The 17th National Academic Conference on Viral Hepatitis and Liver Diseases of the Chinese Medical Association and the 2015 Annual Meeting of the Infectious Diseases Branch of the Chinese Medical Association and the Hepatology Branch of the Chinese Medical Association were held at the China National Convention Center in Beijing on October 24-25, 2015. With the theme of “Hepatology in Rapid Development”, the conference focused on the current progress and hot issues of hepatology research, and presented the latest achievements and development trends in the field of hepatology in all aspects. In the morning of 25th, during the invited presentations of other hepatology venues, the “PBC Diagnosis and Treatment Consensus (2015)” was promulgated, and the key points are summarized as follows: PBC Diagnosis Recommendation 1: For elevated ALP and/or GGT of unknown etiology, routine testing of AMA or AMA-M2 (A1) is recommended. Recommendation 2: For patients with positive AMA or AMA-M2, liver aspiration biopsy is not a necessary test for diagnosis. However, patients with negative AMA/AMA-M2, or with clinical suspicion of other diseases such as autoimmune hepatitis or nonalcoholic steatohepatitis, liver aspiration biopsy is required to assist in the diagnosis (C1). Recommendation 3: PBC can be diagnosed if two of the following three criteria are met: 1. Elevated biochemical indicators reflecting cholestasis, such as ALP. 2. Positive AMA or AMA-M2. 3.Serum AMA/AMA-M2 negative but liver puncture pathology is consistent with PBC. Recommendation 4: AMA positive individuals with normal liver enzymes should be followed up annually for biochemical indicators of cholestasis (C2)). PBC treatment Recommendation 5: Long-term oral UDCA 13-15 mg/kg/d is recommended for PBC patients with abnormal liver enzymes, regardless of their histological stage (A1). Recommendation 6: For patients with intermediate to advanced disease (pathology stage III-IV) use Paris I criteria to assess biochemical response: ALP ≤ 3 ULN, AST ≤ 1.5 x ULN, bilirubin ≤ 1 mg/dl after one year of UDCA treatment; for patients with early disease (pathology stage I-II) use Paris II criteria: ALP and AST ≤ 1.5 x ULN after one year of UDCA treatment, total bilirubin is normal (B1). Recommendation 7: There are no uniform criteria on how to treat patients with incomplete response to UDCA. UDCA combined with budesonide, fibrates, and 6-ethylgoodeoxycholic acid (OCA) may be effective, but long-term efficacy needs further study (C2). Recommendation 8: There is no clear evidence whether UDCA is used for prophylactic treatment in AMA positive but normal liver enzymatic parameters; however, if there is histological evidence of PBC, UDCA treatment may be initiated (C1). Recommendation 9: Liver transplantation is recommended for patients with end-stage PBC. Indications include refractory ascites, recurrent spontaneous bacterial peritonitis, recurrent ruptured variceal bleeding, hepatic encephalopathy, hepatocellular carcinoma, intractable pruritus, and total serum bilirubin over 6 mg/dl (103 μmol/L). (A1) Recommendation 10: For patients with PBC with pruritus, abciximide is preferred and the recommendation is 4-16 g/d. Since this drug affects the absorption of other drugs (e.g. UDCA, digoxin, contraceptives, thyroxine), it should be given at 4-hour intervals from other drugs (B1). Recommendation 11: In patients with malaise, except for other factors causing malaise, modafinil can reduce the symptoms of malaise in patients with PBC, and the recommended dose is 100-200 mg/d (C2). Recommendation 12: Patients with comorbid dry syndrome need to pay attention to change their lifestyle and environment. For patients with dry eye, artificial tears and cyclosporine A ophthalmic ointment can be used. For medically refractory cases, nasolacrimal duct obstruction and combined application of artificial tears (C1) is feasible. Recommendation 13: Calcium and vitamin D supplementation is recommended to prevent osteoporosis. The recommended dose of vitamin D is 200 IU/d for adults and 400-800 IU/d for the elderly (C1). Special conditions Recommendation 14: The diagnosis of PBC/AIH overlap syndrome requires meeting at least two of the diagnostic criteria for each of the two disorders (C2). The diagnostic criteria for PBC are as follows: 1. ALP > 2 ULN or GGT > 5 ULN; 2. Positive AMA or AMA-M2; 3. Liver tissue biopsy showing bile duct injury in the confluent area. The diagnostic criteria for AIH are as follows: 1. ALT>5ULN; 2. IgG>2ULN or SMA positive; 3. Liver tissue biopsy showing moderate to severe perifugal or interlobular lymphocytic fragmentation necrosis (interface hepatitis). Recommendation 15: There is no uniform treatment plan for PBC-AIH overlap syndrome, with UDCA as the first-line treatment and combination immunosuppressive therapy for non-responders (C2). Problems and outlook 1. The pathogenesis of PBC has not been elucidated; 2. There is still a lack of systematic epidemiological data on patients with PBC in China; 3. There is a lack of uniform diagnostic criteria and treatment options for patients with combined autoimmune hepatitis; 4. The prognosis for patients with poor biochemical response to UDCA is poor, and there is no definitive and effective method.