(Vol.6 No.2 --- April 2001)
Many great advances are being made in diagnosis and treatment as our profession prances into the new millennium. Notwithstanding, chronic hepatitis B still stands firm as a formidable foe. Some 350 million people worldwide are chronically infected with the hepatitis B virus, and therefore are at risk of serious illness and death from cirrhosis and liver cancer. In China, chronic hepatitis B has remained a scourge of national health. Around 120 million of the Chinese population are hepatitis B carriers and 10% of them have chronic active hepatitis. The annual incidence of liver-related deaths in Mainland China is about 300,000, the majority of whom are associated with hepatitis B virus infection. Hong Kong, as a Chinese city, is witnessing a similar phenomenon, though to a lesser extent. Chronic liver disease, mostly a sequel of chronic hepatitis B, claims over 400 lives every year in Hong Kong, and ranks eighth among the commonest causes of death.
In deference to the importance of chronic hepatitis B in the local health scene, the Special Features section of this issue is dedicated to this disease. Following the availability of lamivudine, antiviral therapy for chronic hepatitis B continues to generate hope and excitement. The first paper discusses the mechanism of antiviral strategies and introduces different combination therapies in the pipeline. This is followed by a practical review of therapeutic guidelines for chronic hepatitis B in the Asian context. To provide a local perspective, the Hong Kong Association for the Study of Liver Diseases has issued a position statement on the therapy of chronic hepatitis B, which is an update of the previous version published in December 1998. The concept of "prevention better than cure" is exemplified in the next paper which deliberates on the prevention of hepatitis B virus infection and its dismal consequences. Hepatocellular carcinoma, the most dreaded end result of chronic hepatitis B, is revisited in the light of new knowledge in immunology, screening and treatment. In the final paper, the infrequently mentioned topic of HIV/HBV co-infection is addressed because of the increased survival of HIV-infected patients who receive HAART.
The last few years have been marked by a recognition of renewed vulnerability to infectious diseases. Many of them were unknown or only minor threats in the recent past. Others have increased significantly in incidence over the last decade, and some threaten to become bigger hazards in the future. Numerous international conferences have been held to exchange the information and experience in the combat against prevalent, emerging and re-emerging infectious diseases. One of the major meetings, the 7th Western Pacific Congress of Chemotherapy and Infectious Diseases, was successfully held in Hong Kong on 11 to 14 December 2000. Dr. WH Seto, Chairman of the Congress, has kindly agreed to let the Diary publish a number of speakers' abstracts in the Medical Bulletin section. The selected papers will hopefully be of interest to infectious disease physicians, microbiologists, general physicians and colleagues of other disciplines.
It is again my cordial wish that the Diary contents can provide readers with some useful references for their practice.
Dr. Lai Sik-To, Thomas