Top 10 Myths.
Myth No. 1: I do what I want regardless of the disease.
Myth No. 2: Just lower the enzyme, not antiviral.
Misconception No. 3: Do not believe in hospitals, but believe in advertising.
Myth No. 4: Excess worry, reject drugs.
Misconception No. 5: Australia anti-carry, excessive treatment.
Misconception six: fear of mutation, afraid to treat.
Myth No. 7: Psychological burden, not end of the day.
Myth No. 8: Concerned about technology, ignore treatment.
Myth No. 9: Biased hearing and lack of nutrition.
Myth No. 10: ignore the disease, blindly turn negative.
Chronic hepatitis B patients have to face a lot of social and psychological pressure because they not only have to face the illness of the organism, but also because hepatitis B is somewhat contagious, so the desire for treatment is very urgent. The overall level of treatment of chronic hepatitis B is currently low and far from the needs and requirements of patients, leading to a series of serious problems that make chronic hepatitis B patients suffer from many misconceptions in the treatment process. Some cases are easy to solve, but some misconceptions lead to very serious consequences. Therefore, it is important for patients with chronic hepatitis B to understand what misconceptions exist in the treatment and how to deal with them.
One of the misconceptions: I do what I want regardless of the condition.
Some patients have a clear diagnosis of chronic hepatitis B. However, they do not care about their condition and live their lives as they wish, drinking alcohol as usual. This is the first misconception of some patients with chronic hepatitis B. A large number of clinical data and experimental research results show that one of the risk factors for chronic hepatitis B patients to develop end-stage liver diseases such as cirrhosis and hepatocellular carcinoma is alcohol consumption. One of the patients I treated was a middle-level leading cadre, who was diagnosed with chronic hepatitis B in early years, but did not care at all and drank a lot of alcohol every day, 1000 grams of liquor per day, resulting in serious liver stiffness and development of hepatocellular carcinoma at the age of 58, and did not stop drinking even when the liver tumor was discovered, and when the liver tumor was discovered, there was already distal metastasis of the tumor, which not only lost the chance of surgical opportunity of treatment, but even the time of liver transplantation was missed. Chronic hepatitis B is closely related to the development of cirrhosis and hepatocellular carcinoma. If you have the habit of drinking alcohol, the chance of developing cirrhosis and hepatocellular carcinoma will be greatly increased.
Countermeasure: If chronic hepatitis B is found, not only should you pay attention to formal treatment, but also to develop good lifestyle habits and make sure to quit the habit of drinking alcohol. For hepatitis patients, a drop of alcohol is superfluous and should not exist to take a chance.
Myth No. 2: Just lower the enzyme, not antiviral.
For patients with chronic hepatitis B, the most fundamental cause of the disease is the infection with the hepatitis B virus. Therefore, the most fundamental treatment for chronic hepatitis B is antiviral therapy. However, neither interferon alpha, pegylated interferon, nor the nucleoside analogs lamivudine, adefovir, entecavir, or telbivudine are effective in all patients. Some patients lose confidence in the effectiveness of antiviral therapy and do not take antiviral therapy, but only care about liver-protective and enzyme-lowering therapy. Because, the virus in the liver has always existed, without antiviral therapy, the hepatitis virus in the body will not be cleared or suppressed, and liver-protective and enzyme-lowering therapy only may enable some patients to have temporary remission for a certain period of time, but it is rarely the ultimate cure for hepatitis. Therefore, despite the unsatisfactory efficacy of current antiviral therapy, better results can be obtained in a proportion of patients after all, so do not subjectively rule out antiviral treatment options if they are appropriate, otherwise the time for treatment will be lost.
For patients with hepatitis B virus in active replication, positive hepatitis B virus DNA test results, and serum transaminase levels greater than two times or more than the upper limit of normal, antiviral therapy should be actively administered according to the condition and the patient’s specific circumstances, not just liver-protective and enzyme-lowering therapy. Clinicians should understand that the first-line agents for the treatment of this group of patients are interferon alpha and nucleoside (acid) analogs. Although antiviral therapy does not have a significant therapeutic effect in all patients, it is the first line of treatment. I have said that no physician faced with a patient with chronic hepatitis B for whom antiviral therapy is appropriate should deny the patient the right to apply first-line antiviral therapy with interferon alfa and nucleoside (acid) analogs, which are recognized as effective.
