The consensus on prevention and treatment of hepatitis E was released

      On January 6,2023, the press conference of the "Consensus on the Prevention and Treatment of Hepatitis E" was officially held in Xiamen, and the new consensus was officially announced, opening a new chapter in the prevention and treatment of hepatitis E.

      The official release of this consensus will further interpret the etiology, clinical diagnosis, treatment and other related progress of hepatitis E, aiming to provide clinicians and the public with clearer and accurate disease science popularization and diagnosis and treatment reference opinions, which has important guiding significance in the practice of clinical treatment and public health prevention and control.

      The consensus gathered 90 well-known clinical and disease control experts and young and middle-aged elites in the country, and explored a new system of hepatitis E prevention and treatment based on clinical cases to help eliminate the threat of viral hepatitis in 2030 in healthy China.

　　Compared with the well-known diseases such as hepatitis B and hepatitis C, hepatitis E seems to be the "small transparency" of viral hepatitis - the public knows little about hepatitis E, and even some patients still do not know what disease they have after suffering from hepatitis E.

      However, the harm of hepatitis E will not be reduced by the public's neglect of it: according to the statistics of the World Health Organization, there are about 20 million new hepatitis E infections in the world every year, of which 3.3 million patients have hepatitis symptoms.

      Hepatitis E virus is not only prevalent in the world, but also in China in recent years.

      In 2021, China reported that the number of hepatitis E patients was about 26000, and the morbidity and mortality accounted for 2% of all hepatitis. The infection rate and mortality rate had exceeded that of hepatitis A. In 2021, the incidence rate of hepatitis E will be about 1.84/100000, much higher than 1.27/100000 in 2004.

      In addition, in addition to acute and chronic hepatitis, hepatitis E virus infection may also cause extrahepatic abnormalities such as nervous system, blood system, urinary system, and lead to severe consequences such as liver cirrhosis and liver cancer.

      At the same time, the consensus on the diagnosis, treatment and prevention of hepatitis E in China remains in the Diagnostic and Treatment Guidelines for Viral Hepatitis E formulated in July 2009.

      Although foreign guidelines such as the Clinical Practice Guide for Hepatitis E Virus Infection issued by the European Society of Hepatology can still be used for clinical guidance, the foreign guidelines lack evidence-based data in China, and there are problems such as racial differences and differences in marketed drugs. The recommendations of foreign guidelines can not be directly applied to Chinese patients. It is urgent to update the consensus on prevention and treatment of hepatitis E in China.

In the process of formulating the consensus, the Chinese Medical Association Hepatology Credit Committee specially organized relevant experts to consult a large number of published hepatitis E literature, collect and summarize clinical hot issues, and seriously carry out discussions.

      Despite the repeated COVID-19, the expert group continued to forge ahead and finally formed a consensus on the prevention and treatment of hepatitis E. It is expected that this consensus can provide reference for relevant medical personnel in making decisions on diagnosis, treatment and prevention of hepatitis E.

　　The Consensus on the Prevention and Treatment of Hepatitis E has updated various evidences for more than 10 years, introduced six aspects of hepatitis E in detail, including etiology, epidemiology and prevention, pathology, laboratory examination, clinical manifestations, and treatment, and put forward problems to be studied and solved.

      As the latest decision-making basis for the diagnosis, treatment and prevention of hepatitis E in China, the consensus is expected to increase the attention of clinicians and the public to hepatitis E, promote the prevention of high-risk groups, and reduce the incidence and mortality of hepatitis E.

      The consensus points out that hepatitis E is mostly self-limited, so the general public is often unwilling to understand hepatitis E. However, hepatitis E is not self-limiting. Some patients infected with hepatitis E may still lead to severe hepatitis E, liver failure and other serious consequences, seriously affecting the health of patients and even endangering life.

      It should be noted that hepatitis E may bring more serious disease consequences to the elderly, pregnant women, patients with chronic liver disease and other high-risk groups. The disease burden of elderly patients with hepatitis E is serious, with high incidence rate, many complications and high mortality. Pregnant women infected with hepatitis E virus may have adverse effects on the health of pregnant women and fetuses, resulting in premature abortion, maternal death and other adverse consequences. The patients with superinfection of hepatitis B and hepatitis E progressed rapidly and had poor prognosis.

