Li Lanjuan, an academician of the Chinese Academy of Engineering, director of the State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, and chief physician at the First Affiliated Hospital of Zhejiang University, stated in an interview with the media: “Liver problems among middle-aged and elderly individuals not only affect their own health but also impact family well-being. Therefore, it is essential to properly recognize the hazards of viral hepatitis. Individuals with high-risk behaviors should proactively undergo screening as soon as possible, and patients who have been diagnosed should receive active and standardized treatment. Viral hepatitis is not something to fear; hepatitis B can be controlled, and hepatitis C can be cured. I recommend that middle-aged and elderly patients who have engaged in high-risk behaviors take the initiative to get screened, so as to achieve early detection, early diagnosis, and early treatment.”
Transmission routes of hepatitis B and hepatitis C include blood transmission, mother-to-child transmission, and sexual contact. Engaging in high-risk behaviors associated with these transmission routes may lead to hepatitis B or hepatitis C infection. Additionally, in daily life, activities such as sharing razors or toothbrushes, foot care procedures, tattooing, and ear piercing may cause mucosal damage and bleeding, thereby facilitating the transmission of hepatitis B and hepatitis C viruses. If individuals infected with hepatitis B or hepatitis C viruses do not receive timely antiviral therapy, they are at risk of developing liver cirrhosis and hepatocellular carcinoma.
According to the latest data from the National Cancer Center, liver cancer ranks fourth in cancer incidence and second in cancer mortality in China, with hepatitis B-induced liver cancer accounting for as high as 92.05% of cases.
Since the implementation of the “Healthy China 2030” Action Plan, China has been intensifying efforts to control and reduce the prevalence of viral hepatitis while improving access to innovative medicines. Multiple innovative drugs have been included in the National Reimbursement Drug List through medical insurance negotiations.
Advancing China’s Hepatitis Prevention and Control Plan requires not only government support and investment but also concerted efforts and collaboration from healthcare institutions, pharmaceutical companies, and all sectors of society. Gilead Sciences, a global leader in antiviral biopharmaceuticals, is an active participant in this endeavor. Since commencing commercial operations in China in 2017, Gilead has successfully launched five innovative antiviral drugs for chronic hepatitis B and C in the Chinese market. Three of these medications have been included in the National Reimbursement Drug List, thereby expanding drug accessibility and benefiting more patients in need. Furthermore, Gilead continues to invest significantly in supporting nationwide public welfare initiatives for viral hepatitis screening, testing, and free clinics. In collaboration with leading domestic medical diagnostics and pharmaceutical distribution companies, Gilead has jointly launched the “Public Welfare Initiative for Integrated Infectious Disease Diagnosis and Treatment,” aiming to raise public awareness of viral hepatitis and promote early diagnosis, early treatment, and standardized care.
“Creating a healthier world for the public is Gilead’s goal. With over 30 years since its establishment, the company has developed more than 25 innovative drugs, achieving multiple breakthroughs once deemed medically impossible and transforming patient treatment,” said Fangqian Jin, Global Vice President of Gilead Sciences and General Manager of China Region. “We recognize that advancing scientific research and expanding drug accessibility are only part of improving public health. Gilead will continue to develop and strengthen collaborations with all sectors of society, supporting enhancements in healthcare standards and public education, promoting accurate understanding of diseases, reducing stigma, and helping more patients return to normal life as soon as possible.”
During this year’s National Liver Care Day on March 18, Gilead Sciences once again partnered with the China United Liver Health Promotion Center to launch a large-scale free hepatitis C clinic campaign across China. The six-day event will cover more than 100 hospitals in all 31 provincial-level administrative regions nationwide, benefiting over 7,000 patients. For more information about this free hepatitis C clinic campaign, please follow the WeChat official accounts of China United Liver or Gilead Sciences, or scan the QR code below.
New Standards for Hepatitis B Diagnosis and Treatment: Pursuing Therapy Should “Keep Pace with the Times”
Currently, there are approximately 90 million hepatitis B virus (HBV) carriers in China, including 28 million patients with chronic hepatitis B. Significant challenges remain in the effort to eliminate chronic hepatitis B. Furthermore, the patient population is aging; if middle-aged and elderly patients do not initiate antiviral therapy early, their risk of developing liver cirrhosis and hepatocellular carcinoma will increase substantially with age.