Countermeasure: If antiviral therapy is appropriate, administer it promptly and do not neglect antiviral therapy as the most important and first-ranked treatment measure.
Misconception No. 3: Believe in advertising instead of hospitals.
Due to the limited efficacy of the current formal treatment in the treatment of chronic hepatitis B, due to the different views of experts in various regions on the current treatment of hepatitis B, and even the misconceptions of some hospitals or individual physicians, and the biased orientation of the news media towards doctors, patients have a crisis of trust in doctors, so it causes some patients’ trust in hospitals and physicians to decline significantly, and therefore turn to other As a result, some patients’ trust in hospitals and physicians has significantly decreased and they have turned to other informal medical channels. In addition to the eagerness of patients to seek medical treatment, the current management of medical advertisements is confusing, and some advertisements exaggerate, leading some patients to be deceived.
At present, the antiviral treatment for chronic hepatitis B is only effective for some patients, but the efficacy is unsatisfactory for a considerable number of patients. Therefore, many patients believe that chronic hepatitis B is special and difficult to treat, unlike other diseases. In fact, there are many medical problems that cannot be effectively solved. However, we should understand that chronic hepatitis B is also a chronic disease that requires long-term treatment to be effective, as do other types of chronic diseases. For most chronic diseases, the goal that the current level of medical care can pursue is not a cure, but rather the pursuit of maximum control of the disease and minimizing the impact of the chronic disease on the patient’s life and livelihood. This is something that patients with chronic hepatitis B must have the right expectations. For example, hypertension and diabetes are chronic diseases, and it is difficult to find a “famous doctor” or a “famous drug” that will remove the root of the disease overnight. However, patients should realize that although the root cause of the disease cannot be removed overnight, the long-term consequences of proper treatment and improper treatment are completely different. If properly treated using the best available treatment techniques, such as hypertension and diabetes can be well controlled, no serious complications will arise and the patient’s life and quality of life can be largely unaffected. On the contrary, if regular treatment is not carried out, the condition will gradually worsen and deteriorate, producing a series of complications that will have a significant impact on the quality of life in the second half of life. In fact, chronic hepatitis B also belongs to a chronic disease, but this disease because of a certain degree of contagiousness, patients generally have serious social and psychological pressure, so more eager to seek medical treatment, more demanding a complete “conversion”. Driven by this incorrect understanding, they will turn to other irregular medical practices and trust the advertisements. In the end, you spend money, suffer for nothing, do not get the treatment you deserve, some also delay the disease, aggravate the disease. Sometimes we say to patients with great emotion: we are committed to the research and treatment of chronic hepatitis B. If there is a method or a drug in the world that can treat hepatitis B, there is no reason for us not to pay attention to it, on the contrary, we dream of such a drug or treatment. With the development of science today, can we be ignorant of the fact that some non-professional institutions and individuals have effective treatments in their hands?
Some seemingly benign information can mislead people with chronic hepatitis B, if not malicious deception. In recent years, the news media has evolved rapidly, and we live in an age of “information explosion” where the media is full of different hepatitis treatments and medications. If we do not talk about malicious deception, the statements of some lay people alone can lead to serious confusion. For example, there is an endless list of “top tips” for treating hepatitis B on the Internet. However, the majority of people with chronic hepatitis B should be very careful about these opinions. On the one hand, these opinions can sometimes be seriously problematic, and on the other hand, they can be misinterpreted by non-medical professionals. Therefore, patients should not rely solely on the information in the media for their own medical advice, and they should not “treat it like a god”. If you jump to conclusions about your condition based on only a few words from the media, it could lead to a serious disaster. Not to mention the non-medical professionals, nowadays the specialties are getting more and more subdivided, and even non-infectious disease or liver disease specialists, it is difficult to accurately determine the condition of hepatitis, so we advise you to be careful.
Countermeasures: If you have hepatitis B, go to a specialist in a regular hospital and don’t be fooled by the advertisements.
Myth No. 4: Excess worry and rejection of drugs.
Every drug has more or less some adverse reactions. However, the feelings and reactions to the same adverse drug reactions vary considerably from patient to patient. For example, I have a patient who read in magazines and web pages that patients treated with nucleoside (acid) analogs are partly resistant to the drug due to mutations in the viral gene and therefore reject the nucleoside (acid) analogs. No matter how I explained it, it did not help. Some material was also produced to prove that inappropriate application can cause death of patients. The reasons for changes in the condition of patients during the application of nucleoside (acid) analogs, and even the causes of deaths, should be analyzed on an issue-by-issue basis.
