In clinical diagnosis and treatment, because many treatment principles of hepatitis B involve very specialized medical knowledge, it would be very difficult to communicate with patients in these specialized languages, but if we use some easy-to-understand language to visualize the abstract hepatitis B diagnosis and treatment knowledge, patients will be very easy to understand, patient compliance will be good, and the treatment effect will become better. Therefore, we decided to take the time to give some lectures on the diagnosis and treatment of hepatitis B and C in layman’s terms, hoping to provide some useful knowledge to the majority of liver disease patients, so that they can take less detours in the fight against the disease. After hepatitis B invades the human body, it will mainly go through the following stages, which will affect the human body. The first stage: general national infection with hepatitis B virus mostly occurs in mother-to-child transmission or when young, at this time the body’s immune system is not fully developed, the ability is not strong enough to remove the hepatitis B virus, and the hepatitis B virus itself does not cause direct harm to the human body, so this time the human body and HBVDNA peaceful coexistence, people do not offend me, I do not offend, HBVDNA in the body a large number of replication, hepatitis B The hepatitis B virus does not cause harm to the human body and does not need to be treated, and regular review is sufficient. At this time, patients are easily frightened by the astronomical viral load on the checklist, coupled with the misunderstanding of people around them about hepatitis B. Talking about “major triplets” brings a lot of psychological pressure to patients, but in fact, it is not necessary, the hepatitis B virus at this time is like a parasitic bacteria in the human intestine, causing no harm to the human body. The actual fact is that they are not harmful to the human body, so there is no need to be too concerned. Don’t be deceived by some quacks or unscrupulous advertisements and spend money that is not worthwhile. Some patients may ask, “The virus is so high, why not antiviral treatment at this time? As already mentioned, the immune system does not recognize the virus in the body at this time, and interferon and nucleoside drugs are only drugs that help the immune system to control the virus, and can not completely replace the immune system, antiviral treatment at this time, one is not necessary, and the second is not good results. The second stage: as we grow older, when the human immune system gradually develops and matures, gradually break this balance, the immune system to hepatitis B virus recognition, found that HBVDNA is a foreign invasive foreign body, to fight HBVDNA, the human immune system to remove HBVDNA, and because HBVDNA part in the liver cells, so remove the virus at the same time, but also harm or damage the liver cells, there is an increase in transaminases. At this time, the immune system and HBVDNA are fighting each other, the immune system is constantly removing the virus, and HBVDNA is constantly replicating, and the main battlefield is the human liver, and the results of the war, there will be the following kinds of endings: 1, the immune system won: rely on their own body’s strong immune system to quickly take advantage of the HBVDNA will be removed from the body (at this time, the liver cells are still residual There is CCCDNA, but the amount of replicating virus is very small), the major triplet to small triplet, the patient only appear or even do not appear a transient transaminase elevation, some patients in the case of no feeling to turn to small triplet. After this happens, the patient’s hepatitis B five items show small three positive, normal liver function, HBVDNA negative, called: stationary slow hepatitis B, which is the best state a hepatitis B patient can achieve (there are also very few patients will be surface antigen turn negative, that is, completely back to normal, but such cases are extremely rare, and the probability of winning the lottery is about the same, here omitted). The vast majority of patients who do not drink, do not exert themselves, good habits, basically can maintain to maintain this state for life, and no big difference with normal people. However, if smoking and drinking are not abstinent, poor lifestyle habits, there is a risk of HBVDNA resurgence in the future. 2, the immune system and the virus do not share the victory: because the immune system’s fighting power is not enough to completely remove the virus from the body completely, so there will be a protracted war: when the war, transaminases rise, HBVDNA slightly lower. When it stops: normal aminotransferases and positive HBVDNA. At this time, patients mostly show intermittent elevation of transaminases, and the hepatitis flares up again after taking liver-protective drugs to return to normal for a period of time. We call it active slow hepatitis B. At this time, because the body’s own immune system is clearing the virus, but due to the ability is not enough to completely clear the virus, so if this time can carry out antiviral treatment, under the dual action of the immune system and drugs to help the body’s immune system to clear the virus, it will be able to put an end to the battle. When the battle is over, the liver, which is the main battlefield, calms down, liver function returns to normal and HBVDNA turns negative. Patients with better luck will have a negative E antigen, those with worse luck can maintain normal liver function and negative HBVDNA even if the E antigen does not turn negative, and some patients with worse luck will have a rebound of the virus, which will be talked about later and will be skipped here. And if you do not choose antiviral treatment or irregular treatment during recurrent liver inflammation, you will have recurrent liver inflammation, and each liver inflammation is a damage to the liver, and in the decades of repeated struggle, liver fibrosis and liver cancer may be formed. At the same time, the virus in the long struggle with the immune system, superiority and inferiority, some of the virus will appear in the former C region or promoter mutation, making it difficult for the immune system to recognize and remove the virus, as a way to escape the immune system, is what we call E antigen-negative slow hepatitis B. This time is like what it is, give an example you will understand: the immune system is the police, the hepatitis B virus is the bandits, at the beginning the bandits with a hood, very good identification, the police see a catch a, and these bandits themselves will replicate the new bandits, in a state of dynamic balance, the liver has a relatively intense inflammation. And intense liver inflammation patients and doctors are naturally more aware of and pay attention to, will take the appropriate treatment (antiviral and liver preservation), after treatment, liver inflammation calmed down, the disease naturally will not progress forward. And over time, the bandits become cunning, they remove the hood (the former C region or promoter mutation, E antigen turned negative, HBVDNA positive), this time the immune system is not good at identifying which are the bandits, which are civilians, and this time the bandits (replication capacity becomes poor, the ability to cause disease is slightly weaker) will come to play guerrilla warfare, after a period of time out of the thieves to harass the immune system, and The immune system will start another battle to remove the bandits, and while fighting, the liver will become inflamed. Therefore, the inflammation of the liver is generally mild at this time, intermittent and insidious, mainly manifested by intermittent mild elevation of liver function on the laboratory tests, the patient’s conscious symptoms are not obvious, the patient and the doctor are not easily aware of the progress of the disease, plus the patient is prone to paralysis at this time, thinking that his condition is not a big deal, and began not to pay attention to life drinking and staying up late forbidden, the In the long run, although the inflammation of the liver progresses slowly, with the accumulation of years to decades, liver cirrhosis and liver cancer will slowly appear. 1, for hepatitis B virus carriers, only need to do regular review, do not stay up late and do not drink alcohol, all treatment is unnecessary at this time, wait until the transaminases rise before treatment, the best results at this time 2, the big three yang is not necessarily worse than the small three yang, the small three yang is not necessarily better than the big three yang For patients with big three yang, if the liver function is normal, this time no treatment, regular review, the virus does not affect the body at this time; if the liver function is normal, this time no treatment, regular review can be done. If the liver function is not normal, promptly consult a doctor and carry out antiviral treatment as early as possible, the earlier the treatment, the greater the benefit For patients with small triplets, if the HBVDNA is negative, no treatment is needed at this time, regular review is sufficient, this is the best state that can be maintained for patients with hepatitis B For patients with small triplets, if the HBVDNA is positive, it means that the virus has mutated, at this time the liver The inflammation of the liver is characterized by intermittent and insidious, and such patients should not be taken lightly because they are “small triple-positive”, often such “small triple-positive” patients are more difficult.