Academician Zhuang Hui: For a future without hepatitis.
Cctv newsZhuang Hui, who is over the age of 30, is full of silver hair, short and slightly hunched. He has studied hepatitis for decades, talking about the course and future of hepatitis prevention and treatment in China, and his eyes are firm after bright lenses. In the course of the development of hepatitis prevention and treatment in China for more than 30 years, Zhuang Hui thinks that the most significant three aspects of work are hepatitis vaccine, standardized treatment and discrimination of patients. Whenever there is an opportunity, he will make suggestions and appeals at various occasions and meetings.
Committed to vaccination to eliminate the threat of hepatitis B.
On the second floor of peking university health science center Public Security Building, there is an office of Zhuang Hui, which is full of books and magazines. When he is not out, he comes to work in the office almost every day. Opposite the office is a laboratory, and the one next to the office is a conference room. Pushing open the door of the conference room, the first thing you see is the green plants on the rectangular conference table, and the green branches and leaves are occasionally dotted with some red fruits, which shows that the owner of the flowers and plants is an interesting person. There are also two new photo frames from Burnet Institute in Australia, which are also very eye-catching.
As early as the 1980s, Zhuang Hui began to cooperate with Burnet Institute, and it was in 1980 that our country began to incorporate the prevention and treatment of viral hepatitis and scientific research into the national scientific research plan, and Zhuang Hui gradually became the leader of the research from a participant.
For more than 30 years, our country has successfully developed hepatitis A vaccine, hepatitis B vaccine and hepatitis E vaccine. With the successful development and widespread vaccination of vaccines, from the "Eleventh Five-Year Plan" and "Twelfth Five-Year Plan", while strengthening the vaccination of viral hepatitis, we began to study the standardized treatment of hepatitis B and C, and the cure rate has also been significantly improved. China has made great achievements in the field of viral hepatitis prevention and treatment.
Academician Zhuang Hui was a member of the Technical Advisory Group on Viral Hepatitis of the World Health Organization (WHO) and an important promoter of free vaccination of hepatitis B vaccine in China. He can casually say about the development history of China’s hepatitis B vaccination policy. In 1992, the former Ministry of Health brought hepatitis B vaccine into the planned immunization management; In 2002, China incorporated hepatitis B vaccine into children’s planned immunization, and vaccinated all newborns with hepatitis B vaccine free of charge. In 2005, the cost of hepatitis B vaccination for newborns was also completely free; In 2010, newborns born to pregnant women with positive HBsAg were vaccinated with hepatitis B vaccine and then vaccinated with hepatitis B immunoglobulin free of charge; In 2009, 2010 and 2011, children under the age of 15 were replanted with hepatitis B vaccine for three consecutive years.
What Zhuang Hui is most proud of is that due to the comprehensive prevention and control strategy of hepatitis B vaccination, the hepatitis B seroepidemiological survey in 2014 showed that the prevalence rate of hepatitis B surface antigen among people aged 1-4 in China dropped to 0.32%, and that among people aged 5-14 was 0.96%, which reduced the number of new hepatitis B virus infections by 30 million, and prevented 80 million children from being infected with hepatitis B virus.
Committed to improving the standardized treatment of hepatitis
Zhuang Hui thinks that the second place in the meaningful work is to organize the formulation of guidelines for the prevention and treatment of hepatitis B and C in China. "Through the interpretation and promotion of these two guidelines throughout the country, it has greatly promoted the standardized diagnosis, treatment and prevention of hepatitis B and C in China … … These two guides are more useful than how many SCI papers are written. "
Under the leadership of Zhuang Hui, China formulated the Guidelines for the Prevention and Treatment of Hepatitis C and Hepatitis B in 2004 and 2005, among which the most important thing is to regard antiviral treatment as the key to the treatment of hepatitis B and C, which makes the antiviral treatment of hepatitis B and C more standardized and the curative effect further improved.
At present, among the 28 million chronic hepatitis B patients in China, only about 2-3 million people are receiving antiviral treatment. "Why not receive treatment? The main reason is that the treatment cost is too expensive." Zhuang Hui said. "At the same time, hepatitis C can be cured at present, and we must find ways to promote the accessibility of new drugs."
Under the leadership of Zhuang Hui, he submitted many suggestions to the National Health and Family Planning Commission and relevant departments. Finally, in 2016, through negotiations between the government and pharmaceutical companies, the monthly cost of tenofovir disoproxil fumarate, an antiviral drug for hepatitis B, dropped from 1,470 yuan to 490 yuan, a decrease of 67%. At the same time, in 2017, china food and drug administration approved the first direct antiviral drug for oral hepatitis C. After 3-6 months of treatment, 95% of hepatitis C can be cured.
Committed to eliminating hepatitis discrimination
Zhuang Hui’s third concern is about hepatitis B discrimination. It is said that in the big discussion on whether to cancel the compulsory physical examination of hepatitis B before entering school and employment, he used epidemiological logic to refute those voices who were afraid that canceling the physical examination would lead to the epidemic of the disease. He said: "From an epidemiological point of view, if normal contact can infect, the entrance nodes of primary schools, middle schools and universities will be the peak of hepatitis B virus infection, but in our epidemiological investigation, we have not seen this situation."
Although the documents issued by the National Health Planning Commission and other three departments have played a very good role in promoting the policy of non-discrimination for hepatitis B patients, the discrimination against hepatitis B in society has not been completely eliminated. For example, a village doctor with hepatitis B carrier was afraid to show up during the recording of TV programs, and covered his face during the video recording. This shows that he is afraid of showing his true face, and no one dares to see him. He is also worried that his son can’t find a partner and so on. We still have a long way to go to eliminate discrimination against patients with viral hepatitis, including hepatitis B and C, hepatitis A and hepatitis E.
The World Health Organization proposes that by 2030, the new cases of chronic hepatitis B and C will be reduced by 90%, the mortality rate of hepatitis B and C will be reduced to 65%, and the treatment of chronic hepatitis B and C will cover 80% of patients, thus eliminating the public health problem of viral hepatitis. "Optimization of hepatitis immunization, standardized treatment and discrimination of patients", Zhuang Hui said, doing well in these three aspects is to promote the prevention and treatment of hepatitis in China, and also for a future without hepatitis.
July 28th is World Hepatitis Day, and this year’s theme is "Standardizing detection and treatment to curb the harm of hepatitis". "At present, the number of hepatitis patients in our country is too small. There are 28 million patients with hepatitis B, but only more than 2 million patients are treated, less than 10%, and less than 1% patients with hepatitis C. Only early diagnosis and early treatment can curb the harm of hepatitis." Zhuang Hui said.