In the process of nucleoside (acid) analogue application, the selection of cases is very important. Patients without cirrhosis can be effectively controlled during the treatment with nucleoside (acid) analogue, even if there is a genetic variation of the virus and drug resistance, and there are fluctuations in the disease, such as an increase in serum transaminase level or an increase in serum bilirubin level, as long as the disease can be effectively controlled with appropriate treatment. With appropriate treatment, the disease can be effectively controlled without serious consequences. It is also worthwhile to use nucleoside analogs for those whose disease has been fluctuating but can be controlled for a certain period of time after the use of nucleoside (acid) analogs. For patients with combined cirrhosis, especially those with decompensated cirrhosis, if genetic mutation and drug resistance of the virus occur during nucleoside (acid) analogue therapy, the rapid return of wild-type virus due to inappropriate discontinuation of the drug or the replication of mutation-resistant virus, causing increased liver damage, at this time, if the extent of liver damage exceeds the functional reserve of the liver, liver failure will result, resulting in Death. When we analyze most of the clinical cases of liver failure during the application of nucleoside (acid) analogues in China, it is easy to find that most of the patients belong to this kind of situation. Of course, to determine the cause of deterioration during nucleoside (acid) analogue therapy, some causes and triggers unrelated to nucleoside (acid) analogue drugs should be excluded, such as overexertion, application of liver-damaging drugs, alcohol consumption, changes in the condition itself, etc.
For the antiviral treatment of patients with decompensated cirrhosis, the application of interferon alpha is contraindicated. This is because some patients develop changes in the immune system after the application of interferon alpha, which can cause deterioration of the disease and endanger the patient’s life. However, there are many positive clinical studies on the application of nucleoside (acid) analogs for antiviral therapy in patients with decompensated cirrhosis. For example, the application of nucleoside (acid) analogs can significantly improve the 5-year survival rate of patients with decompensated cirrhosis. Numerous clinical studies have confirmed that the 5-year survival rate of patients with decompensated cirrhosis is only 14%, in other words, 86% of patients with decompensated cirrhosis die within 5 years. However, after antiviral treatment with nucleoside (acid) analogs, the 5-year survival rate can be increased to 50-55%. This is a considerable improvement. However, despite this, half of the patients with decompensated cirrhosis die within 5 years with antiviral treatment with nucleoside (acid) analogs, so it is not surprising that there are some deaths during the application of nucleoside (acid) analogs if the treatment is given to patients with decompensated cirrhosis. Therefore, clinicians and patients with decompensated cirrhosis must be very aware of this result. It is true that antiviral treatment with nucleoside (acid) analogs in patients with decompensated cirrhosis can improve the survival rate at 5 years, but nevertheless half of the patients die within 5 years. The treatment of these patients must be clearly explained to the patients and must not give them the illusion that everything is fine with the application of nucleoside (acid) analogs for antiviral therapy. As long as the patient has a correct expectation and a correct understanding of the trend of the disease development, then this problem becomes easy to solve.
The benefit of antiviral therapy with nucleoside (acid) analogs in patients with decompensated cirrhosis is also confirmed by the results of patients awaiting liver transplantation. In patients with chronic hepatitis B cirrhosis who present with indications for liver transplantation, regular antiviral therapy is mandatory before and during the perioperative period to prevent hepatitis recurrence in the transplanted liver. During the application of nucleoside (acid) analogue therapy, a proportion of patients whose disease has been gradually controlled as a result of antiviral therapy, in some cases, no longer require liver transplantation. Therefore, nucleoside analogue therapy can indeed benefit some patients under realistic conditions. However, it is important for patients to understand that the use of nucleoside analogs may benefit some patients, but at this time it does not completely prevent further deterioration or even death. As long as there is good communication between clinicians and patients, and both sides understand the outcome of treatment and have a correct expectation, the majority of patients can understand whatever the outcome of treatment is, and it will not develop to the point of medical disputes and lawsuits.
Countermeasures: Nucleoside (acid) analogues are the first-line drugs for antiviral therapy at present. As for viral resistance mutations that occur in the course of treatment in general patients, they generally do not cause serious consequences after treatment; for patients with decompensated cirrhosis, both clinicians and patients must have a correct view and expectation for the outcome of treatment.
