On July 28, 2014, World Hepatitis Day, the 16th online interview of the National Health and Family Planning Commission invited Zhang Guoming, Director of the Epidemiology Department of the Immunization Planning Center of the Chinese Center for Disease Control and Prevention, and Jia Jidong, Director of the Liver Disease Research Center of Beijing Friendship Hospital, Capital Medical University, to introduce the prevention and control of viral hepatitis in China. The current status of work and popularization of disease prevention knowledge. Here I have extracted some of your concerns and shared them with you. Netizen: As an ordinary person, how to pay attention to their own health and do their own protection? Director Jia Jidong: First of all, we should know whether we are infected with hepatitis B (hepatitis B), hepatitis C (hepatitis C) or whether we have antibodies. If you have not been infected with hepatitis B and do not have the relevant antibodies, we should be vaccinated against hepatitis B, which is the best protection for ourselves. Of course, some special groups of people whose drinking water and food hygiene conditions are not very good should also be vaccinated against hepatitis A (hepatitis A) and hepatitis E (hepatitis E). Secondly, we should try to avoid some bad living habits and personal hygiene habits, especially not to share toothbrushes and razors which can cause slight breakage of skin mucosa. Again, avoid multiple sexual partners and unprotected risky sexual behavior. Finally, it is also necessary to avoid some unnecessary injections or invasive operations, especially in places with less than perfect medical facilities, to avoid traumatic cosmetic procedures, such as eyebrow tattooing and body piercing, etc. You should go to places with better sterilization facilities, stricter operations and compliance with protocols. Other aspects, such as avoiding alcohol, especially avoiding excessive drinking is a means to prevent alcoholic liver disease; and avoid obesity, reduce non-alcoholic fatty liver; avoid drug abuse, especially unnecessary drugs, these drugs are also a very important cause of drug-related liver damage. Netizen: Which types of viral hepatitis now have vaccines? Director Zhang Guomin: At present, the viral hepatitis that can be prevented and controlled by vaccines are hepatitis A, hepatitis B and hepatitis E. Currently, there are live attenuated hepatitis A vaccines and inactivated hepatitis A vaccines on the market. Live attenuated vaccine is sufficient for one dose, while inactivated hepatitis A vaccine requires two doses. For hepatitis B, we encourage adults, especially high-risk groups, to receive hepatitis B vaccine. The immunization program for hepatitis B vaccine is 0, 1, and 6 months, with the second dose to be given in the second month after the first dose and the third dose to be given in the sixth month. Our current market also has a hepatitis E vaccine, which is a vaccine developed independently by China and can effectively prevent hepatitis E. Netizen: Usually we have received hepatitis B vaccine, after a few years, the titer may be low, is there any recommended time point for replenishment? Director Zhang Guomin: Some experts believe that even if the titer of hepatitis B antibody is low, it can produce protection just as well because of the immune memory, and at this time, if there is hepatitis B virus exposure, the antibody will also rise in a short period of time, and it will also produce protection, so it is not recommended to boost. However, if you are a person in a high-risk occupation, it is certainly safest to keep your antibody titer at a relatively high level. Netizen: How can I get along with my colleagues who are hepatitis B carriers? Director Jia Jidong: You can establish normal working, studying and living relationships. As long as you do not share toothbrushes, razors and other items that may cause minor trauma to the skin and mucous membranes and blood exposure, other normal contacts, including dining together, are not a problem. Netizen: Is there a cure for hepatitis B? If not, how should I take care of it? Director Jia Jidong: When we say hepatitis B, we are mainly referring to chronic hepatitis B, because acute hepatitis B is self-healing and does not necessarily need to be treated. The percentage of chronic or acute hepatitis occurs differently depending on the timing and age of the infection. If you are infected as a newborn or infant, once you are infected with hepatitis B, more than 90% or at least 70% of the time, you will develop chronicity. If an adult is infected with the hepatitis B virus, more than 90% are acute and do not require treatment. Most of what we usually talk about in terms of how to treat hepatitis B is chronic hepatitis B. Up to now, unfortunately, there is a lack of a very effective cure for chronic hepatitis B. In other words, most patients’ conditions can be controlled through treatment, but it is difficult to cure them completely. The current treatment methods can only make less than 10% of patients turn surface antigen negative, which is close to clinical cure, and more than 90% of the treatment goals are to slow down the disease progression, reduce the occurrence of cirrhosis and liver cancer, and improve the quality of life by controlling the virus. The main goal of treatment is to control the disease, and a small number of patients can achieve clinical conversion or cure based on the control of the disease. If antiviral treatment is needed, it must be antiviral treatment, while paying attention to not drinking alcohol, not being obese, not abusing drugs, etc. Netizen: Does antiviral treatment for hepatitis B require lifelong medication? What are the side effects of long-term use of current antiviral drugs? Director Jia Jidong: Nowadays, antiviral drugs are divided into two categories, one is the injectable interferon class, and the other is the oral nucleoside or nucleotide analogs. When we say long-term medication, we mean oral medication, but some patients may need lifelong medication, such as those who have cirrhosis, we do not advocate stopping medication; and those patients who are E antigen negative, that is, patients with small triplets, if they need treatment, these patients often relapse after stopping medication, we believe that long-term treatment is needed, that is, lifelong medication. For patients with major triple-positive disease, after oral drug treatment, they can achieve E antigen seroconversion, which is what the people call the conversion from major triple-positive to minor triple-positive. In conclusion, whether a patient needs long-term treatment and how long the course of treatment should be depends on the individual. A small number of patients, including those with cirrhosis, may need long-term medication because once the medication is discontinued, the disease may rebound and worsen, and the therapeutic effect achieved may be lost. Netizen: Can women who are hepatitis B carriers breastfeed after having a baby? Director Zhang Guomin: For newborns of hepatitis B virus surface antigen-positive mothers, we first recommend that the newborns be well protected by receiving hepatitis B vaccine and hepatitis B immunoglobulin as soon as possible within 24 hours after birth. Of course, a second and third dose of hepatitis B vaccine should be given at one month and six months of age. In this case, we believe that breastfeeding is still possible.