Infectious Diseases

The Department of Infectious Diseases at the Honglou campus of the Tenth Affiliated Hospital of Southern Medical University (Dongguan People's Hospital) is a comprehensive discipline integrating medical care, teaching and research. Founded in 1980, the department is the earliest established and relatively large-scale infectious disease specialty in Dongguan. It serves as the vice-chair unit of the Infectious Disease Management Professional Committee of the Guangdong Hospital Association, the vice-chair unit of the Infectious Disease Professional Committee of the Guangdong Primary Medicine Society, the vice-chair unit of the Infectious Diseases Branch of the Dongguan Medical Association, a core unit of the Greater Bay Area Research Center for Emerging Major Infectious Diseases, and the chair unit of the Hepatology Special Committee of the Dongguan Medical Association.

After several decades of accumulated development, the specialist strength of the Department of Infectious Diseases has continuously improved and the depth of the specialty has continuously deepened. At present the department has several functional areas, including the infectious diseases inpatient department, a liver disease clinic, a care clinic (guan'ai clinic) and a fever clinic, with 28 open beds; the ward environment is comfortable and management is standardized. The department has an annual outpatient volume of more than 300,000 visits, including 260,000 visits at the fever clinic and nearly 60,000 visits at the liver disease clinic, more than 900 inpatient admissions per year, and more than 100 artificial liver treatments per year.

The department has strong medical and technical capability and a well-developed talent echelon. At present it has 34 medical and nursing personnel, including 5 chief physicians, 4 deputy chief physicians and a nursing team of 21, with 6 physicians in the physician group holding master's or doctoral education. The department is equipped with a batch of advanced devices, including fiberoptic bronchoscopy, color Doppler ultrasound, ventilators (including non-invasive ventilators), blood purification machines, high-flow humidified oxygen therapy devices, mechanical sputum expulsion devices, cooling blankets, ECG monitors and defibrillators, which guarantee the performance of the department's advanced techniques.

At present, the department's services reach 32 towns and districts, and it accepts difficult consultations and referrals of critical cases in infectious diseases from across the city. The department was the first in the city to introduce new artificial liver technology, and is a hospital of the “National Demonstration Center for Artificial Liver and Blood Purification Technology” (the artificial liver “one city, one center” project), of the China Liver Failure Blood Purification Diagnosis and Treatment (Yuanhang) project, of the HBV mother-to-child zero transmission project, and of the Rainbow Plan – Liver Cancer Early Screening Alliance; it is also the designated treatment unit for hepatitis C in Dongguan and the designated treatment unit for AIDS in Dongguan. It is at the leading level in the city in the diagnosis and treatment of chronic hepatitis, cirrhosis, liver failure, autoimmune liver disease, fatty liver, AIDS and various opportunistic infections, sepsis, central nervous system infections, and investigation of fever of unknown origin.

The department is a national standardized residency training base specialty base for infectious diseases; it has several part-time professors at medical colleges and universities and 2 supervisors of master's degree students. It undertakes standardized residency training in infectious diseases and undergraduate teaching at the clinical medical college, and carries out theoretical teaching in infectious diseases as well as clinical clerkship and internship supervision for multiple majors of Guangdong Medical University, including clinical medicine, preventive medicine, pharmacy, forensic medicine and stomatology.

The department's scientific research has yielded abundant results. In recent years it has obtained multiple provincial- and municipal-level research projects; in the past 5 years it has published more than 30 high-quality papers in core journals in China and abroad, and has participated in compiling several books.

The department continuously improves its daily outpatient workflow and enhances patients' experience of care. It has successively opened specialty clinics including infectious diseases clinic, hepatitis clinic, hepatitis C clinic, hepatitis B clinical cure clinic, mother-to-child transmission blockade e-clinic, cirrhosis specialty clinic and fatty liver clinic, and has launched an AIDS one-stop service clinic and an HIV infection prevention clinic. By building an HIV-friendly doctor platform, it provides people living with HIV with medical services across the full life cycle.

During the COVID-19 pandemic from 2020 to 2022, all medical and nursing staff of the Department of Infectious Diseases were dispatched to Dongguan Ninth People's Hospital, serving as the main force responsible for the diagnosis, treatment and care of patients with COVID-19 across the city; the department received multiple national, provincial and municipal honours, and several staff members received municipal and hospital honours such as “Anti-epidemic Pioneer.”