Myth No. 5: Aus anti-carrier, over-treatment.
Our chronic hepatitis B virus infection includes a significant proportion of people who test positive for viral markers, but whose serum transaminase levels are always normal. In this part of the population, some patients do not understand the situation and blindly ask for “conversion”, thus spending a lot of money, but as a result, they spend money, suffer, but do not receive the desired effect. Strictly speaking, these patients should receive treatment because after all, there is virus in their bodies, and quite a few of them have liver biopsies that show varying degrees of liver inflammation, and the possibility of normal transaminases developing towards cirrhosis and hepatocellular carcinoma cannot be completely ruled out. Therefore, strictly speaking, this group of patients with hepatitis B virus infection needs treatment. It is not correct to think that this group of patients does not need treatment. The problem is that this group of patients responds very poorly to the currently recognized effective antiviral treatment regimens both at home and abroad, and therefore, as a last resort, patients are advised to observe, have regular checkups, and withhold specific antiviral treatment for the time being.
There is a wide variation in the recognition and importance given to AUD positive disease. A small number of patients with positive AoA and normal serum transaminases are worried and anxious. They take all kinds of treatment measures, but they are not effective. Some of them even take partial prescriptions and believe in advertisements, and end up spending money and suffering, but not getting the treatment effect they deserve. It is not uncommon to see patients who have taken many detours for this reason.
The solution: go to a regular hospital, find a specialist, and make the right decision.
Misconception No. 6: fear of mutation, afraid to treat.
The antiviral treatment of chronic hepatitis B, the choice of drugs are interferon alpha and nucleoside (acid) analogues. The clinical application of nucleoside (acid) analogs has been in China for many years, and domestic clinicians have rich clinical experience with them. Rigorous clinical studies and clinical practice at home and abroad have confirmed that nucleoside (acid) analogs have a definite and obvious therapeutic effect against hepatitis B virus, and nucleoside (acid) analogs are currently approved drugs in China and play a very important role in the antiviral treatment of chronic hepatitis B. While seeing the clinical efficacy of nucleoside analogs, we have also noticed some limitations of nucleoside analogs, which is that some patients develop mutations in hepatitis B virus DNA polymerase after treatment with nucleoside analogs, resulting in drug resistance. Regarding the cause of drug resistance during the administration of nucleoside (acid) analogs, some clinicians and patients have misconceptions that it is the genetic mutation of hepatitis B virus caused by the application of nucleoside (acid) analogs that leads to drug resistance. Whether it is the genetic mutation of the virus caused by the application of nucleoside (acid) analogues or the process and result of drug selection is not difficult to resolve from a quasi-species point of view. From the results of foreign studies and ours, drug resistance in the process of applying nucleoside (acid) analogs is not the result of nucleoside (acid) analog drug induction, but an outcome of drug selection. From a quasispecies perspective, the hepatitis B viruses in the blood of patients with hepatitis are highly related with minor differences in their genetic sequences; therefore, the hepatitis B viruses in the blood of each patient are a viral group consisting of genetically highly related viruses with minor differences, and the components of this viral group are in constant change. Therefore, the introduction and application of the quasispecies concept has changed our view of the state of existence of hepatitis viruses from that of a single virus to that of a population of viruses, and from a static state to a state of continuous change, thus revolutionizing our understanding of the state of existence of hepatitis viruses. From the quasispecies viewpoint, the viruses in each patient’s serum are diverse, and if one drug is applied, it is unlikely to have the same effect on all viruses, regardless of the mechanism of action and effectiveness of the drug. Then viruses that are sensitive to the drug are significantly inhibited, but those that are not sensitive to the drug are not significantly affected. Therefore, after a period of time, the proportion of drug-sensitive viruses in the virus group will gradually decrease, and conversely, the proportion of insensitive viruses in the virus group will gradually increase. This dynamic process can only be understood if the state of existence of hepatitis B virus is viewed from a quasi-species perspective. Therefore, the correct view should be that viral genetic mutations originally exist, because the replication capacity of viruses with mutations is lower than that of viruses without mutations, so that mutated viruses occupy a minority position in the entire virus population, and after drug administration, the relative proportion of mutated viruses changes significantly due to the different sensitivity of different viruses to drugs, causing them to become the dominant population. This makes it easy to detect. If the quasispecies theory does not strongly support this idea, the fact that mutant viruses can be detected in the blood of patients who have never applied nucleoside (acid) analogs, and even in the blood of hepatitis patients before nucleoside (acid) analogs were used clinically, fully supports our current understanding of the principles and processes of viral genetic variation and drug resistance development.
