China makes progress in hepatitis prevention, control

As this year's World Hepatitis Day was marked on Sunday, Chinese officials and experts highlighted the country's significant progress in the prevention and control of hepatitis, an inflammation of the liver that causes severe liver disease and cancer.

Infections from hepatitis have shown a steady decline in China thanks to enhanced monitoring and comprehensive interventions, said Chang Jile, deputy head of the National Disease Control and Prevention Administration.

Data showed that the prevalence rate of hepatitis B surface antigen has fallen continuously in the country particularly among children under five, where it has been controlled to below 1 percent. Hepatitis B is one of the most burdensome infectious diseases globally and is considered a significant public health issue in China.

When people discuss hepatitis, they typically refer to the highly infectious and harmful forms of viral hepatitis. There are five main strains of the hepatitis virus, categorized as types A, B, C, D and E.

The incidence rate of hepatitis A in China had dropped from 55.69 per 100,000 individuals in 1991 to 1.06 per 100,000 in 2020, and the incidence rate of hepatitis E remained relatively low, at 1.85 per 100,000 in 2021, said Li Jian, an expert with the Chinese Center for Disease Control and Prevention (China CDC).

Treatment for viral hepatitis has also improved in China, with more patients now being able to receive standard treatment, said Chang. The antiviral cure rate for hepatitis C patients has exceeded 95 percent.

According to the National Cancer Center, China added approximately 367,700 new cases of liver cancer in 2022, with a standardized incidence rate of around 15.03 per 100,000 individuals, indicating a downward trend.

The WHO's global hepatitis elimination strategy aims to reduce new infections of viral hepatitis by 90 percent and deaths by 65 percent between 2016 and 2030, while increasing the diagnosis rate to 90 percent and the treatment rate to 80 percent.

China in action

In recent years, China has adopted a prevention-first approach, integrating prevention and treatment, with the entire society working together to eliminate hepatitis, Chang told a convention held earlier this month to promote both World Hepatitis Day and actions designed to eliminate hepatitis.

The country aims for a comprehensive disease control system by 2030, with disease control and prevention institutions as the backbone, medical institutions as support and community-level medical and healthcare providers as the final safety net, according to a document released in December 2023.

Additionally, the prices of antiviral medications for the treatment of hepatitis have been lowered through bulk procurement and negotiations. Antiviral medications for hepatitis B are now covered by the country's basic medical insurance, and antiviral medications for hepatitis C have been added to the national list of essential medicines, significantly reducing the financial burden on patients.

Enhanced screening

Despite this progress, elimination of hepatitis viruses remains a challenging quest for China.

Experts attribute the situation to several factors, including a significant population of hepatitis virus carriers and patients, insufficient capacity of grassroots medical and healthcare services, social stigma concerning hepatitis patients, and low public awareness of hepatitis prevention and control.

Approximately 75 million people are living with chronic hepatitis B in China, according to China CDC researcher Yin Zundong.

Experts have called for efforts to step up diagnosis and treatment to more quickly identify those who are undiagnosed and untreated, saying this is crucial to reducing the incidence of severe liver diseases.

The diagnosis and treatment rates for hepatitis B in China fall significantly short of the WHO's 2030 targets, according to Li.

Zhang Wenhong, head of the National Medical Center for Infectious Diseases, emphasized the importance of grassroots medical services, integration of hospitals with disease prevention and control institutions, and multidisciplinary cooperation.

Wang Yu, chairman of the Chinese Foundation for Hepatitis Prevention and Control, called for enhanced management of hepatitis patients through the course of the disease as well as early liver cancer monitoring among those with chronic hepatitis.

According to the latest reform resolution adopted earlier this month at the third plenary session of the 20th Central Committee of the Communist Party of China, efforts will be made to improve the country's public health system, promoting collaboration and integration between hospitals and disease prevention and control institutions.

The country will also boost capacities for disease monitoring and early warning, risk assessment, epidemiological investigation, testing and inspection, emergency response, and treatment.