China is a large country with hepatitis B. Moreover, chronic hepatitis is still difficult to cure and has the risk of progressing to cirrhosis and liver cancer. As a result, the public is afraid of talking about “liver” and even discriminates against people with hepatitis B and hepatitis B virus. Understanding how hepatitis B is transmitted and recognizing the various misconceptions that have been circulating for a long time can help alleviate fears and eliminate discrimination. One of the misconceptions: common meals infected with hepatitis B, should share meals with hepatitis B infected people. Among the common viral hepatitis, hepatitis A and E are digestive tract infections, which require meal sharing, fecal disinfection and other digestive tract isolation. Hepatitis B is not an infectious disease of the digestive tract, so daily study, work or living contact, such as working in the same office (including sharing office supplies such as computers), shaking hands, hugging, living in the same dormitory, eating in the same restaurant and sharing toilets without blood exposure, is generally not infectious. Epidemiological and experimental studies have also not found that these two types of hepatitis can be transmitted by blood-sucking insects (mosquitoes, bedbugs, etc.). Hepatitis B is a blood-borne disease and is mainly transmitted through blood (transfusions and blood products, broken skin and mucous membranes), mother-to-child and sexual contact. Due to strict screening of blood donors for hepatitis B surface antigen, hepatitis B virus infection caused by blood transfusion or blood products is less common. Other factors such as foot trimming, tattooing, earring piercing, accidental exposure of medical personnel at work, sharing of razors and toothbrushes can also be transmitted. Mother-to-child transmission occurs mainly during the perinatal period, mostly through contact with the mother’s blood and body fluids during delivery, but with the use of hepatitis B vaccine combined with hepatitis B immunoglobulin, mother-to-child transmission has been greatly reduced. Unprotected sexual contact with hepatitis B positive persons, especially those with multiple sexual partners, increases the risk of infection with hepatitis B virus. Myth No. 2: Once infected with hepatitis B virus, it will become chronic hepatitis B. People infected with the hepatitis B virus
A person who has not been cleared after 6 months is called chronically infected with the hepatitis B virus. Age at the time of infection is the most important factor affecting chronicity. The risk of chronicity is as high as 90% for those infected in the perinatal period, while the rate drops to 25-30% in infancy (0-5 years), and only 5-10% of those infected after age 5 develop chronic infection. Therefore, as long as mother-to-child transmission of hepatitis B virus is properly blocked and hepatitis B vaccination for infants and children is done, chronic hepatitis B can be controlled. Since the inclusion of hepatitis B vaccine in the free immunization program in 2000, the infection rate of infants and children has dropped significantly. The 2006 national epidemiological survey on hepatitis B showed that the chronic hepatitis B virus infection rate of children under 5 years old in China is only 1%, which has reached the level of European and American countries. Myth No. 3: Hepatitis B is inherited from the mother to the child. Hepatitis B has a family aggregation phenomenon, generally manifested by the presence of hepatitis B virus infection in the mother, children, siblings at the same time. Therefore, many hepatitis B patients mistakenly believe that this is a hereditary disease, and even dare not get married and have children. To answer this question, it is important to first understand what a genetic disease is. A genetic disease is a disease caused by a genetic mutation or chromosomal aberration. A genetic disease is a disease associated with a genetic defect that is directly caused by the parents from the DNA level. An infectious disease, on the other hand, is a disease caused by an otherwise healthy person (or fetus) that is infected by an infectious agent. Let’s go back to the question, is hepatitis B a genetic disease or an infectious disease? Obviously, hepatitis B is not caused by a mistake in the body’s DNA, but by an infection with the hepatitis B virus. We often see mothers with hepatitis B and several children, or even three generations of a family with hepatitis B. So why is this? The mother-to-child transmission of hepatitis B, which we commonly see, is actually a transmission of blood and body fluids as well, only by a different route. During delivery, the newborn is exposed to a large amount of maternal blood, which is the primary route of hepatitis B infection in newborns, i.e., mother-to-child transmission. In addition, intrauterine infection can occur when the mother’s blood vessels are broken on the uterine surface during pregnancy, such as in cases of placental abruption, and leakage of maternal blood into the fetal circulation, which has a less than 5% chance of occurring. It can be seen that mother-to-child transmission, regardless of the cause, is actually the transmission of the hepatitis B virus from the mother to the next generation through the internal route. Therefore, hepatitis B is an infectious disease, not a genetic disease, and can be interrupted by hepatitis B vaccination and hepatitis B immunoglobulin.