      Mild infection of hepatitis E usually takes symptomatic treatment and supportive treatment as the main treatment. When the disease is serious, ribavirin and interferon should be given according to the patient's physical condition α、 Liver transplantation and other therapies.

      At the same time, the consensus recommended that the high-risk population with hepatitis E infection and the population with potentially severe disease after infection (patients with chronic liver disease, women of childbearing age, the elderly, etc.) be vaccinated with HEV vaccine. The consensus emphasized that the recombinant hepatitis E vaccine can effectively prevent hepatitis E, and the prevention effect is lasting.

      Recombinant hepatitis E vaccine developed by China ® (Escherichia coli) was officially approved by the State Food and Drug Administration in 2012 and has been on the market for ten years. It is the only hepatitis E vaccine officially approved in the world.

Yikening, hepatitis E vaccine ® It is jointly and independently developed by China's Xiamen Wantai Canghai Biotechnology Co., Ltd. (hereinafter referred to as Wantai) and Xiamen University. After 14 years of research and development, it has experienced more than 60000 independent experiments of product development.

      After inoculation of hepatitis E vaccine, it can stimulate the body to produce neutralizing antibodies against HEV and prevent HEV infection. Its effectiveness and safety have been fully confirmed in clinical application for more than 10 years, and it still has preventive effect after vaccination for 4.5 years. At the same time, it also has good safety and immunogenicity in the elderly and patients with chronic liver disease.

　　The release of the "Consensus on the Prevention and Treatment of Hepatitis E" marks the official launch of hepatitis E prevention and treatment related projects.

      At the meeting, Professor Xu Xiaoyuan, director of the Department of Infectious Diseases of Peking University Medical Department, stressed that the prevention and treatment of hepatitis B and hepatitis C had made certain achievements in the past 30 years, while hepatitis E was still ignored by the public. The incidence rate of hepatitis E is higher than that of hepatitis A. However, its detection project has not been carried out in many hospitals, especially in grass-roots hospitals.

      The release of the "Consensus on the Prevention and Treatment of Hepatitis E" and the establishment of the expert group can reach the last mile to promote the construction of a healthy China, improve China's health level and eliminate viral hepatitis including hepatitis E.

      Zhang Jun, dean of the School of Public Health of Xiamen University, delivered a speech, explaining the incidence of hepatitis E and the story behind vaccine research and development. He said that the success of the development of hepatitis E vaccine opened a new path for the development of genetic engineering vaccine.

      Chairman Li Shicheng of Wantai shared the development process of Wantai.

From left to right: Professor Xu Xiaoyuan, President Zhang Jun, Chairman Li Shicheng

　　At the meeting, Vantai also donated 1.2 million yuan of scientific research fund to the China Liver Health to support the research project of hepatitis E and help the prevention and treatment of hepatitis E.

       At the conference, experts and scholars from disease control, clinical and universities discussed "how to build an ecosystem for prevention and treatment of hepatitis E", discussed the reasons why hepatitis E was ignored, how to attract the attention of primary medical and health units, and what projects and clinical research enterprises should carry out in the application of hepatitis E vaccine, and shared views, expressed suggestions, and made suggestions for the construction of an ecosystem for prevention and treatment of hepatitis E.

       In order to better let primary medical units understand hepatitis E, attach importance to hepatitis E, and fully study the 2022 Consensus on the Prevention and Treatment of Hepatitis E, the conference launched a tour of the consensus on hepatitis E, which will carry out in Beijing, Shanghai, Guangzhou, Hangzhou, Shijiazhuang, Wuhan, Changsha, Chengdu, Chongqing, Hefei, Kunming, Nanning, Fuzhou, Nanchang, Taiyuan, Jinan, Nanjing, Shenyang, Zhengzhou Interpretation of the Consensus of 20 cities in Xi'an and the lecture tour of the Hepatitis E Prevention and Treatment Forum. It is reported that the first round of tour will cover Beijing, Shanghai, Guangzhou and other places.