In clinical work, we often encounter such patients: some of them come to the clinic, and the first thing they say is that they are in trouble with school and employment because they have been found to have hepatitis B. Can they be treated to turn their hepatitis B to negative; others believe in the false propaganda of some media and go to the so-called “turn to negative” treatment, and end up spending a lot of money, and sometimes The liver function that was normal is not compensated. The goal is to turn hepatitis B negative, which many patients earnestly hope for, and many irregular medical institutions and some media that help the tigers seize this point and promote the ability to turn “large and small triplets negative”. The actual fact is that you can get a lot more than just a few of these. There are several aspects to this: What are the markers of the hepatitis B virus? Will it turn negative? The markers of the hepatitis B virus in the blood, that is, the indicators by which hepatitis B virus infection can be diagnosed. The common clinical markers include the five hepatitis B items and hepatitis B DNA. The five hepatitis B items include HBsAg (surface antigen), HBsAb (surface antibody), HBeAg (e antigen), HBeAb (e antibody) and HBcAb (core antibody). A positive surface antibody indicates that the body is already immune to the hepatitis B virus and the possibility of re-infection with the hepatitis B virus is extremely low. The term “conversion” usually refers to the conversion of surface antigen, e antigen and DNA. So what does it mean when these indicators turn negative? Is it possible to achieve them? We’ll talk about it one by one: 1. surface antigen A negative surface antigen means complete clearance of the hepatitis B virus, which means complete freedom from the hepatitis B virus. Can the surface antigen of hepatitis B turn negative? It depends on the specific situation. In the case of acute hepatitis B virus infection in adults, about 95% of patients are able to completely clear the virus within six months by their own immune system, and eventually the surface antigen turns negative and surface antibodies appear. Unfortunately, the majority of patients are currently chronically infected with the hepatitis B virus, formed, for the most part, because of infection at an early age and chronic hepatitis caused by the inability of the body’s immune system to clear the virus due to its incompetence. The possibility of turning negative for surface antigen in chronic infections is very small, with only a 1% chance of turning negative naturally each year, and only about 3% chance of turning negative even through antiviral treatment. 2, e antigen e antigen to negative, and the emergence of e antibody, clinically known as e antigen seroconversion. In the past, e antigen positivity was called “major triplet” and e antibody positivity was called “minor triplet”, but e antigen seroconversion is the conversion of “major triplet” to “minor triplet”. e antigen seroconversion, i.e. “major triplet” to “minor triplet”. The E antigen natural conversion rate is about 10% per year, and through antiviral treatment, it can reach about 40%. 3, HBV DNA Hepatitis B virus DNA is the nucleic acid of hepatitis B virus. With antiviral treatment, 80% of patients can become negative for HBV DNA, which means that viral replication is inhibited and the disease is relatively stable, so the possibility of developing liver cancer and cirrhosis in the future is greatly reduced. What is the goal of hepatitis B treatment? Is it a “major and minor triplet conversion”? Since the current treatment is not able to completely eliminate the virus and turn the surface antigen negative, why do we need to fight the virus in treatment? What is the goal of hepatitis B treatment? The Guidelines for the Treatment of Chronic Hepatitis B in the United States, Europe, Asia Pacific and China all state that the goal of hepatitis B treatment is to “maximize long-term suppression or elimination of hepatitis B virus, reduce hepatocyte inflammation and necrosis and liver fibrosis, delay and stop disease progression, reduce and prevent liver decompensation, cirrhosis, hepatocellular carcinoma and their complications, and thereby improve quality of life and prolong survival. time”. The primary goal is to suppress the virus and reduce the inflammation of liver tissue, while the ultimate goal is to reduce and prevent the occurrence of liver failure, cirrhosis and liver cancer. How to treat your “major and minor triplets” correctly? As mentioned earlier, the virus can be suppressed through treatment, but do all people with hepatitis B virus need antiviral treatment? No, not at all. Guidelines in the United States, Europe, Asia Pacific and China all consider DNA positivity and a more than twofold increase in transaminases as criteria for antiviral treatment of chronic hepatitis B. In addition, for patients with existing cirrhosis, antiviral treatment is required as long as the hepatitis B DNA is positive, regardless of whether the transaminases are elevated. It can be seen that for most people with hepatitis B virus infection, just having positive DNA and active viral replication is not antiviral treatment; the key also depends on whether there is inflammation in the liver tissue and whether the transaminases are elevated. There are two reasons for this: first, the proportion of people with normal transaminases who progress to liver cancer and cirrhosis is not high, i.e., it is not necessary; rather, the current antiviral treatment is less effective for people with normal transaminases. Why are there so many false advertisements? How to identify them? Since the current treatment is not able to completely remove the virus, why are there so many advertisements of “transferring small and large triplets to negative” to deceive people? The reason is very simple, the interest is made, irregular medical institutions are to make money, irresponsible media is also to make money, and the regulatory authorities due to lazy governance, which caused the current situation. The performance of false advertising can be described as diverse, there are ancestral secret recipes, gene therapy, biological missiles, posing as military medical institutions, there are also contracts to treat the ineffective refund, countless tricks. The common feature, however, is to expand the efficacy of the treatment, thereby deceiving patients into falling for it. Remember, no matter what the advertised treatment method is, how fanciful the treatment mechanism is, if the advertised efficacy is “surface antigen to negative”, “large and small triplet to negative”, “complete cure If the advertised efficacy is “surface antigen conversion”, “major and minor triplet conversion”, “complete cure”, then it is definitely false advertisement.