What should I do if I have hepatitis B? What should I do if my liver function is abnormal? How should I treat hepatitis B? What is hepatitis B major and minor triple yang? Does hepatitis B necessarily progress to cirrhosis and liver cancer? First of all, we should know that hepatitis B is a very common disease and is the most common chronic viral infection in the world, and China is one of the highly endemic countries. The number of hepatitis B patients in China is very high, reaching an average of 1 in 10 people at its peak, and this situation only gradually eased after the emergence of the hepatitis B vaccine, however, to date, chronic hepatitis B patients in China still account for 7.18% of the total population, or about 90 million people. Therefore, even though it is unfortunate to have hepatitis B, do not feel that it is something that the sky is falling or that it is embarrassing to talk about, after all, there are so many people who are the same as us, and we are no worse than anyone else. Will I be infected if I eat, shake hands, hug, etc. with a hepatitis B patient? Hepatitis B can be transmitted through blood, body fluids, sex, and in China, a very large percentage of chronic hepatitis B patients are vertically transmitted from mother to child. Some people will say that they often hear that it is easy to be transmitted with mouth ulcers, or mosquito bites. In fact, these are only theoretical possibilities, it needs to be very coincidental that the hepatitis B virus in the body fluids or blood of a hepatitis B patient happens to enter your ulcer, while not yet destroyed by your body’s normal immune defense, and then happens to infect your liver cells, and finally happens to successfully colonize and survive; or a mosquito bite a hepatitis B patient, happens to suck a mouthful of blood with the hepatitis B virus, in When the mosquito bites you, the hepatitis B virus happens to run into your blood, while not yet destroyed by your body’s normal immune defense, and then happens to infect your liver cells, and finally happens to successfully colonize and survive. Such perfect conditions realistically do not exist, at least, in all the years since the world discovered the hepatitis B virus, there has not been a single case of chronic hepatitis B infection due to eating, shaking hands, hugging or mosquito bites with a hepatitis B patient. So what is hepatitis B major and minor third-positive? In fact, this is just a common name, clinically speaking, there is no intentional distinction between major or minor triplets, and, in addition to these two types, there are many other types, and major or minor triplets are not indicators of light or severe disease. We often refer to the hepatitis B two-and-a-half, refers to 1 pair (surface antigen + surface antibody), 1 pair (e antigen + e antibody), half (core antibody), because the core antigen is located in the nucleus, it is difficult to detect, so only the core antibody can be detected. 1, surface antigen HBsAg, is an important sign of current hepatitis B infection, almost so to speak, HBsAg positive means suffering from acute or chronic hepatitis B, HBsAg negative means no hepatitis B (except for occult hepatitis B). 2, surface antibody HBsAb, is a sign of immunity to hepatitis B. Usually people who take the hepatitis B vaccine (which actually removes the “core” of the hepatitis B virus shell) will show a positive HBsAb, and this part of the population will not be infected with hepatitis B again, and have immunity to the hepatitis B virus. 3, e antigen HBeAg, is a sign of hepatitis B virus replication, HBeAg positive, the higher the value, on behalf of hepatitis B virus replication about the powerful, the higher the content of hepatitis B virus in the blood. 4, e antibody HBeAb, the opposite of e antigen, when HBeAb positive, represents low level of hepatitis B virus replication and low level of hepatitis B virus in the blood. 5, core antibody HBcAb, is an important sign of having been infected with hepatitis B, for example, acute or chronic hepatitis B patients are definitely positive for HBcAb, but again a large proportion of people, especially adults, can be infected with the hepatitis B virus without any symptoms, relying on their own immunity to completely remove the hepatitis B virus, and eventually the blood will show HBsAb and HBcAb positive, this is also Very healthy and immune to hepatitis B. As mentioned above, 1/3/5 positive is major triple yang and 1/4/5 positive is minor triple yang. Then an important indicator is hepatitis B DNA (HBV-DNA) The complete hepatitis B virus DNA molecule, a ring-closed cccDNA, is very stubborn and difficult to be completely removed. The normal reference range we usually see is hepatitis B DNA < 500 IU/ml, but in fact the level of hepatitis B DNA in normal human blood should be 0. However, the latest testing methods have been able to lower this lower limit of detection to 10 IU/ml. Positive hepatitis B DNA is a necessary condition for the diagnosis of hepatitis B virus infection, so to speak, if the hepatitis B DNA is 0, then you must not have hepatitis B. So what should you do if you have chronic hepatitis B? First of all, we should know the natural course of hepatitis B. Generally speaking, the natural course of chronic hepatitis B has four phases. 1, immune tolerance period Hepatitis B virus and the human body peace period, most of the children or young patients, manifested as high levels of hepatitis B DNA, major triplets, but normal liver function or mild abnormalities, this period does not need treatment for the time being, only regular re-examination of liver function, hepatitis B DNA, liver ultrasound can be. 2, immune clearance period The body began to actively remove the hepatitis B virus, most of the young and middle-aged patients, this period of time is long, some people short, depending on the individual. Most of them show a decrease in the level of hepatitis B DNA, and some patients can convert e antigen to e antibody to enter the low activity replication period, and a very small number of patients have s antigen clearance and s antibody, that is, the disease is self-healing, but this situation is extremely rare, <1%. During this period, the human immune system attacks the hepatitis B virus, killing the hepatitis B virus while also killing a large number of liver cells, abnormal liver function, serious liver failure may occur, and even life-threatening; immune clearance period, the liver repeatedly inflammatory necrosis to recovery and then to inflammatory necrosis, repeated cycles, prone to cirrhosis. 3.Low active replication phase Hepatitis B virus enters the dormant phase, mostly seen in young and middle-aged patients. After the immune clearance period, some patients enter the low activity replication stage of hepatitis B virus, mostly manifested as low level of hepatitis B DNA, even below the lower limit of detection, positive s antigen, negative e antigen, positive or negative e antibody, and normal or mildly abnormal liver function. The risk of progression to cirrhosis is also greatly reduced in this stage. 4.Reactivation stage Hepatitis B virus reactivation is mostly seen in middle-aged patients, and the risk increases after the age of 40. It is characterized by elevated levels of hepatitis B DNA, positive or negative e antigen, positive e antibody, abnormal liver function, and the need for liver protection and antiviral treatment. In short, it is not necessary to deliberately distinguish which stage the disease is in, and whether treatment is needed depends mainly on liver function and hepatitis B DNA indicators.