Hepatitis B is a common disease in our country, is the most important cause of cirrhosis, liver cancer, so far there is no effective therapy
Hepatitis B is a common disease in our country, is the most important cause of cirrhosis, liver cancer, so far there is no effective therapy in the treatment of hepatitis B patients; face, often feel confused, confused, there are a lot of people don't even know they have been infected with the hepatitis B virus in imperceptibly, then we how to early detection of hepatitis B, and give reasonable the treatment? Today, Southern Medical University,, southern hospital infection, deputy director of the physician to talk about this problem.
1 how is hepatitis B infected? The handshake, kiss and other acts of life will not be infected with hepatitis B?
Thank you This is a problem but also the existence of a commonplace talk of an old scholar, misunderstood view! The spread of hepatitis B virus, so far the domestic and international experts agree that the hepatitis B virus through body fluids, blood borne, that is to say, only the health of human body fluids, blood directly or indirectly exposed to hepatitis B virus infection with body fluids, blood, can be infectious hepatitis B virus. At present, there are a lot of misunderstanding that eating will be infected, mainly because of hepatitis B infection, "family aggregation". In fact, between family members is not through the transmission of hepatitis B virus infection but indirect infection by eating, occasionally sharing toothbrushes, razors, menstrual underwear and other family members together and washing contaminated clothing furniture and other ways; as for kissing is basically does not exist, only the kiss in the existence of both oral ulcer cases will happen, because the virus does not exist in saliva; and the handshake is Arabian Nights is infected with hepatitis b!
2 parents have hepatitis B, the probability of the birth of children infected with hepatitis B? Hepatitis B expectant mothers during pregnancy can take some measures to avoid infection to the fetus?
This is a matter of concern for many couples of childbearing age. For the father, whether hepatitis B basically does not affect the children's hepatitis B infection, hepatitis B is the father of the child's infection often occurs in children after birth, but now the child born will receive the hepatitis B vaccine, can play a protective role, so don't worry about his father's problems. But the mother of hepatitis B infection on the child's influence is very important. A hepatitis B (hepatitis B virus E antigen HBeAg positive) "mother, if you do not do any preventive measures, 99% children will be infected, of course, if the mother of hepatitis B virus E antigen, and HBV negative DNA infected children, then the probability is very low; in general, HBV DNA in the mother's blood is higher, the higher the probability of infection.
About hepatitis B mothers during pregnancy to prevent hepatitis B infection to the fetus measures, China's 2010 version of the guidelines for prevention and treatment of hepatitis B has a clear explanation, namely: HBsAg positive mothers of newborns after birth within 12 hours of bilateral hip anterior lateral muscle were injected with hepatitis B immunoglobulin 100IU and recombinant yeast hepatitis B vaccine (10mg or China hepatitis B vaccine 10mg hamster oocytes), born after 1 months and 6 months respectively second and third needle inoculation of hepatitis B vaccine; such as newborns within 12 hours of birth of injection of hepatitis B immunoglobulin and hepatitis B vaccine, can accept breastfeeding. Through the above treatment, about 90% of newborns can prevent hepatitis B infection.
As for about 10% did not play a preventive role of the newborn, is mainly due to hepatitis B infection occurs during pregnancy, known as "intrauterine infection, for intrauterine infection, have suggested that hepatitis B pregnant mothers 3 months after the monthly injection of hepatitis B immunoglobulin 200IU, but research shows that the treatment had no obvious effect, so at present do not advocate the preventive measures. In fact, hepatitis B immunoglobulin 200IU for newborns to play a clear role of hepatitis B virus, but for adult moms is an utterly inadequate measure ", not to play any role.
The recent small sample research in China and South Korea are found with active hepatitis hepatitis B mothers, if in March after pregnancy due to disease treatment to telbivudine antiviral therapy, 100% received hepatitis B vaccine and hepatitis B immune globulin injection of neonatal hepatitis B virus infection can be avoided. Unless, of course, expectant mothers need treatment, they generally do not.
3 what are the high incidence of hepatitis B? If you suspect that you are infected with hepatitis B virus, how should we check? Is there a window period?