Outside working hours, the department enthusiastically supports public welfare and devotes itself to science communication regarding infectious diseases. Every year it organizes dozens of free consultations, science popularization activities and health education sessions, reaching communities, industrial parks and schools in all 32 towns and subdistricts of the city, and has repeatedly been awarded the title of “Outstanding Volunteer Service Team” by Dongguan People's Hospital.

Featured Diagnosis, Treatment and Technologies

1. Artificial liver Liver failure is severe liver damage caused by multiple factors, leading to severe impairment or decompensation of the liver's synthetic, detoxifying, metabolic and biotransformation functions, giving rise to a group of clinical syndromes whose main manifestations are jaundice, coagulation dysfunction, hepatorenal syndrome, hepatic encephalopathy, and ascites.

In China, hepatitis B virus (HBV) is the most common cause of liver failure. There are about 76 million people with chronic HBV infection in China, of whom about 20 million to 30 million have chronic hepatitis, and about 8 million or more cases will progress to end-stage liver disease such as cirrhosis and liver failure. Each year, 500,000/1,000,000 new cases of HBV-related liver failure occur, and if effective treatment is not given, the fatality rate is as high as 60%–80%.

The artificial liver support system (abbreviated as “artificial liver”) is an extracorporeal life support system that temporarily replaces part of the liver's functions, and is one of the main treatments for liver failure; among its forms, the non-biological artificial liver (NBAL) has been proven effective and is widely used clinically.

The department's artificial liver technology is well established, and gratifying results have been obtained in extensive clinical application: this technology effectively raises the cure-and-improvement rate of severe hepatitis, and in particular can significantly raise the cure-and-improvement rate of patients with liver failure in the early and middle stages. Since 2023, the department has cumulatively performed more than 300 artificial liver sessions, successfully rescuing large numbers of patients with severe hepatitis and with acute-on-chronic liver failure.

2. Clinical cure of hepatitis B Hepatitis B was widely considered in the past to be a disease that could not be cured and required lifelong carriage of the hepatitis B virus; however, with advances in medical technology and changes in treatment concepts, the concept of clinical cure of hepatitis B has become widely accepted. Clinical cure of hepatitis B is also called functional cure of hepatitis B; it refers to a state in which a treated patient with chronic hepatitis B, after stopping treatment, still remains negative for hepatitis B surface antigen, with HBV DNA undetectable and liver function indices normal.

At present, more than 400,000 new liver cancer patients are added each year in China, and more than 90% of liver cancers are caused by hepatitis B virus infection. Among the approximately 76 million carriers of the hepatitis B virus currently in China, 20 million to 30 million people need treatment.

The department has specially opened a “hepatitis B clinical cure clinic,” a specialty clinic aimed at “clinical cure of chronic hepatitis B,” offering hepatitis B patients a new patient-centred diagnostic and treatment model of “full-course scientific management” and formulating individualized diagnostic and treatment plans, including disease risk prediction and adjunctive therapy, among others. Since this clinic was opened, it has to date received more than 5,000 patient visits; at present, there are several hundred patients receiving interferon therapy and follow-up, and among the group of patients treated for clinical cure of hepatitis B from the hepatitis B “advantage population” in the past 2 years, nearly more than 30% of patients have obtained “clinical cure” through this treatment.

3. Blocking mother-to-child transmission of hepatitis B Mother-to-child transmission is an important route of transmission of the hepatitis B virus, and the rate of chronicity after infection with hepatitis B virus (HBV) during the perinatal period and in infancy is about 90%. Female carriers may transmit the infection to the next generation through mother-to-child transmission during their childbearing years, which is the main reason for the formation of familial clusters of HBV infection.

This type of mother-to-child infection can be blocked through medical intervention! When pregnant women with chronic HBV infection receive antiviral treatment during pregnancy and their newborn infants receive basic immunoprophylaxis with hepatitis B vaccine combined with hepatitis B immunoglobulin, the mother-to-child transmission rate can be reduced to below 0.3%.

At present, the department provides outpatient counselling services for pregnant and postpartum women with hepatitis B, safeguarding women of childbearing age and “hepatitis B mothers.” For pregnant and postpartum women who are positive for hepatitis B surface antigen, the department performs quantitative HBV DNA testing and liver function testing, assesses the severity of liver disease on the basis of the infected woman's serum HBV DNA, liver function level and liver morphology, and thereby evaluates the timing of anti-HBV treatment and guides antiviral treatment.

