Many people believe that hepatitis B can not be cured, and there are no obvious symptoms, so there is no need for treatment, and even think that the treatment of hepatitis B is purely a waste of time and money. Experts point out that this view is very wrong. Hepatitis B is the main cause of chronic liver disease, liver cirrhosis and primary liver cancer, and if left unchecked, the damage can’t be underestimated. July 28, 2011 is the first World Hepatitis Day officially recognized by the World Health Organization, and is also the fourth disease day recognized by the World Health Organization, with the theme “This is Hepatitis ……”, which aims to make more people aware of the dangers of hepatitis and draw attention to it. The world’s 1 million people die each year from hepatitis B-related diseases Currently, 2 billion people worldwide have been infected with the hepatitis B virus, about 350 million hepatitis B virus carriers, of which the Asia-Pacific region accounts for two-thirds, China has 120 million people carrying the hepatitis B virus. Zhuang Hui, an academician of the Chinese Academy of Engineering, recently pointed out at the first Asia-Pacific Frontier Liver Disease Forum that chronic hepatitis B is a serious global public health problem, with about one million patients dying from hepatitis B-related diseases each year, the seventh leading cause of death worldwide. ”From the source of the disease, chronic hepatitis B is an immune-mediated disease,” Zhuang Hui, an academician, described it graphically: “Chronic hepatitis B is a war between the body’s immune system and the hepatitis B virus, and after the two sides have killed each other, the liver is left with a broken wall, leaving a large number of liver cells damaged and dead. If the war is intensified and prolonged, it will lead to liver fibrosis, cirrhosis and even liver cancer.” Quantitative monitoring of e/s antigen is the “vane” of the efficacy of treatment. In fact, e/s antigen conversion is a “weathervane” for doctors to observe the efficacy of treatment. The first indicator is the e antigen, which is produced by the hepatitis B virus, and when the e antigen is positive, the virus is replicating more actively. The second indicator is the hepatitis B virus DNA level, which shows how much hepatitis B virus is in the patient’s body. The third indicator is transaminase, which reflects the level of inflammation in the liver. Chen Liyuan, director of the Liver Care Center at the Chinese University of Hong Kong, pointed out that “if a person’s own immunity can keep the hepatitis B virus under control, the e antigen in the serum disappears and e antibody appears, then the amount of hepatitis B virus is very low, and the liver inflammation can also disappear, which is also known as immune control, immune control is the way to achieve a clinical cure for chronic hepatitis B. “ Therefore, for hepatitis B treatment goals, there are gold, silver and bronze medals. Chen Liyuan said that the bronze medal goal is to inhibit viral replication; silver medal goal is to convert e antigen, the current goal of drug withdrawal, that is, to achieve lasting immune control; gold medal goal is s antigen clearance, conversion, to achieve clinical cure, only through interferon therapy can be obtained. Chen Liyuan believes that the longer the immune control period, the better, so that there is no damage to the liver. The long-term follow-up also shows that these patients have a lower chance of developing cirrhosis and liver cancer. The newest treatment idea is not to relapse after stopping medication Many hepatitis B patients have a concern that they need to take medication for life for hepatitis B treatment. In fact, experts say that durable immune control can keep chronic hepatitis B patients from relapsing after stopping medication. The current treatment of chronic hepatitis B drugs are mainly divided into two categories: one is the nucleoside (acid) analogues, with the role of inhibiting the replication of viral DNA; the other is a long-acting interferon class, with the dual role of antiviral and immunomodulatory. In the battle between the body’s immune system and the hepatitis B virus, the nucleoside (acid) analogs are designed to reduce the number of viruses, which can suppress the virus during the medication period, but once the medication is stopped, the disease will return, so long-term medication is required, and at the same time, there is a possibility of virus resistance during the treatment process. Because it does not kill liver cells, it does not damage liver function, but it is difficult to completely eliminate the hepatitis B virus. The long-acting interferon is a two-pronged approach that reduces the number of viruses on the one hand, and targets the source of the disease on the other, stimulating the body’s immune system so that the disease can still be controlled for a long time after the limited course of treatment, and will not return. Therefore, after treatment, there are relatively more patients who have changed from “major tri-positive” to “minor tri-positive”, and some of them may also have a negative surface antigen, and will not relapse after stopping the medication. Therefore, it is recommended that young patients start their antiviral treatment with interferon. ”The patient should choose the right medication for him or her under the guidance of a professional doctor, depending on the situation. “The treatment of hepatitis B can not be completed overnight, and requires a period of persistence, so patients should not believe in rumors to avoid delaying the disease.
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