The clinician’s insight into the development of viral genetic variation and drug resistance can help to relieve patients’ concerns. Some patients are so concerned about the development of mutation and resistance that they reject the use of nucleoside (acid) analogs, the main anti-hepatitis viral drugs, thus depriving some patients who are suitable for antiviral therapy of a good opportunity for treatment, which is unwarranted.
From the current clinical studies, the emergence of adefovir will be an important solution to deal with lamivudine resistance and become an important weapon for clinicians to deal with genetic variation and drug resistance.
Countermeasures: Aggressive antiviral therapy and correct treatment of hepatitis B virus genetic variation and drug resistance.
Myth No. 7: Psychological burden, not to end the day.
Chronic hepatitis B patients eventually part of the patients will develop into cirrhosis, hepatocellular carcinoma and other end-stage liver disease, and lead to the death of some patients. A large number of clinical and epidemiological findings show that hepatitis B virus infection is a relevant factor for hepatocellular carcinoma. However, chronic hepatitis patients develop hepatocellular carcinoma in only a minority of patients, not all. This makes it a matter of odds for the individual. The progression from chronic viral hepatitis to hepatocellular carcinoma is the end result of multiple factors and long-term interactions, and the influencing factors are very complex. It is important to have a proper understanding of the possibility of developing hepatocellular carcinoma, both in terms of the correlation between hepatitis B and hepatocellular carcinoma, but also in terms of the fact that such a rate is not very high. Some of the measures we take to treat chronic hepatitis B are also important to prevent cirrhosis and hepatocellular carcinoma.
The results of studies on areas with high prevalence of hepatitis B virus infection confirm that widespread vaccination against hepatitis B substantially reduces the incidence of hepatitis B and also substantially reduces the incidence of hepatocellular carcinoma. The rate of cirrhosis and hepatocellular carcinoma was also significantly reduced in patients with hepatitis B who underwent regular antiviral therapy. Therefore, it is important to have a correct understanding of the rule of chronic hepatitis B patients developing cirrhosis and hepatocellular carcinoma, and in terms of the current medical level, active antiviral treatment measures can effectively prevent the occurrence of cirrhosis and hepatocellular carcinoma while treating chronic hepatitis B. Along with the necessary treatment, it is also necessary to adjust the psychological state, as well as to develop good habits, such as a strict ban on alcohol. All these, even for the treatment of chronic hepatitis B, are simultaneously preventing the occurrence of cirrhosis and hepatocellular carcinoma. Instead of worrying all day long, it is better to seriously take the right treatment measures for regular antiviral therapy, because too much psychological burden is not only not good for treatment and conversion, but also affects the prognosis; while regular antiviral therapy can effectively prevent the occurrence of cirrhosis and hepatocellular carcinoma.
Countermeasures: adjust the psychological state, develop good living habits, and actively treat correctly to reduce the impact of the disease.
Myth No. 8: Care about technology and ignore treatment.
Advances in science and technology are the only correct way to finally solve the treatment of chronic hepatitis B. Science and technology continue to advance and provide new therapeutic drugs and treatment techniques, and it is completely understandable that hepatitis patients are eager for new technology and new treatments. Only the joint efforts of patients and scientific workers can finally solve this problem. Concern for new advances is not a substitute for current formal treatment. I have encountered many patients who spend their days obsessed with finding new drugs and new treatments, but relatively ignore the current treatments that have been clinically proven to be effective. Individual patients are well informed about new advances, but suffer as a result and do not enjoy even the most basic therapeutic measures. For example, they are particularly concerned about some of the upcoming therapeutic drugs such as Adefovir, Bac, gene vaccines, and gene therapy, but do not use any of the drugs that are currently in clinical use and proven to be effective, waiting only for new therapeutic drugs and new treatment technologies, thus delaying their disease.