To further curb the prevalence of chronic hepatitis B, the Guidelines for the Prevention and Treatment of Chronic Hepatitis B (2019 Edition) recommend antiviral therapy for all patients who test positive for HBV DNA and have elevated alanine aminotransferase (ALT) levels (after excluding other causes), or those with normal ALT levels but presenting high-risk factors or histological evidence of hepatic inflammation and fibrosis on liver biopsy.
In addition to early diagnosis and treatment, standardized management of hepatitis B is also crucial. Academician Li Lanjuan stated, “Individuals infected with hepatitis B virus (HBV) should fundamentally suppress viral replication to alleviate hepatocellular inflammation, necrosis, and hepatic fibrosis, thereby delaying and reducing liver function impairment and decreasing the incidence of liver failure. Concurrently, the status of the liver must be evaluated, with regular monitoring of HBV DNA levels being particularly important. High-sensitivity assays facilitate the detection of low-level viral activity; it is recommended that middle-aged and elderly patients undergo regular high-sensitivity testing to assess the efficacy of antiviral therapy. Suppressing HBV DNA levels to below 20 IU/mL can effectively reduce the risk of hepatocellular carcinoma and prevent the recurrence of chronic hepatitis B.”
Currently, the nucleos(t)ide analogues recommended by clinical guidelines have been included in the National Reimbursement Drug List, so middle-aged and elderly patients seeking long-term standardized treatment no longer need to be overly concerned about the financial burden.
Hepatitis C Can Be Virologically Cured; Timely Treatment Can “Eliminate Future Risks”
According to statistics, there are approximately 10 million individuals infected with hepatitis C in China, indicating a substantial gap remains in achieving the goal of “eliminating the public health threat of hepatitis C.”
The primary transmission routes of chronic hepatitis C virus (hereinafter referred to as HCV) include blood transfusions and blood products, exposure through broken skin and mucous membranes, sexual contact, and mother-to-child transmission. Many individuals become infected with HCV unknowingly. Due to the nonspecific symptoms of hepatitis C, most infected individuals lack the initiative to undergo screening, resulting in high rates of missed diagnosis, low consultation rates, and suboptimal treatment uptake.
Given China’s large population base, more precise prevention and control strategies are needed to identify hepatitis C virus (HCV)-infected individuals among its 1.4 billion people. Implementing targeted HCV screening for patients who proactively seek medical care is a cost-effective and highly efficient strategy. In addition to increasing the rate of proactive screening among high-risk populations, establishing HCV screening programs for outpatient, emergency, and inpatient populations within healthcare institutions will effectively identify potential cases.
Academician Li Lanjuan pointed out: “Individuals with a history of iatrogenic exposure, including those who have undergone surgery, dialysis, unsterile dental procedures, or organ or tissue transplantation, as well as those preparing for special or invasive medical procedures; individuals who received blood transfusions or blood products before 1993; plasma donors before 1996; and those whose family members or friends are infected with hepatitis C are all considered high-risk populations. I recommend that middle-aged and elderly individuals with a history of high-risk behaviors undergo hepatitis C screening at accredited medical institutions or include hepatitis C screening in their annual health check-ups. Meanwhile, it is hoped that medical institutions will establish standardized clinical pathways. When middle-aged and elderly patients receive treatment in departments other than infectious diseases, if they are found to have a history of high-risk behaviors or if examinations reveal HCV infection, they should be assisted with referral and treatment. It is hoped that medical institutions can provide one-stop assistance for screening, diagnosis, referral, and treatment, thereby enabling early diagnosis and early treatment, which will significantly improve patients’ treatment rates and cure rates.”
A few years ago, the advent of pan-genotypic direct-acting antiviral (DAA) regimens enabled sustained virologic response (SVR) rates exceeding 90% in the majority of patients with hepatitis C virus (HCV) infection. In 2019, the Guidelines for the Prevention and Treatment of Hepatitis C were updated again. The new guidelines explicitly state that the treatment of chronic hepatitis C has entered the pan-genotypic era, with interferon-free pan-genotypic regimens recommended as the first-line therapy. Furthermore, pan-genotypic oral direct-acting antivirals have been included in the national medical insurance reimbursement list, thereby reducing the financial burden on patients and improving drug accessibility.