1, hepatitis B virus is generally blood transmission. It is not easily transmitted by eating, shaking hands, or air. 2, when infected at a young age become carriers, the reason is that the immune immaturity at a young age, the immunity of the wrong hepatitis B surface antigen as their own synthetic protein. The majority of those infected in adulthood will be cured and produce surface antibodies because the immune system is mature and knows that the surface antigen is a foreign molecule. However, after replication, the virus will release the surface antigen protein and e antigen protein on the liver cell membrane after denucleation (viral DNA). 5. Young carriers have immature immune systems and therefore remain oblivious to the virus and this “special” hepatocyte. 6. These carriers grow up and split into two groups, one in which the immune system suddenly recognizes the “faulty” liver cells and attacks them, and acute hepatitis begins. This kind of people account for 25% of all carriers, the remaining 75% of people continue to carry without disease, but as this kind of people get older, the immunity is more and more mature, began to recognize all kinds of antigens, first of all, the e antigen is recognized, the body itself produces e antibodies, into a small triplet of carriers, the number of viruses every 4,5 years will be reduced once a party or so, until the age of older, basically the amount of virus The number of viruses will decrease every 4,5 years, and when you get older, basically the amount of viruses will be less and less, the tolerance of immunity will be completely broken, even the surface antigens will be recognized, and the virus will be completely removed. In 25% of carriers, the t-lymphocytes of their immune system attack the hepatocytes with “faulty membranes” and the hepatocyte membranes break down or the hepatocytes are completely killed, and the cytoplasmic glutaminase is released into the bloodstream and the ALT rises. When the liver mitochondria glutathione only when the liver cells are completely killed out of the blood, so why the general hepatitis, glutathione will be higher than glutathione, is this reason. 8, but the immune system of hepatitis people is still very immature, can only recognize the “cell membrane with surface antigen and e antigen” of the liver cells, but no response to the antigen, only know stupidly kill the infected liver cells. 9, hepatitis human t lymphocytes are still killing infected liver cells, the virus is constantly eliminated, but hepatitis is still going on, but the virus is also replicating, but the virus it is also under great pressure, the immunity is always killing their “nest” liver cells, so it is also thinking of ways, so generally after a few years of hepatitis, some virus This is a node of mutation, this mutation point is the synthesis of e antigen, it no longer release e antigen to the liver cell membrane, this mutation of the virus escaped, and then unrestrained replication, the big three hepatitis patients become small three hepatitis. 10, small triple hepatitis is dangerous, because the virus is forced to mutate by the immunity, although the replication rate is not so high (generally less than 5 times), but this mutated virus is more tenacious, hepatitis lasting episodes, but ALT and AST and not very high oh, usually is not more than 100, or more than 100, some people just eat liver medicine even, think it is not a big deal ah 11, the big three hepatitis people, e antigen is positive, e antibody is negative, this kind of people’s immune system t lymphocytes are attacking the infected liver cells, then the doctor may recommend you antiviral treatment, preferred interferon, because interferon this kind of thing ah, you know how it works? Interferon will firstly change the receptors on the surface of some hepatocytes to produce anti-viral proteins on the surface, and the virus will not be able to infect such hepatocytes. Secondly, interferon will increase the density of human leukocyte histocompatibility antigen on the hepatocyte membrane and promote the effectiveness of T cells in lysing infected hepatocytes. thus playing an immunomodulatory role. The actual fact is that you can find a lot of people who are not able to get a good deal on this. The problem is that the person who invented the long-acting interferon was very clever, he knew that the kidneys could easily eliminate the small molecules of ordinary interferon from the body, so he reconstituted the interferon by attaching a huge molecule (the pegylated glycol molecule) to the ordinary interferon molecule, and the kidneys excreted this “large molecule”. 13, nucleoside drugs are also antiviral, the antiviral principle of this drug can be completely different from interferon, this kind of drug is through the inhibition of viral DNA polymutase to inhibit the replication of the virus, polymutase is what? The nucleoside class of drugs is a very thieving molecule that can bind to the hepatitis B virus’s polymase, making the polymase useless, DNA replication will be inhibited, a very simple principle, right? 14, nucleoside drugs are so stupid, only inhibit the catalyst of viral DNA replication of the polymutase, if the virus, once the work, the polymutase mutation, nucleoside drugs on it completely ineffective, so, lamivudine resistance is how it happens, and the medication takes a long time, usually several years, why, because you inhibit its replication, but the viral DNA in the nucleus of the liver cells, it is Once you stop the drug, it immediately wakes up, and violently create polymorphic enzymes to replicate the virus, you can not just stop the drug, oh, or the work is lost, eat it, eat it for several years, because the life of liver cells is only about 5 months, and so the natural death of infected liver cells, those in the nucleus of the virus ancestors only with the natural death of liver cells and die, eat him for several years until the DNA negative, e antigen negative The liver cells will be renewed and the stubborn viral ancestors will disappear almost, before the drug can be stopped, understand? 15, to talk about cirrhosis of the liver. The specific principle is that t lymphocytes kill the infected liver cells, sometimes dissolve the killed liver cells so that the new cells can grow out, but the fuck sometimes it will not dissolve it, the killed liver cells become a lifeless As time passes, if the hepatitis is not cured, or intermittent attacks, then this fibrous tissue will be more and more, forming nodules, liver cells also need to be replenished, right? The original location is occupied, alas, find another location to grow, so the hepatocyte proliferation began. 16, cirrhosis is more and more fibrous tissue in the liver cells, are forming sheets. At this point, if the patient goes for an ultrasound, the ultrasound doctor will tell you that the portal vein is dilated. The portal vein is like a large water pipe that connects the stomach and small intestine and other organs, so that the things you eat from the stomach and small intestine are directed to the liver through the portal vein, and then the liver is processed to form nutrition and then passed to the heart through a large water pipe, and the nutrition is transmitted throughout the body. It’s that simple. 17, cirrhosis, the liver inside a lot of fibrous tissue, are like “stones”, blood can not flow these “stones”, like a water pipe is blocked some outlets, the portal vein blood pressure is large, so it is dilated, so the portal vein dilated is a sign of cirrhosis. Therefore, the dilated portal vein is a sign of cirrhosis. 18, the above-mentioned principle of interferon, interferon can be stopped at any time, there is no viral resistance to the nature of the interferon to know why look at the above principle of interferon will understand, but nucleoside analogs absolutely can not just stop, the principle of the above is also very clear, and, decided to nucleoside analogs treatment, the general doctor will recommend the most potent drugs to treat, why, to put it bluntly, is afraid of Virus mutation, first with the most violent nucleoside analogues to try to reduce the amount of virus in a few months at the latest a year to within the range of detection, is the so-called 3 times below, DNA negative, otherwise, if you use the effectiveness of the nucleoside analogues not violent, the virus is not fast enough to reduce the time of replication is easy to mutate, then the use of drugs is more trouble, understand? The first time you decide to use nucleoside drugs, you will definitely have to use them for a long, long time. The actual nucleosides are usually not recommended by doctors to give antiviral treatment to these people, why, it is very simple, this nucleosides have to eat a piece every day, there is no impact on fertility who can not say, because of the impact on fertility birth deformed children, this is not a joke. The immune system is not good enough. The immune system is not enough.