In our country, including the high incidence of hepatitis B in neonates and infants under the age of 15, hepatitis B surface antibody negative non immune population, the population once infected with hepatitis B, chronic risk, especially newborns can be as high as 90%; other high risk groups include: medical personnel, personnel, in frequent contact with blood agency staff, organ transplant patients, often received blood or blood products, chemotherapy, immunosuppressive therapy free of disease function are low, prone to injury, HBsAg positive family members, male homosexual or multiple sexual partners and intravenous drug abusers.
If suspected of being infected with hepatitis B virus, as long as the examination of hepatitis B surface antigen and E antigen can be made clear, if the surface antigen, E antigen, certainly have hepatitis B virus infection, need further examination of liver function, HBV DNA, E antigen, quantitative ultrasound and FibroScan; if the surface antigen of E antigen negative, but it needs further examination. HBV DNA HBV DNA, if higher than 1000 copies /mL (or 200IU/mL), also need to do the further inspection.
If it is chronic infection, there is no "window period" for hepatitis B; acute infection, there will be a "window period", usually in medicine as incubation period, incubation period of hepatitis B with large span, short for 1 months, the elderly up to 4 months.
4 medical hepatitis B liver cirrhosis liver cancer trilogy is the inevitable development of hepatitis B patients?
How to face the medical trilogy?
Hepatitis B is the main cause of liver cirrhosis and liver cancer, but the hepatitis B liver cirrhosis liver cancer trilogy is not necessarily the experience of every hepatitis B virus infection. Epidemiological investigation showed that in untreated hepatitis B infection, the ratio of asymptomatic HBV carriers cirrhosis each year only 0.9%, the probability of chronic hepatitis cirrhosis patients each year is not more than 3%. The vast majority of liver cancer due to liver cirrhosis, but the incidence is quite low: no risk of symptoms of chronic hepatitis patients and carriers of liver cancer each year does not exceed 0.6%, even to the development of liver cirrhosis, the annual incidence of HCC is not more than 4%. For patients with hepatitis B virus infection, hepatitis B virus infection was lower in patients with hepatitis B virus infection and hepatitis B virus infection.
Therefore, hepatitis B patients without heavy-hearted of hepatitis B trilogy, it is important that we should have the correct measures. Details on how to prevent early complications of liver cancer and cirrhosis, in my personal website article.
5 how to control the condition of hepatitis B, do not let it further development?
What treatment method does second liver have at present? Chinese medicine treatment of hepatitis B is reliable, how do you see? Moreover, many of the patients were in the liver, health care consumption, what is needed?
It should be noted that not all hepatitis B virus infection can cause liver damage, so the first need to be clear whether there is liver damage, and then consider the control of the disease. Simple method to discover whether there is damage to the liver is regularly check transaminase, general requirements, under the age of 30 hepatitis B infection need to check if every March transaminase, normal transaminase, do not need treatment, if the treatment for liver transaminases, about half a year still can not eliminate the virus, you need to further check the degree of liver damage, can consider the B-ultrasound examination and FibroScan ultrasound found no blood disease, cholecystitis and gallstones splenomegaly without cirrhosis, or FibroScan liver elasticity value of more than 9.8kPa, should be considered for antiviral therapy to control the progression of the disease. To never check, more than 30 years of age, especially E, HBV antigen negative DNA higher than 10000 copies /mL (or 2000IU/mL) or above the age of 40 years old people, should do a thorough check, if there is the problem, is also the need for antiviral therapy, if the check is not clear condition, it is necessary to liver biopsy clear.
For the control of the disease, the main emphasis of antiviral therapy, including interferon and nucleoside (acid) oral drug, which need long-term medication, not without stopping, young patients or patients with fertility requirements need careful consideration, don't make a hasty decision; other treatment including liver protecting medicines, anti fibrotic drugs and traditional Chinese medicine. The characteristics of our traditional Chinese medicine treatment is the treatment of hepatitis B, but the need for antiviral treatment of patients, must not blindly emphasis on traditional Chinese medicine in the treatment of neglect of antiviral therapy, especially has clear progression of hepatic fibrosis or cirrhosis patients, antiviral therapy is critical. For health care products, there is no relevant research shows that health care products against hepatitis B treatment effect, in my opinion, do not advocate the use of.
Specifically, HBV infection patients must stop drinking, especially long-term drinking, even have hepatitis B must be emphasized in alcohol control.
6 now many hepatitis B patients are in the pursuit of "negative", is "negative" and "cure" is one thing? Hepatitis B can be cured?
