International Hepatology

Diabetes and liver disease are common chronic diseases in China. They interact with each other in terms of pathogenesis, clinical manifestations, and therapeutic targets, often serving as mutual risk factors. Effective co-management can help reduce the disease burden. To support the development of diabetes and liver disease co-management in China, this journal, in collaboration with the China Diabetes and Liver Disease Co-Management Initiative (CDL), presents the CDL Literature Monthly Review. Each month, we share relevant literature on the mechanisms of disease, diagnostic and therapeutic advancements concerning diabetes combined with liver disease, and invite experts in the field to provide commentary. We hope this review offers valuable insights and assistance to researchers, clinical practitioners, and front-line medical workers engaged in scientific research and clinical treatment.

In 2023, the Chinese Society of Hepatology of the Chinese Medical Association updated the 2017 guidelines on managing ascites and associated complications in cirrhosis. These revised guidelines, now termed "Guidelines on the Management of Ascites in Cirrhosis," provide comprehensive recommendations for the diagnosis and treatment of cirrhotic ascites, spontaneous bacterial peritonitis (SBP), and hepatorenal syndrome (HRS). This article summarizes these guidelines, emphasizing the importance of evidence-based practices and individualized patient care.

In recent years, the burden of non-alcoholic fatty liver disease (NAFLD) and liver cancer has become increasingly heavy, with a growing incidence of NAFLD-related hepatocellular carcinoma (HCC). Recently, Professor Yutao Zhan from Beijing Tongren Hospital delivered a fascinating presentation titled "Advances in Research on NAFLD-Related Liver Cancer." The presentation comprehensively analyzed the prevention and control strategies for NAFLD-related liver cancer from the perspectives of risk factors, monitoring, and prevention. Here, we summarize the key points from Professor Zhan's report.

In the journey of cancer treatment, drug-induced liver injury is a significant issue that cannot be overlooked. The "8th International Forum on Drug-Induced Liver Injury," held on May 25, 2024, focused on the management of drug-induced liver injury caused by anticancer drugs, inviting numerous renowned experts and scholars from around the world for rich academic exchanges. During the forum, we had the honor of interviewing Professor Victor Navarro from the Department of Hepatology at the Einstein Medical Network in Philadelphia, Pennsylvania, USA. He shared his unique insights on the management of drug-induced liver injury in oncology.

Recently, the "8th International Forum on Drug-Induced Liver Injury and the 9th National Conference on Drug-Induced Liver Injury" along withthe release of the 2024 primary care version of  "Chinese Guidelines for the Diagnosis and Treatment of Drug-Induced Liver Injury" was held in the beautiful city of Xiamen. The theme of this conference focused on the management of liver injury caused by anti-tumor drugs, and it featured extensive academic exchanges by numerous renowned experts and scholars from home and abroad. We were honored to have Professor Guruprasad P. Aithal from the University of Nottingham share his insights on the clinical characteristics and treatment strategies for immune checkpoint inhibitor (ICI)-induced liver injury. This in-depth interview with Professor Aithal provides valuable guidance, helping us better understand and manage this potentially severe adverse reaction.

Greetings to all experts and colleagues. In this issue of the CDM Monthly Review, we will share six recent articles in the field of portal hypertension diagnosis and treatment (four on diagnostic monitoring and two on multidisciplinary treatment). This issue features reviews by invited experts: Professor Pengyuan He from the Center for Infectious Disease Control at the Fifth Affiliated Hospital of Sun Yat-sen University, Professor Wei Gou from the Hepatology Department at the Qingdao Sixth People's Hospital, and Professor Airong Hu from the Liver Disease Center at the Ningbo No.2 Hospital.

Hepatic sinusoidal obstruction syndrome (HSOS) is a hepatic vascular disease characterized by edema, necrosis, and detachment of the endothelial cells in the hepatic sinusoids, hepatic venules, and interlobular veins, leading to microthrombi formation, intrahepatic congestion, liver injury, and portal hypertension. Clinical manifestations include abdominal distension, liver pain, ascites, jaundice, and hepatomegaly. In cases of sudden liver enlargement, liver pain, jaundice, and ascites, HSOS should be suspected. This article features a classic HSOS case shared by Professor Shao Ming's team from Shanxi Yuncheng Huiren Hospital, detailing their diagnosis and treatment experience.

Antiviral treatment can maximize the long-term suppression of hepatitis B virus (HBV) DNA replication, reducing liver necrosis, fibrosis, cirrhosis, liver cancer, and other complications, thereby improving the quality of life and extending the survival time of hepatitis B patients. Currently, long-acting interferon is recommended as a first-line treatment option by guidelines in Europe, the United States, the Asia-Pacific region, and China. Long-acting interferon treatment for chronic hepatitis B (CHB) offers a greater probability of achieving clinical cure and is also the most effective means of reducing the risk of liver cancer. Recently, at the 17th National Conference on Clinical Liver Diseases in 2024, Professor Qing Xie from Ruijin Hospital presented a report titled "Contributions and Challenges of Long-Acting Interferon in the Clinical Cure of Chronic Hepatitis B." This article from Hepatology Digest summarizes the report for our readers.

Clinical cure of chronic hepatitis B (CHB), also known as functional cure, is achieved when patients remain HBsAg negative after stopping treatment, with or without the presence of anti-HBs, HBV DNA levels below the detection limit, and normal liver biochemical indicators. However, HBV covalently closed circular DNA (cccDNA) may still persist in the nuclei of liver cells in these patients. Therefore, clearing HBV cccDNA remains a major obstacle to achieving complete virological cure of CHB. Recently, at the 17th National Clinical Conference on Liver Diseases held in Shenyang, "Hepatology Digest" invited Professor Jun Cheng from Hebei Wutu Pharmaceutical Co., Ltd. to discuss the clearance of HBV cccDNA and other related issues.

With the increasing aging population in China, major chronic diseases have become the leading cause of death and the most significant disease burden for Chinese residents. As an essential means of treating chronic diseases, medications urgently require scientific, rational, and precise usage and management. At a domestic academic conference, Professor Houwen Lin from Shanghai Jiao Tong University School of Medicine, gave a remarkable academic report titled "The Role of Clinical Pharmacy in the Diagnosis and Treatment of Major Chronic Diseases." He provided a detailed introduction of how the clinical pharmacy team at Renji Hospital, driven by clinical needs, established key technologies for precise medication and new drug clinical positioning for major chronic diseases such as cardiovascular metabolism, rheumatology, and oncology. This article summarizes the report's content for the readers of Hepatology Digest.