1. Background Information:

Kanazawa University (KU) oversees a program entitled “Establishment of Research Platform toward Eradication of Hepatitis Virus-related Liver Diseases in East Asia.” The program, sponsored by the Japan Society for Promotion of Science (JSPS), has operated since 2018. KU has been implementing research and education on viral hepatitis-related liver diseases in cooperation with East Asian universities/institutes including Fukui University (Japan), Sichuan University (China), Mongolian National University of Medical Sciences (Mongolia), Mongolian Academy of Sciences (Mongolia), Haiphong University of Medicine and Pharmacy (Vietnam) and Hanoi Medical University (Vietnam).
To encourage collaborative research in this field, the 1st International Symposium on Viral Hepatitis was held in Hanoi, Vietnam in December, 2014 and the 2nd one was held in Ulaanbaatar, Mongolia in June, 2015. Furthermore, the 3rdone was held in Chengdu, China in June, 2016 and the 4^th one was held in Hai Phong, Vietnam in Nov, 2018.  Through these symposiums, KU seeks to widen the understanding of epidemiology and treatment of viral hepatitis, including HBV and HCV, in participating countries. In the short time since these symposiums were started, we have seen significant progress in national plans of treatment of viral hepatitis. The substantial progress made in the past warrant a 5th symposium in Ulan Bator, Mongolia, where we plan to update and collaborate further about viral hepatitis in each country.

2. Organizers:

Professor Kaneko Shuichi, Kanazawa University, Japan
Professor Davaadorji Duger, Mongolian National University of Medical Sciences, Mongol
Professor Oyunsuren Tsedsuren, Mongolian Academy of Sciences, Mongolia

3. Symposium objectives:

1. To raise awareness, surveillance, prevention and treatment of hepatitis in Mongolia.
2. To review the status of epidemiology, national action plans of hepatitis treatment in Japan, China, Vietnam, and Mongolia.
3. To discuss problems and solutions toward controlling viral hepatitis in Japan, China, Vietnam, and Mongolia.
4. To discuss strategies of dissemination of WHO guidelines about HBV and HCV to Japan, China, Vietnam, and Mongolia.
5. To discuss strategies of treatment for HBV/HDV coinfected patients, which is a serious health-care threat especially in Mongolia.
6. To encourage young doctors/researchers to undertake clinical and basic research on viral hepatitis.

4. Dates and site:

May 17^th, 2019
Novotel Ulaanbaatar Hotel, Ulan Bator, Mongol

5. Language:

English

6. Travel fee for hotel accommodation and flight:

Paid by Kanazawa University and Japan Society for the Promotion of Science (JSPS).

7. Tentative symposium program:

Please see the attached file.

8. Proposed agenda:

The following will be presented by speakers from each country:

1. Epidemiology of viral hepatitis, and viral hepatitis-related liver diseases
2. Effective screening and discovery of hepatitis-virus infected people
3. Effective check-ups for hepatitis-virus infected people
4. Liver fibrosis assessment
   How to assess liver fibrosis? Liver biopsy or non-invasive tests such as APRI score, FIB-4 index or fibroscan etc.
5. HBV vaccination
   • HBV vaccination targets (health care workers, sex workers, people who inject drugs (PWID), men who have sex with men (MSM), etc.) 
   • Vaccination strategy (dose, booster, interval, monitoring, etc.)
   • Universal vaccine strategy (when, dose, interval, monitoring, etc.)
   • Efficacy of vaccination
   • Cost of vaccination
   • Implementation of dissemination of national vaccination plan for HBV
6. HBV treatment
   • Treatment targets: who should be treated? In terms of liver fibrosis, age, HBe Ag/Ab status, ALT level, HBs Ag positive mother in the third trimester of pregnancy etc.
   • Drugs: availability of tenofovir, entecavir, lamivudine, adefovir and pegylated-interferon, selection of drugs (first line treatment and second line treatment after treatment failure and/or emergence of resistant virus) and costs for drugs
   • Monitoring of treatment response and toxicity (availability of HBV-DNA, HBe Ag/Ab and so on, frequency of monitoring, implementation of monitoring, and awareness of drug toxicity such as renal function)
   • Criteria for treatment discontinuation
   • Strategy for the prevention of maternal-infant HBV transmission
   • Strategy for the treatment for HDV-coinfected patients
7. HCV treatment
   • Treatment targets: who should be treated? In terms of liver fibrosis, age, and ALT levers etc.
   • Drugs: availability of direct-acting antivirals and pegylated interferon, selection of drugs (first line treatment and second line treatment after treatment failure and/or emergence of resistant virus), and costs for drugs.
8. Hepatocellular carcinoma monitoring
   • Availability of Ultrasonography (quality, who examines, interval), tumor markers (AFP, DCP)
   • Closer examinations after monitoring test positive (availability of CT/MRI, dynamic enhanced or not, rate of reference to specialist)
   • Immune therapy and liver transplantation