China News Service, Beijing, July 26 (Reporter Li Chun) July 28, 2021 is the eleventh World Hepatitis Day.
Under the guidance of the National Health Commission, the National Bureau of Disease Control and the Representative Office of the World Health Organization in China, the China Hepatitis Prevention and Control Foundation recently held the 2021 World Hepatitis Day promotion around the theme of "active prevention, active detection, standardized treatment, and comprehensive curbing of hepatitis hazards." The conference promoted the elimination of hepatitis and set off an upsurge in the whole society to fight against hepatitis.
Leaders of relevant departments, experts in Beijing, and nearly 300 medical and health personnel and representatives of pharmaceutical companies from across the country attended the event.
China has the conditions to eliminate the harm of hepatitis
Viral hepatitis is the Class B infectious disease with the largest number of reported cases of legally reported infectious diseases in my country.
It is estimated that there are currently about 86 million hepatitis B virus carriers in the country, of which about 28 million are chronic hepatitis B patients requiring treatment; about 4.5 million hepatitis C patients.
In 2016, the 69th World Health Assembly adopted the "Global Health Sector Strategy: Viral Hepatitis (2017-2021)", which proposed to eliminate the public health hazards of viral hepatitis by 2030.
Zhang Meiying, vice chairman of the 11th National Committee of the Chinese People's Political Consultative Conference and honorary chairman of the China Hepatitis Prevention Foundation, said that with the mass production of hepatitis B vaccine in the 1990s, China finally obtained a powerful weapon to declare war on hepatitis B, through mass immunization and reinoculation. Vaccines, especially hepatitis B vaccine, are included in the neonatal planned immunization and the development of mother-to-child blocking technology, which has moved the barrier of prevention forward and curbed the virus infection from the source.
Patients are the first person responsible for their own health. They must lay down their burdens through publicity and actively accept and adhere to scientific and standardized treatment.
It is necessary to mobilize all sectors of society to jointly fight hepatitis, a major disease endangering human health, and promote continuous new progress in China's hepatitis prevention and treatment cause.
Wang Hesheng, deputy director of the National Health Commission and Director of the National Disease Control and Prevention Bureau, stated that the National Health Commission will comprehensively promote the implementation of actions to eliminate hepatitis C public health hazards in the next step.
In the near future, it will jointly issue a work plan with multiple departments, emphasizing the deepening of the "three-medicine linkage" of medical care, medical insurance, and medicine, and fully implement the seven key tasks of "five strengthening, one increasing, and one implementing", to minimize new infections of hepatitis B and reduce hepatitis C Popularity level.
At the same time, continue to implement a comprehensive prevention and control strategy focusing on vaccination, strengthen treatment and management, improve the accessibility of standardized antiviral treatment and patient compliance, and strengthen social mobilization and popular science knowledge.
According to Hao Chunpeng, deputy secretary-general of the China Medical Insurance Research Association, 66.59% of medical insurance coordinating areas across the country include viral hepatitis diagnosis and treatment in the coverage of employee medical insurance outpatient clinics. The actual reimbursement ratio reaches 60.68%, and the reimbursement ratio for inpatients is close to 80%.
6.05% of the medical insurance coordinating areas included the diagnosis and treatment of viral hepatitis in the coverage of the residents' medical insurance outpatient clinics, and the actual reimbursement ratio was 52.38%, and the actual reimbursement ratio for the inpatient part reached 60%.
While continuing to expand the coverage of medical insurance, centralized purchases have reduced drug prices and the burden of drug costs for insured patients, greatly improving the availability of hepatitis medications.
Continue to strengthen vaccination to strengthen the hepatitis B immune barrier
Continue to strengthen hepatitis B vaccination and cut off the transmission route from the source is the basis for carrying out the elimination of hepatitis B.
Liang Xiaofeng, vice president of the Chinese Preventive Medicine Association and chair professor of Jinan University, said that the timely vaccination rate of neonatal hepatitis B vaccine in my country is over 90%.
National hepatitis B flow regulation data in 2014 showed that the child hepatitis B virus infection rate continued to decline, and the HBsAg (hepatitis B surface antigen) prevalence rate of children under 5 years of age continued to remain below 1%, and the difference in the child hepatitis B virus infection rate between regions and between urban and rural areas has further narrowed.
In the past ten years, the reported incidence of acute hepatitis B has been declining year by year, and will drop to 2.67 per 100,000 in 2020.
Dr. Gao Li, the representative of the World Health Organization in China, praised China's impressive progress in eliminating the harm of hepatitis B.
He said that 20 years ago, China began to provide free hepatitis B vaccination for all children, and children born today are the generation with almost no hepatitis B.
This milestone progress means that we have greatly reduced the number of cases of liver cancer and cirrhosis in the offspring.
Promote hepatitis diagnosis and treatment, reduce the incidence of liver cirrhosis and liver cancer
Chronic hepatitis B and C infections are the main causes of liver cirrhosis and liver cancer. The huge stock of patients means that if effective measures are not taken, it will lead to a heavy burden of disease.
Jia Jidong, a professor at the Beijing Friendship Hospital affiliated to Capital Medical University, pointed out that the number of deaths from cirrhosis worldwide continued to rise from 1990 to 2017, of which hepatitis B and C accounted for about half.
