For hepatitis B patients, the progression from slow hepatitis B (chronic hepatitis B) to cirrhosis to liver cancer is a haunting nightmare. Especially after the progression from slow hepatitis B to cirrhosis, many people think that it is not far from liver cancer. In fact, this is not the case, said Dr. Tong Guangdong, chief physician, cirrhotic patients can reduce the occurrence of liver function loss if treated properly, especially it is possible to reverse cirrhosis. 30% of slow hepatitis B patients will develop cirrhosis Hepatitis B has always been a disease with a high infection rate in China. According to Tong Guangdong, about 56.7% of the population in China is infected with hepatitis B virus (HBV). After adults are infected with HBV, most of them can produce antibodies by themselves, while infants and children with low resistance and incompetent immune systems become chronically infected. Therefore, the development of chronic infection is mostly in childhood, when the body’s immune function is not complete. By age, about 30% of the infected are between the ages of 1 and 5, 6% between the ages of 5 and 15, and only 1%-5% of the infected adults after the age of 15. Patients who are chronically infected are called chronic carriers of HBV. This carriage status is about 8-20 years, after which, as the body’s immune function continues to be sound and the virus changes, the body’s own immunity begins to clear the HBV virus from the body, and it enters the slow hepatitis B phase. During the clearance period, the body clears the virus and the virus immune escape, repeatedly battling, resulting in repeated inflammation and fibrosis repair of the liver, and eventually liver fibrosis gradually formed cirrhosis. ”Among the chronically infected people, some patients will clear HBV through their own bodies,” said Tong Guangdong, “there will be two destinations from the carriage to the clearance phase, one destination is the deterioration of the disease into cirrhosis, and one destination is the stabilization of the disease into inactive HBsAg carriers. Inactive HBsAg carriers, if they are no longer active, have a better clinical outcome, with less than 4 percent developing cirrhosis and liver cancer. In contrast, up to 30 percent of patients with slow hepatitis B deteriorate to develop cirrhosis, and once cirrhosis occurs, 7.4 percent of patients may become hepatocellular carcinoma in three years and about 20 percent in five years.” When cirrhosis progresses to decompensation, most die from complications such as upper gastrointestinal hemorrhage or refractory ascites and anuria. “So, we tell patients how not to let it develop cirrhosis.” Tong Guangdong said. Treatment of cirrhosis of liver B should be standardized Once the disease is found to progress into cirrhosis should be standardized as early as possible. Cirrhosis antiviral treatment compared to slow hepatitis B patients different points, Tong Guangdong stressed: due to the long duration of cirrhosis B patients, complex medication history, and even the existence of irregular discontinuation of drugs and other reasons, the patient’s body virus quasi-species complex, and may even already exist pre-existing mutant virus strains, often prone to drug resistance. Even the application of the most potent antiviral drugs is difficult to avoid the occurrence of drug resistance, so this time it is necessary to reduce drug resistance by means of combination therapy, which is also recommended by the current guidelines for the prevention and treatment of hepatitis B in China. ”At present, one of the antiviral drugs is interferon and one is nucleoside analog. For patients with hepatitis B cirrhosis who are clinically more likely to choose nucleoside analogs, and for patients who have previously received nucleoside analogs and have had drug resistance, it is recommended that two oral nucleoside analogs without cross-resistance be used for treatment. One of the most basic combinations is the combination of Herceptin (lamivudine) + Haverix (adefovir).” Tong Guangdong said, “Preventing drug resistance is actually equivalent to treatment success, and with successful treatment, no loss of compensation will occur. If a single drug is used, the complexity of the quasispecies of cirrhosis, which means that the virus is complex, is prone to drug resistance, and cirrhosis resistance has more serious consequences and is prone to failure to compensate. Combination therapy serves to cover multiple drug resistance sites and prevent drug resistance. At the same time, in the early stage of cirrhosis to control the virus, abate the cause of the disease, inflammation long-term inactivity, then the already liver fibrosis tissue slowly reversed, and finally it is likely to reverse cirrhosis.” In addition, Tong Guangdong said that patients in the stage of cirrhosis should be prepared to take long-term medication, and to follow medical advice to regulate the use of drugs, do not stop without permission. People with a family history of hepatitis B need to have annual liver function tests, and if the tests reveal low white blood cells and platelets, and a dark complexion, yellow urine and abdominal distention, you need to consider if there is something wrong with your liver.