4. Antiviral treatment of hepatitis C Hepatitis C is liver inflammation caused by the hepatitis C virus (HCV); after infection it can lead to chronic hepatitis, cirrhosis and even liver cancer. It is transmitted mainly through blood (blood transfusion, sharing syringes, unsafe medical procedures, etc.) as well as through mother-to-child transmission and sexual transmission. Fortunately, hepatitis C is a curable disease: through early detection and standardized treatment, patients can obtain a favourable prognosis.

Early treatment of patients with hepatitis C to achieve cure as soon as possible can greatly reduce the incidence of cirrhosis and liver cancer. As the designated hospital for the diagnosis and treatment of hepatitis C, Dongguan People's Hospital has accumulated rich experience in the treatment of hepatitis C and has opened a dedicated hepatitis C clinic. Since the hepatitis C clinic was specially opened in June 2022, more than 1,000 cases of hepatitis C have been cured.

5. One-stop diagnosis and treatment service for AIDS AIDS is a preventable and treatable infectious disease; reasonable preventive measures can prevent the occurrence of transmission. To sustain good HIV/AIDS prevention and treatment work and safeguard the quality of life of people living with HIV, the department opened an “AIDS loving-care clinic” (aixin clinic) as early as 2010, providing patients with services such as HIV/AIDS counselling, diagnosis, follow-up management and comprehensive care. In 2022, the department further upgraded the loving-care clinic into a “care clinic” (guan'ai clinic), dedicated to providing comprehensive HIV/AIDS prevention and treatment services for people living with HIV, including post-exposure prophylaxis after high-risk sexual behaviour, pre-exposure prophylaxis, and follow-up treatment of HIV/AIDS patients. It can also guide HIV-positive individuals and their spouses on safe preparation for pregnancy, ensuring that the safety of the HIV-negative spouse is not affected while a healthy baby can be born. For patients whose condition is stable on antiviral therapy, an internet medication mailing service can be provided after assessment.

The department admits patients with severe infections related to AIDS using currently advanced laboratory and therapeutic methods, including various opportunistic infections caused by acquired immunodeficiency, sepsis, central nervous system infections, severe pneumonia, and respiratory failure.

6. Standardized diagnosis and treatment of cirrhosis Cirrhosis is a chronic progressive liver disease, and its features vary depending on the stage of cirrhosis. In the early stage (compensated stage) symptoms are not obvious and may be limited to fatigue and reduced appetite. In the late stage (decompensated stage), severe symptoms such as jaundice, ascites, gastrointestinal bleeding and hepatic encephalopathy appear, and treatment is more difficult.

To further improve treatment outcomes for patients with cirrhosis, the department has opened a cirrhosis clinic, which receives patients with cirrhosis caused by different aetiologies. Drawing on advanced diagnostic equipment and rich clinical experience, it provides accurate diagnosis and individualized treatment plans for patients with different degrees of disease, delivering standardized diagnosis and treatment across the full course of the disease, and effectively improving the systematicity of treatment and treatment outcomes for these patients.

7. Antiviral treatment of hepatitis B in children The younger the age at which a child is infected with HBV, the higher the rate of chronicity. It is as high as 90% in the perinatal period and in infancy, and 20%–30% in children aged 1–5 years. Clinical symptoms of hepatitis B infection in children are more insidious than in adults; most infected children have no obvious symptoms and abnormalities are often found on liver function tests. A few may develop fever, fatigue, poor appetite, abdominal discomfort, and others, and a very small number may progress to HBV-related cirrhosis, liver failure or liver cancer.

The clinical cure rate of antiviral treatment in children with chronic hepatitis B can reach more than 40%; therefore children with hepatitis B should actively undergo evaluation for antiviral treatment with a view to achieving clinical cure. This department's hepatitis B clinic provides treatment for paediatric hepatitis B and has rich clinical experience.

8. Fever clinic The fever clinic is located on Level 1 (ground floor) of the Infectious Diseases Medical Center and has separate adult and pediatric fever clinics. All the consulting physicians hold the professional rank of attending physician (zhuzhi yishi) or above and have rich clinical experience, and the clinic operates 24 hours a day (including public holidays). The fever clinic is fully equipped internally, providing one-stop diagnostic and treatment services and facilities for payment, blood collection, treatment, pharmacy and imaging examinations; it enables a full-process service for febrile patients from registration to obtaining medication and treatment, effectively reducing the need for patients to travel between different areas of the hospital and making care more convenient for them.