In 2020, there were 830,180 deaths from liver cancer worldwide, and 391,152 deaths from liver cancer in my country, accounting for 47% of the world’s total.
Hepatitis B and C antiviral therapy is the secondary prevention of liver cirrhosis and liver cancer. Long-term antiviral therapy can block and reverse liver fibrosis and cirrhosis caused by HBV infection, reduce the mortality of patients with hepatitis B compensatory cirrhosis, and prolong The survival period of patients with hepatitis B liver cirrhosis in the decompensated stage can reduce the incidence of liver cancer in hepatitis B patients.
The main drugs recommended by my country and the World Health Organization hepatitis C guidelines have covered HCV genotypes 1-6. Unlike hepatitis B, although there is no vaccine for hepatitis C, more than 90% of patients take direct antiviral drugs (DAA) for 12 weeks , Can achieve a complete cure.
In the treatment of hepatitis B, entecavir, tenofovir dipivoxil, propofol tenofovir and pegylated interferon are first-line drugs recommended by international and domestic guidelines, which can effectively inhibit virus replication and greatly slow down the process of liver disease.
The "Guidelines for the Prevention and Treatment of Chronic Hepatitis B (2019 Edition)" propose that clinical cures should be pursued for some suitable patients.
Wang Fusheng, academician of the Chinese Academy of Sciences and director of the National Infectious Diseases Clinical Medicine Research Center, introduced the research progress of clinical cure and immunotherapy of chronic viral hepatitis.
At present, countries around the world are stepping up research and development of new drugs to explore the cure of chronic hepatitis B.
Due to the liver's innate and adaptive immune tolerance to hepatitis B virus, immunotherapy for hepatitis B has a better prospect.
Gao Zhiliang, a professor at the Third Affiliated Hospital of Sun Yat-sen University, said that the “China Chronic Hepatitis B Clinical Cure (Everest) Project” initiated by the China Hepatitis Prevention Foundation in 2018 has effectively enrolled 13,679 patients by the end of June 2021, achieving clinical practice. 2281 cases were cured.
Obtaining a clinical cure can greatly improve the long-term clinical outcome of patients with chronic hepatitis B and some patients with liver cirrhosis, and reduce the risk of liver cancer.
Liu Zhongfu, a researcher at the China Center for Disease Control and Prevention, said that since 2017, a number of direct antiviral drugs (DAA) for hepatitis C have been approved for marketing, and 4 of them have been included in the medical insurance catalog, including three imported drugs and one. Home-made drugs.
The focus of hepatitis C prevention and treatment is early detection, early diagnosis, and early treatment. However, there are still large gaps in current prevention and treatment work, which is mainly reflected in the low awareness rate of public hepatitis C prevention and treatment; the detection rate is low, with a total of about 2.7 million reported cases, which is only an estimate About 1/3 of the number; medical institutions have insufficient diagnostic capabilities, and the proportion of nucleic acid testing in reported cases is less than 60%; the proportion of standardized antiviral treatment is low, only 10% to 15%.
Multilateral efforts to jointly promote the elimination of hepatitis hazards
The action to eliminate the hazards of hepatitis requires multi-party coordination to form a joint force to effectively advance.
Yang Xizhong, executive vice chairman of the China Hepatitis Prevention Foundation, said that as the only national public fundraising foundation in the field of liver disease in my country, the Liver Foundation, under the guidance of the National Health Commission and the Ministry of Civil Affairs, strives to build a foundation for all sectors of society concerned about hepatitis prevention platform.
In the past year, focusing on the prevention and treatment of hepatitis B, a series of major public welfare projects and scientific research have been carried out around the clinical cure of hepatitis B, the reduction of the incidence of liver cancer in patients with hepatitis B, and the treatment of hepatitis B hypoviremia.
Promote the establishment and improvement of in- and out-hospital hepatitis C referral mechanisms and hepatitis C screening management for key populations in 21 provinces, municipalities, and municipalities across the country.
In addition, the Liver Foundation pays close attention to standardizing prevention and treatment, diagnosis and treatment at the grassroots level, organizes experts to go to the plateau, the grassroots level, and enter the old areas, and train nearly 10,000 front-line medical and health personnel.
71,000 liver disease-related scholars, clinicians, and disease control personnel participated in various international and domestic academic exchange activities organized by the Liver Foundation.
Since July last year, 91.87 million yuan of funds and materials have been raised, 30 public welfare projects have been carried out, covering 31 provinces, autonomous regions and municipalities, and have made positive contributions to curbing the harm of viral hepatitis and related liver diseases and improving the health of the people.
In order to expand the social influence of hepatitis prevention and treatment, at this publicity conference, the Liver Foundation invited Cai Guoqing, a well-known singer in my country, as the ambassador for hepatitis prevention and treatment.
In the past year, the public and medical and health personnel have actively participated in popular science activities.
The conference also awarded prizes to the winners of the "Cure Hepatitis B·Light Up the Future" poster design contest and the winners of the "Science Popularization Action to Eliminate Hepatitis B Harm-I Want to Answer Questions" competition.
Various caring companies donated money and materials, which effectively promoted liver disease academic exchanges, research on prevention and treatment technologies, and patient education.
Related companies have also won the "Hepatitis Elimination Public Welfare Award" this year.
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