The “three dos” and “three don’ts” for hepatitis B patients

Chronic hepatitis B is caused by hepatitis B virus infection, although it is difficult to cure, but the disease can be effectively controlled and prevent the progressive development of the disease is completely achievable. For this reason, patients with hepatitis B should do “three to” and “three not to”. Many chronic hepatitis B patients with elevated transaminases are often asymptomatic, so regular checkups can help detect and treat lesions in a timely manner, especially for patients over 45 years old with cirrhosis and a family history of liver cancer. If liver function continues to be normal, the examination can be done every six months to a year, including at least liver function and ultrasound; if liver function is not normal, the examination should be done at least once a month while undergoing treatment, and then extended when liver function returns to normal; patients receiving antiviral therapy should also be examined for HBV DNA and five indicators every three to six months. Patients with longer history and older age should also pay attention to check the methemoglobin, and if it is significantly higher, ultrasound or CT examination should be done to exclude the possible existence of hepatocellular carcinoma. Patients with elevated aminotransferases found in the examination should be treated seriously and liver function should be restored to normal in time. Elevated serum transaminases are caused by inflammation and necrosis of liver cells, the higher the transaminases, the more necrosis of liver cells and the more serious the disease is. Liver cells have a strong regenerative capacity, but if regeneration is not timely, it may be replaced by more fibroblasts, forming the so-called fibrosis, and fibrosis is more cirrhosis. On the other hand, although hepatocytes can regenerate after necrosis, repeated inflammatory stimulation can induce heterogeneous proliferation of hepatocytes, which increases the risk of hepatocellular carcinoma. Therefore, it is quite important to treat the disease carefully, control the inflammatory reaction of liver in time, and promote the regeneration of liver cells. Thirdly, we should pay attention to life conditioning. Drug treatment is limited, but life conditioning is unlimited, and the so-called “three parts of treatment and seven parts of nourishment” is true. The content of life conditioning includes scientific diet, good living habits, and maintaining a peaceful state of mind. For patients with normal liver function, we advocate a high protein (e.g. two eggs and one glass of milk per day), high vitamin (e.g. one apple or one pear per day) and low fat diet, avoid smoking and alcohol, eat less or no spicy food, have a regular life and ensure sufficient sleep. To have a correct understanding of their own disease, do not have to be depressed, nor do they have to be anxious and bored, always maintain an optimistic spirit to improve their immunity, to promote the recovery of the disease is quite important. Fourth, do not believe in advertising China’s advertising law clearly stipulates that advertising for hepatitis B is not allowed, so when we see a hepatitis B advertisement, let’s not evaluate whether the advertisement is true, first of all, we can be sure that it is illegal. Nowadays, some pharmaceutical advertisements are very covert and often appear in the media in the form of news reports or scientific propaganda, which can easily make patients fall for them. In fact, to identify whether it is an advertisement is very simple, is to see whether the article leaves a specific address and phone number, leaving the address and phone number is definitely an advertisement. For hepatitis B, the majority of advertisements use “turning negative” as bait. There are many meanings to “turn negative”, is it surface antigen turn negative, e antigen turn negative, or HBV DNA turn negative? Patients must understand each other’s promises before treatment to prevent being cheated. The latter two can be done, but it is extremely difficult for chronic hepatitis B patients to turn surface antigen negative, do not listen to their nonsense. The first is not to take drugs for hepatitis B itself, and the second is not to take drugs for other somatic factors. This is a common phenomenon for many hepatitis B patients, in order to achieve the purpose of the cure, many patients look around for prescriptions and recipes, the result is that not only did not cure the disease, but make the condition more complicated, the reason is that many of the so-called prescriptions or recipes are bad quackery in order to cheat money and fabricated, there is no science. The reason is that many of the so-called prescriptions or secret remedies are made up by unscrupulous quacks in order to cheat money. The liver is an important metabolic organ of the body, most drugs need to be metabolized by the liver, and many drugs also have direct toxicity to the liver, so patients with hepatitis B long-term use of a drug to be cautious. The complete transformation (marked by the surface antigen transformation) is the greatest wish of hepatitis B patients and the ultimate goal of our treatment, but, due to the biological characteristics of the hepatitis B virus, we currently have no drugs that can completely eradicate hepatitis B. Very few patients can achieve this goal. Although, antiviral therapy with interferon or nucleoside analogs can increase the likelihood of surface antigen conversion, this possibility is uncertain. In addition, there are certain indications for antiviral therapy, and we do not advocate that hepatitis B carriers receive treatment; we also do not advocate that in order to be able to be treated with antiviral therapy, one should intentionally raise transaminases by drinking alcohol or working with fatigue, which is putting the cart before the horse. It is undesirable to blindly pursue “turning negative”, and we should be scientific and sensible in our treatment so as not to burden ourselves with heavy ideological and financial burdens.