International Hepatology

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.

Diabetes and liver disease are prevalent chronic conditions in China. They often interact in terms of pathogenesis, clinical manifestations, and treatment targets, acting as mutual risk factors. Joint management can alleviate the disease burden. To support the development of co-management of diabetes and liver disease in China, this journal, in collaboration with the CDL (China Diabetes and Liver Disease Co-management Action Plan), launches the CDL Literature Monthly Review column. Each month, we share relevant research on the mechanisms and treatment advancements of diabetes combined with liver disease, inviting experts in the field to provide commentary. This aims to offer insights and assistance to researchers and frontline medical professionals in scientific research and clinical practice.

Hepatic sinusoidal obstruction syndrome (HSOS), also known as hepatic veno-occlusive disease, is a common secondary vascular liver disease caused by various factors leading to damage to sinusoidal endothelial cells, resulting in sinusoidal obstruction and hepatic congestion. Clinically, it primarily presents with abdominal distension, liver pain, rapid ascites accumulation, hepatomegaly, and jaundice, which can lead to severe liver dysfunction, multi-organ failure, and even death. Professor Qingchun Fu's team from the Shanghai Public Health Clinical Center shares a clinical case and their experience in diagnosing and treating a patient with HSOS induced by combined drug and alcohol use.

Recently, the 25th National Conference on Traditional Chinese Medicine and Hepatobiliary Diseases organized by the Chinese Association of Traditional Chinese Medicine was successfully held in Chongqing. The conference invited distinguished TCM masters, academicians, renowned TCM experts, and hepatology specialists from across the country to deliver academic reports, focusing on the hot and challenging issues in the diagnosis and treatment of liver diseases with TCM. At the conference, Professor Li Li from Beijing Hospital of Traditional Chinese Medicine, presented a report titled "Latest Advances in the Clinical Cure of Chronic Hepatitis B." The following is a summary of the report for our readers.

Cyclin-dependent kinase 4/6 (CDK4/6) inhibitors have brought transformative breakthroughs to the clinical treatment of hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) breast cancer patients. The combination of CDK4/6 inhibitors and endocrine therapy has become the standard regimen for HR+/HER2- locally advanced and metastatic breast cancer. In the adjuvant treatment phase for early-stage breast cancer, CDK4/6 inhibitors have also shown positive results and have been approved for indications. The 2024 ASCO conference presented multiple advancements in the adjuvant treatment of HR+/HER2- early-stage breast cancer with CDK4/6 inhibitors. At the recent 5th Comprehensive Cancer Treatment Academic Conference of the Xinghai Medical Forum, Oncology Frontier invited Professor Yang Zhang from The Second Hospital of Dalian Medical University, Professor Kejing Zhang from Xiangya Hospital of Central South University to elaborate on and discuss the research progress of CDK4/6 inhibitors in adjuvant therapy for HR+ early-stage breast cancer.