What to look for in chronic hepatitis B

  Chronic hepatitis B is an infectious disease caused by the hepatitis B virus. The HBsAg positivity rate in our general population was 7.18% in 2006, and there are about 20-30 million patients with chronic hepatitis B. Hepatitis B is characterized by a slow onset, with subclinical and chronic forms being more common. The disease is mainly transmitted through blood, mother-to-child and sexual contact.  Definition of chronic HBV infection Those who have been HBsAg positive for more than 6 months or have a history of hepatitis B or HBsAg positivity and are still HBsAg positive are diagnosed as having chronic HBV infection.  Goals of chronic hepatitis B treatment Maximize long-term suppression or elimination of HBV, reduce hepatocyte inflammation necrosis and liver fibrosis, delay and stop disease progression, reduce and prevent liver decompensation, cirrhosis, liver cancer and their complications, thus improving quality of life and prolonging survival time.  Chronic hepatitis B treatment mainly includes antiviral, immunomodulatory, anti-inflammatory and hepatoprotective, anti-fibrotic and symptomatic treatment, among which antiviral treatment is the key, as long as there is an indication and conditions allow, standardized antiviral treatment should be carried out.  Domestic and foreign anti-HBV drugs approved for chronic hepatitis B mainly include a-interferon and nucleoside (acid) analogs, of which nucleoside (acid) analogs are oral antiviral drugs, convenient, safe and more suitable for long-term treatment.  Currently, lamivudine (Hepteine), adefovir (Hovirix, name Zheng), entecavir, and telbivudine are used in China, and thymidine α1 and bitter ginseng are also used in clinical trials.  Herceptin, as the first antiviral drug for the treatment of chronic hepatitis B, has the following effects: (1) Rapidly and continuously inhibit the replication of hepatitis B virus DNA (2) Promote HBeAg seroconversion, which is commonly known as “major triplet” to “minor triplet “(3) Improve liver function and normalize ALT level (4) Reduce the incidence of cirrhosis and hepatocellular carcinoma, and improve the quality of life and survival rate of patients.  The management of antiviral therapy 1) should choose the appropriate antiviral regimen under the guidance of physicians; 2) should strengthen the follow-up, establish treatment files, adhere to long-term treatment, in principle, patients do not easily discontinue antiviral therapy drugs on their own; 3) purchase drugs in regular hospitals.