Treating liver fibrosis is key to fighting hepatitis

Hepatic fibrosis is the excessive deposition of fibrous connective tissue in the liver and is the result of an imbalance between fibroproliferation and fibrolysis. Fibroplasia is a repair response of the organism to injury. Repeated or persistent chronic inflammation and necrosis of the liver parenchyma due to various etiological factors can lead to persistent fibroplasia in the liver, resulting in the formation of hepatic fibrosis. Liver fibrosis is a chronic liver disease caused by many reasons, in China, the most important cause of liver fibrosis is hepatitis B. Other causes such as alcoholic hepatitis, steatitis, and fatty liver disease. Others like alcoholic hepatitis and fatty liver can lead to the development of chronic liver disease, and liver fibrosis is the common pathological basis of these diseases. ■ Liver fibrosis is difficult to treat In recent years, antiviral treatment of chronic hepatitis B has made great progress, but overall the effect is not yet very satisfactory, and some patients are not suitable or intolerant of antiviral treatment; in addition, the cause of some chronic liver disease is not a virus, and it is not yet possible to remove the cause. Therefore, the study of the mechanism of liver fibrosis and the diagnosis and treatment methods have important theoretical significance and practical value for reducing the consequences of cirrhosis and primary liver cancer caused by chronic hepatitis B and other liver diseases. The study of liver fibrosis is a subject to which much attention is paid both at home and abroad at present. Basic and clinical studies in recent years have shown that the formed liver fibrosis or even early cirrhosis can be reversed if effective cause-specific treatment can be given, or if the synthesis of extracellular matrix can be directly inhibited and/or its degradation can be promoted. Theoretically, this is true, but the actual treatment is difficult. Currently, the use of modern medicine to treat liver fibrosis has a short history, lacks large sample studies, and generally focuses on antiviral and anti-inflammatory treatments. Interferon is the main drug, which is expensive with many side effects, difficult for patients to tolerate, and has an imprecise efficacy. Although many drugs have been proposed in recent years, many of the new anti-hepatic fibrosis drugs are still under experimentation and have not yet reached clinical approval for use. Some experts even point out that it is a misunderstanding to overemphasize anti-inflammatory treatment for liver fibrosis treatment. Summarizing the lessons learned from past failures of liver fibrosis treatment, one of them is the overemphasis on anti-inflammatory. In fact, anti-inflammation is only a component of liver fibrosis treatment, and anti-inflammation alone cannot achieve ideal results. The second one is that the so-called hematological indexes were overemphasized in the past treatment, but in fact, sometimes the hematological indexes cannot reflect whether the treatment is effective or not. Since patients with liver fibrosis need long-term treatment and there is a lack of standards to determine the efficacy of treatment in a short period of time, this makes clinical treatment difficult. It usually takes more than 10 years for liver fibrosis to develop into cirrhosis. If patients do not actively treat the disease at an early stage and wait until cirrhosis occurs, it will be too late to treat the disease. With age, liver fibrosis will also worsen, after 55 years of age liver fibrosis will be significantly aggravated, a lot of people retired two or three years after the early cirrhosis of the liver appeared. According to statistics, the global hepatitis B virus (HBV) infected about 2 billion people, of which 300 million are chronic carriers. In addition to more than 30 million chronic hepatitis B patients in China, there are also a considerable number of chronic hepatitis C patients. In Europe and the United States, in addition to viral hepatitis, there are still a large number of patients with alcoholic hepatitis caused by long-term alcohol consumption. Research shows that the risk of liver cancer in patients with chronic hepatitis B is more than 200 times higher than that of ordinary people, and more than 95% of liver cancer patients are evolved from chronic hepatitis B. The best way to prevent liver cancer is to prevent chronic hepatitis B from developing. The best way to prevent the occurrence of liver cancer is to provide hepatitis patients with dual treatment of anti-virus and anti-hepatic fibrosis to reduce the possibility of cancerous liver cells. Liver fibrosis is a relatively dynamic process: on the one hand, fibers proliferate, and on the other hand, fibers are degraded. If fiber proliferation is dominant, the disease will move forward, and to a certain extent, cirrhosis will occur. If the disease is further aggravated, it will lead to liver decompensation and even liver cancer. Nowadays, one of the focuses of related researches is to fight against liver fibrosis in order to reduce the possibility for patients to progress to cirrhosis and liver cancer.