There are also some patients who ask what good drugs are available in your hospital as soon as they enter the door when they see a doctor. I can only answer that there is no pharmaceutical company that produces drugs for our hospital alone, and other hospitals cannot buy them. So, the reason why Beijing Ditan Hospital has a high level of hepatitis treatment is not because our hospital has special drugs, but because there is a unique level of understanding and treatment of hepatitis as a whole. Therefore, there is no need for patients to travel around the country seeking the “magic pill” for hepatitis.
Currently, the news media is taking advantage of the eagerness of chronic hepatitis B patients to seek medical treatment by confusing them with inaccurate advertisements and cheating them out of money. Gene therapy, for example, is a term that appears frequently in advertisements. About gene therapy is a gene-level treatment technology that emerged in the last decade of the 20th century. In China, only three clinical research programs have been approved in the field of genetic diseases and oncology, and only in a very small number of patients, and not widely used in the clinic. As for gene therapy for viral hepatitis, it has been a hot spot for experimental research, but so far, no clinical treatment program has been approved for viral hepatitis. Therefore, any current treatment for viral hepatitis in the name of gene therapy is either illegal or fraudulent.
Countermeasure: Care about the drugs and technologies that will be used clinically for treatment, and pay more attention to the best treatments available.
Myth No. 9: Bias and nutritional deficiencies.
Chronic hepatitis B patients are not to abstain from eating, how to abstain from eating, this is also an important issue facing patients with chronic hepatitis B. Because of the vast size of our country, the habits of different regions are different, therefore, the taboo situation of patients with chronic hepatitis B is not the same. However, we sometimes see malnutrition due to inappropriate avoidance of food, which has a significant impact on the immune system of the body, thus causing low resistance of the patient, which is not conducive to recovery from hepatitis.
A patient with early cirrhosis, listened to a long list of “can not eat” food, the result is that you can not eat this and that, after several years of torment, although only 30 years old, but the body condition due to long-term nutritional deficiencies, resulting in low immunity, resulting in liver disease recovery is also seriously affected. There is also a “careless” female patient, cheerful and open-minded, although the living conditions are very good, but for personal diet life but negligent arrangements, every day either swimming or playing mahjong, although the liver function condition is still good, cirrhosis diagnosis time is relatively short, but because the serum albumin level is only 29 grams / liter and ascites. There are also some patients who, in order to treat their liver disease, “take supplements” every day, resulting in severe steatohepatitis. These are all negative consequences of abnormal eating habits and are matters that should be noted by patients with chronic hepatitis B.
Countermeasures: In principle, except for the prohibition of alcohol, patients with chronic hepatitis B are free to eat and drink.
Myth No. 10: Blindly turning negative despite the disease.
One day when I was in the specialist clinic, a patient flung himself down in front of me with tears in his eyes and asked me to find a way to save him. I hurriedly helped him up and asked him to show me all his labs. The serum transaminase level had been normal and the AoA was positive. But the lab sheets from hospitals around the world were thick stacks, often with lists of the various drugs this patient had “tried” over the years. Other patients, in order to turn negative, quit their jobs, leave their families, and go around the country to see doctors, only to waste their money. Some farmers told me that they sold their houses and cows in order to get a negative result, which resulted in the “destruction of their families”, but it did not help their condition.
Although the hepatitis B vaccine has been used for more than ten years and the immunization against hepatitis B has achieved good results, we still see some young patients around 10 years old due to the unbalanced development of economic conditions in different regions and the different knowledge and attention to disease prevention. Once again, we call for the strengthening of scientific and popular knowledge of hepatitis B prevention and treatment, and the universal vaccination against hepatitis B. Because once you have hepatitis B, the treatment is very tricky, but the current hepatitis B vaccine has a very positive effect on immunoprophylaxis. Therefore, we should start with immunoprophylaxis to radically control the prevalence of hepatitis B virus infection nationwide. Parents of children who have acquired hepatitis B virus infection without effective prevention are very anxious as the only child in the family. Since this group of children will encounter various difficulties in the future, such as enrolling in daycare and going to school, parents will do whatever it takes to treat them. This feeling is completely understandable, but it is important to handle this situation calmly and scientifically, and not to treat blindly or excessively. Blind and excessive treatment will not only fail to help the affected child, but will probably also have harmful results, which will be regretted in the end.
Countermeasures: Conversion is not a treatment goal that can be pursued at present. The majority of patients with chronic hepatitis B should be more alert to the practice of cheating money under the banner of conversion.