In the treatment of hepatitis B, "negative" is very important, but should realistically determine the "negative" target. In the treatment of hepatitis B in the existing, if the hepatitis B E antigen positive treatment should be the goal of the pursuit of "E antigen negative" and "HBV DNA." and "E antibody", of course, is also the target of the liver function is normal; if E antigen negative, is the pursuit of "HBV DNA negative and normal liver function; as for surface antigen the dream of" negative (the so-called "cure"), actually could not be met for the target. In the present method of treatment, despite 1 years of interferon can make about 8% of the patients appeared surface antigen negative, but even surface antigen negative patients, the use of immunosuppressive drugs for other diseases will still appear relapse, surface antigen, E antigen and positive, and for the treatment of chronic hepatitis B is still not available the pursuit of a thorough "cure", only the pursuit of "stable" condition after discontinuation of treatment of hepatitis B after discontinuation, still need regular inspection, to confirm HBV DNA at a low level (less than 10000 copies /mL), liver injury.
7 please talk about the common mistakes of hepatitis b:
A) before the hepatitis B liver, now everything is normal, including the detection of hepatitis B virus DNA is normal. Does not mean that hepatitis B has been cured, no recurrence?
If not treated, the natural state of surface antigen negative, surface antibody, can be considered "B healing", without the use of immunosuppressive drugs without recurrence; but if it is the hepatitis B surface antigen positive, is not that cure".
B) "small Sanyang" is not more than the big three small risk, you can not rush to treat?
If HBV DNA is positive, "small Sanyang" than "big 3 this world" risk. Overall, the "small Sanyang" patients must have experienced between the immune system and hepatitis B virus war, the outcome of this war is the result of hepatitis B virus and liver cells die, compared to the "big 3 this world", "small Sanyang" war will be more, so the liver injury is heavier also see "small Sanyang"; the incidence of liver cirrhosis patients than the big three high in clinical. Therefore, for "small Sanyang" patients, must check if the HBV DNA HBV DNA, more than 10000 copies of /mL, in accordance with the "big 3 this world" approach, and a detailed examination, to determine the degree of liver damage, are necessary to start antiretroviral therapy treatment as soon as possible; if the liver function is normal, there is no immediate need for antiviral therapy regular check, period should be shortened to 3 months.
(c) hepatitis B antiviral need lifelong medication right?
Hepatitis B antiviral treatment needs to be treated for life as a condition of liver damage. If the disease has been developed to decompensated cirrhosis, such as ascites, jaundice, appeared serious upper gastrointestinal bleeding and other symptoms, so antiviral therapy requires lifelong treatment, because the disease most will appear after discontinuation of recurrence, if not timely treatment, the consequences are very serious, some patients even go on the road of no return even if; timely detection of disease and treatment, but previous treatment efforts will work not completed. For compensatory cirrhosis, although the promotion of long-term medication, but in the long-term treatment to eliminate the virus, if the condition is stable after stopping, in the premise of regular testing can rest assured that the drug. For the common hepatitis, once the treatment target is reached, and the consolidation treatment for a period of time, can also be discontinued.
It should be emphasized that, no matter what kind of condition, 1-2 years after stopping drugs must adhere to a regular inspection every 3 months, if necessary, to shorten the inspection interval, in order to detect and treat the recurrence of possible disease.
(d) hepatitis B patients without symptoms do not need to check and treatment, is this right?
This is a very wrong statement! The liver is a silent organ, it silently endured the outbreak of hepatitis B, only when it can not afford to, will show symptoms. We often see some seemingly healthy patients, once the disease yibingbuqi, this is a typical performance. So no matter how, once found that hepatitis B infection, be sure to check the liver function through regular monitoring to find out whether there is a hepatitis transaminase activity, if repeated virus hepatitis activity more than half a year, have not been eliminated, you need to consider the necessity of antiviral therapy. On how to deal with the infection of hepatitis B virus, in my website article have detailed proposals for the group of reference.
8 experts message
Hepatitis B is not terrible, terrible is our understanding of the misunderstanding of hepatitis b! The diagnosis and treatment of hepatitis B, must adhere to the scientific principle, must be to the regular hospital for treatment, must not believe advertising, folk remedies, and otherwise harass the people and waste money! Not all of the hepatitis B patients will develop liver cirrhosis and liver cancer! Hepatitis B, happy life!
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