There are two different types of chronic hepatitis B virus infection: chronic hepatitis B virus carriage and chronic hepatitis B. The former is a healthy person who is carrying the virus; the latter has developed the disease. The two are not distinguished by “major triplet” or “minor triplet”, but by whether the serum transaminases are elevated. Today we are going to talk about chronic hepatitis B virus carriage, which is a big event accounting for nearly 10% of our population, can we not figure it out?
How does chronic hepatitis B virus carriage occur?
The very majority of chronic hepatitis B virus carriers were infected as children and can come from their mothers, family members, or from social transmission. The immune system in children is not fully developed and the hepatitis B virus is not easily cleared after infection.
After the implementation of the comprehensive pediatric vaccination program, the rate of chronic hepatitis B carriage among children has decreased significantly, but a small number of infants and children are still infected. Infection occurs mainly in newborns of e antigen (HbeAg)-positive mothers, and there may be multiple reasons for this.
The reasons may be.
1. the current routine hepatitis B vaccine program in China, with insufficient doses for newborns of mothers with chronic hepatitis B virus infection
2. failure to coadminister hepatitis B immunoglobulin
3. if the mother’s serum viral level is very high, even a standardized prophylactic regimen may fail, and these pregnant women are best advised to consult a specialist
4. there are also a very small number of newborns who can be infected in utero
5. There are also a few newborns who do not respond to the hepatitis B vaccine.
The hepatitis B virus causes chronic infection of the hepatocytes, at which time the virus replicates continuously in the hepatocytes, which can continuously secrete the virus so that the vast majority of the hepatocytes are infected and are not destroyed due to the absence of an immune response. Hepatocytes are long-lived, so the virus can continue to infect for long years. In this sense, it may take several generations to control the hepatitis B virus epidemic.
How does a person with chronic hepatitis B virus infect others?
Chronic hepatitis B carriers with “major triplets” are infectious, but only through specific channels.
1. importation of blood and blood products, including contact with body fluids containing blood.
2. sexual intercourse, especially between men of the same sex.
3, mother-to-child transmission. Hepatitis B virus is transmitted via blood, and both 1 and 2 transmission routes actually use blood as a carrier. There are currently very reliable preventive measures in place, and as long as they are implemented, they will not cause transmission.
Eating together, studying or working together is not contagious. Even mothers with “major triplets” can give birth and breastfeed as long as they take precautions.
Inappropriate social initiatives to prevent hepatitis B can cause social problems and should not “expand” the actual transmission routes. The current inaccuracy of social discrimination against people with chronic hepatitis B is still widespread, and national regulations are yet to be implemented, and a real and reasonable solution may await the implementation of the right to privacy of personal health information.
The government’s employment of chronic hepatitis B virus carriers is restricted to a very small number of occupations (military and police, sports, child care, diet, etc.), and schools and employers should treat carriers according to regulations and not discriminate. The government can already admit chronic hepatitis B carriers as civil servants. Should gentlemen in charge of personnel work comply with national regulations?
What should chronic hepatitis B virus carriers do?
At present, the carrier friends outside the care of their own problems mainly have to rely on themselves, to learn the correct health care knowledge from the standardized channels, and be alert to the hazards of improper propaganda in the pharmaceutical market.
It is not possible to clear the carrier status of hepatitis B virus with certain drugs at the moment. There is nothing you can do about it, so you can just settle for the status quo of “living in peace” with the virus, and the good news is that you are now healthy. Don’t have the false fear that your acquaintance or father or brother with cirrhosis or liver cancer has a different course of infection than you do, and as long as you know, you will prevent it, so it won’t happen to you. There is no need to worry about interacting with friends, sharing meals and shaking hands will not infect others; to get married and have children, there is no need to hesitate, the spread of hepatitis B virus can be prevented. Because about 25% of carriers will develop hepatitis unknowingly, there is no way to know in advance whose head this 25% chance will fall on and when it will fall on someone’s head, so regular liver function tests are of utmost importance.
Liver disease is sometimes insidious and sometimes progresses more potentially, especially in e antigen negative infected individuals. It is unlikely that you will miss a diagnosis as long as you have regular checkups.
What is the most important measure?
It is actually very simple, just check serum transaminases every 3 months for those with viral replication and every 6 months for those without replication. People suspected of having cirrhosis will also have a B-mode ultrasound and methemoglobin every 6 months.