HBsAg-negative seroconversion. Low baseline HBsAg quantification and dynamic decline during treatment are currently recognized as the best indicators for predicting HBsAg-negative seroconversion. However, other factors such as viral genotype, elevated transaminases during treatment course, immune cell function and cytokine levels, and host factors can all influence HBsAg-negative seroconversion. This article reviews the relevant indicators and potential predictive factors for HBsAg-negative seroconversion.


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