China is a large country of hepatitis B. According to the relevant epidemiological data, the rate of hepatitis B virus infection in China is 57.6%, of which the rate of hepatitis B virus surface antigen carriage is 9.8%; the country is now suffering from chronic hepatitis patients more than 20 million cases. Therefore, chronic hepatitis B is still a common infectious disease threatening the people in China. In my clinical work for many years, I found that many people infected with hepatitis B virus have developed cirrhosis or even liver cancer because they did not have good regular checkups and came to the hospital. It makes me feel very sorry. If these patients had known to go to the hospital for regular checkups at an early stage of their hepatitis B virus infection, it is possible that a large proportion of them would not have progressed to cirrhosis or even liver cancer. This is because only through regular checkups can we find out which patients need to be treated and which chronic carriers evolve into chronic hepatitis and need to be treated. So how often should you be tested for hepatitis B virus infection? What are the tests? How to understand liver function? The author will answer the above questions one by one. A. What should be checked regularly for hepatitis B virus carriers? Patients infected with the hepatitis B virus, the first hospital check-up should be a comprehensive examination. These tests include hepatitis B virus two-to-one, DNA of hepatitis B virus, liver function, alpha-fetoprotein, blood count and abdominal ultrasound. How often you should be reviewed should depend on the results of the last test to decide when to come for the next test and what content to do. Generally, patients with no problems, or what we often call healthy carrier status, can be examined once every six months to a year. Patients with problems should be examined once every 3 months, especially for patients with elevated fetoprotein but no tumor detected by abdominal ultrasound or CT should be examined once every 3 months. The reason is that it takes about 3 months for liver cancer to double in size. In the super early stage of liver cancer, AFP is obviously elevated, but the lump cannot be detected by ultrasound, CT or MRI. After 3 months, the lump may be detected in ultrasound, CT or MRI, and at that time, surgical resection is curable, therefore, it is best to check once every 3 months. What I mentioned above are the time for routine review, but if the following discomfort occurs, come to the hospital for review in time. These discomforts are manifested in the following aspects: First, the unexplained feeling of weakness and easy fatigue is not significantly relieved even after rest. Sometimes there is discomfort or even pain in the liver area, secondly, there are symptoms of the digestive tract, nausea, aversion to grease, decreased appetite, foul-smelling stools or sticky Thirdly, sometimes you can find yourself (or others can find) yellowing of the skin and eyes, urine color, such as a sudden change from clear to yellow, or a distinct foul smell. Second, what is checked at each examination? Many people think that it is enough to check the hepatitis B virus “two to half” and liver function biochemistry at the hospital. Some people even check only the “two and a half”. In fact, this is not true. I believe that a person with chronic hepatitis B virus infection should have their first hospital visit for hepatitis B etiology (commonly known as “two and a half”), hepatitis B virus replication index (the genetic code of the hepatitis B virus, also known as DNA), liver function tests, fetoprotein (also known as fetal fetus AFP), liver fibrosis index and liver biochemistry. ), liver fibrosis indicators and abdominal ultrasound. Because there are two aspects of liver damage, one is inflammation, which we can see from liver function tests, if the liver function is abnormal, it means that there is inflammation in the liver, which means we can say that the abnormal liver function indicates that there is damage to the liver. Another one is fibrosis (in severe cases, cirrhosis), which sometimes cannot be seen from the liver function. Only from the abdominal ultrasound, blood tests of fibrosis indicators and even liver tissue biopsy is needed to clarify whether there is liver damage. What to check in the future should be determined by the results of the previous examination. However, every time, the hepatitis B virus replication index, i.e. DNA, liver function and abdominal ultrasound should be checked. Third, the significance of these tests Check the liver function (is commonly referred to as transaminases, the clinical blood test to detect liver function of transaminases are mainly two kinds, one is called glutamic aminotransferase (ALT); the other is called glutamic aminotransferase (AST)). Their normal values are below 40U/L. Since ALT and AST mainly exist in the liver cells, when they are significantly elevated, it indicates liver injury. Of course, in addition to transaminases, biochemical tests of liver function should also check whether bilirubin is elevated, globulin is elevated, and albumin is decreased. The hepatitis B virus two-and-a-half and DNA tests are mainly to see the replication of the virus (replication indicates infectiousness) and the choice of treatment and medication when treatment is needed. The liver cancer marker, AFP (also known as fetal fetal globulin), is tested. Of course, sometimes I have encountered patients with high AFP who did not develop liver cancer in clinical practice. Therefore, it is necessary to combine with other clinical tests (such as abdominal ultrasound or even abdominal CT and angiography) to clarify whether tumors are present. The purpose of ultrasound examination is to clarify whether there is damage to the liver and the degree of damage from the images (e.g. whether there is chronic hepatitis and the degree of chronic hepatitis, whether there is cirrhosis and the degree of cirrhosis). It is also possible to detect small liver cancers. Of course, there are times when liver function tests and abdominal ultrasound do not reveal clear evidence of chronic hepatitis, and further laboratory tests for liver fibrosis and invasive tests, namely liver tissue biopsy (also known as liver puncture), are required. Of course, with the development of medicine, there are now some new non-invasive tests called liver elastography (fibroscan), which are non-invasive tests to determine whether there is liver fibrosis and the degree of fibrosis. Finally, we would like to remind all chronic hepatitis B virus infected patients that sometimes, to determine whether you have developed chronic hepatitis, cirrhosis or even liver cancer, one laboratory test result or auxiliary test result alone cannot determine your diagnosis, but you need to combine all your tests to make a comprehensive judgment, and sometimes you need regular review and dynamic observation to confirm the diagnosis.