How to cure chronic hepatitis B

Based on years of research and clinical experience, we would like to talk about how to cure chronic hepatitis B from three aspects. First, can chronic hepatitis B be cured completely? Patients in general, including some doctors, believe that chronic hepatitis B cannot be cured completely. This is not the case. In a recent expert symposium, many experts could cite several patients with chronic hepatitis B that they had encountered that were completely cured, whether “cured” or “self-healed,” no one dared to say, but in any case, a few patients were indeed But in any case, there are a few patients who are completely cured, as evidenced by negative surface antigen (HBsAg), positive surface antibody (anti-HBs), negative HBVDNA, normal liver function, and long-term non-relapse. Secondly, how can I be completely cured? Theoretically, it is possible for a patient to be completely cured if he or she can develop sufficient specific immunity to the hepatitis B virus. This is evidenced by the fact that the vast majority (over 95%) of adults with acute hepatitis B disease heal spontaneously. These patients are not on antiviral drugs, but the virus is completely cleared. It is the patient’s own specific immunity. Therefore, how to make chronic hepatitis B patients develop strong specific immunity like acute hepatitis B is an important direction of research by foreign scholars. Once this problem is solved, a complete cure for chronic hepatitis B disease will be possible. It must be noted, however, that this is still only a good hope and is being studied, with some rather encouraging results. To date, however, there is no treatment that is very definitely effective. What is being studied more is the hepatitis B vaccine plus various adjuvants, some of which have shown some efficacy and should be further tested. Third, what should the patient do now? We already have some very good antiviral drugs such as interferon, lamivudine, adefovir, adenosine monophosphate, sodium phosphonate, bitter ginseng, and so on. Therefore, for patients who are suitable for these drugs, they should be applied if conditions permit, but immunomodulatory drugs and therapies, especially specific immunity, can also be added. For patients who are not suitable for these drugs, such as patients with normal liver function and carriers, patients with mildly elevated transaminases, and patients with poor economic conditions, specific immunotherapy can be tried. Once the efficacy of these therapies is confirmed, they can of course be gradually expanded to treat a wide range of patients. It must be emphasized that the course of application of currently effective antiviral drugs must be long, at least one year or even several years, because only with long-term medication and specific immunotherapy can the body slowly generate specific immunity on its own, and once specific immunity is generated, complete healing is possible. Since each patient has a different time to develop specific immunity, it is not easy to predict the exact duration of medication, but the general principle is that the longer the time, the greater the chance of complete healing.