It’s the end of the year again, and once again, a few people are happy and a few people are sad. Everyone will make a small summary of this year’s work or life. Everyone will also hope for the next year’s success and good health. For hepatitis B patients, how is your treatment effect this year? How is your mindset? Are you full of confidence to continue treatment next year? Or this year you have not been able to get good results, are worried about the next treatment? Today, Xiaoyu will share with you the reasons why hepatitis B patients have poor results, hoping to help confused patients and friends. Drag The most taboo thing about disease treatment is the word “drag”. For the treatment of chronic hepatitis B is more so, there are a lot of patients think that they do not have uncomfortable symptoms, after checking the blood found that the liver function is not a problem, so they think it’s okay. By the time they realize there is a problem, they may have missed the best treatment period. China’s 2015 edition of the Chronic Hepatitis B Prevention and Control Guidelines clearly states that the annual incidence of cirrhosis in patients with chronic hepatitis B is 2% to 10%. The annual incidence of compensated cirrhosis progressing to hepatic decompensation is 3% to 5%, and the 5-year survival rate of decompensated cirrhosis is 14% to 35%. The annual incidence of HCC in non-cirrhotic HBV-infected patients is 0.5% to 1.0%. The annual incidence of HCC in cirrhotic patients is 3% to 6%. Therefore, all HBsAg-positive patients should be tested for serum, HBV DNA, biochemical parameters, and liver fibrosis. This is especially true for patients >30 years of age with a family history. Antiviral therapy should be started as soon as the criteria for antiviral therapy are met, rather than delaying and waiting for symptoms to become apparent before considering it. Perhaps by the time you start to think about it, the disease has progressed to the cirrhosis stage, making treatment more difficult. Patients can follow the chronic HBV infection patient management flow chart below. Urgency The desire for speed is even more true for the treatment of chronic diseases. Hepatitis B patients need to be patient enough to treat their disease and not rush. Whether you choose to treat with nucleoside analogs or long-acting interferon, there is a testing cycle, and not all patients will be able to see results in a short period of time. If the patient is in a hurry to change or stop the drug because the indicators failed to decline in the first few months of treatment, this is a wrong approach. The recommended course of treatment for interferon is usually 1 year, while nucleoside analogs are longer or even lifelong, and the 2015 China Hepatitis B Guidelines have increased the recommended course of treatment for patients treated with nucleoside analogs, and the criteria for discontinuing the drug are more stringent. Patients should follow the recommended course of treatment, and monitor the corresponding indicators during treatment, and analyze whether they need to change, add or stop the drug according to the results of monitoring. Blindness Blindness is often due to ignorance. Now is not the same as before, patients know nothing about the disease can only listen to the doctor’s advice, now is the era of information explosion, patients can learn from various channels to understand their own disease. China is a big country with hepatitis B. Not only the national government cares about this disease, but also drug companies, public welfare organizations, doctors and so on will make corresponding efforts to popularize the knowledge of hepatitis B. Therefore, patients should become active and proactive, and reasonably manage their own disease. Nowadays, we can still see advertisements about the miracle drug for hepatitis B on the Internet, which fools ignorant patients to take this miracle drug to get a complete cure. Dear patients, Hepatitis B cannot be completely cured so far, and it is important to say three times, Hepatitis B cannot be completely cured so far, Hepatitis B cannot be completely cured so far. Therefore, all medicines that say they can cure hepatitis B are false. Another thing is that regarding the choice of medication for treatment, many patients appear to be at a loss, so when the doctor gives advice, they ask the doctor to make the decision for them. The choice of medication as well as the regimen will be more beneficial to the patient if there is a thorough communication between the doctor and the patient. If you have no contraindications to interferon and wish to stop the drug as soon as possible without relapse, or if you have reproductive needs, you may prefer long-acting interferon treatment, aiming to stop the drug in a fixed course of treatment. If you are a patient with interferon contraindications, or you do not have any special requirements for treatment duration, and want to take the drug conveniently, you can choose entecavir or tenofovir with a high barrier to drug resistance for treatment. Overall, if patients learn more about their disease and participate in the process of managing their condition, treatment will be more targeted and may achieve twice the result with half the effort. Indulgence A large proportion of patients have poor hepatitis B outcomes because of a lack of regular monitoring during treatment. Regular monitoring is conducive to fully grasp the progress of disease treatment, determine the efficacy of treatment and optimize the adjustment of the treatment plan in a timely manner. Many patients start antiviral treatment and then leave it alone, just take the medication on time without monitoring the relevant indicators. This means that patients will not be able to know if a drug is not working well or if they have developed resistance to it, and by the time a year or two has passed, the disease may still be in the same place or may have progressed, and optimization may not be the best way to achieve results. Therefore, patients need to follow the guideline recommendations to regularly monitor the corresponding indicators and ask their doctors to analyze and interpret them. Savings Since many Chinese patients with chronic hepatitis B come from rural areas and are not well off, many of them choose lamivudine, the cheapest hepatitis B treatment drug, for treatment in order to save money. But they just see the price advantage of lamivudine treatment for one year, not realizing that lamivudine drug resistance and recurrence rate are extremely high, and the treatment is less than four or five years, more is life-long treatment. Therefore, Xiaoyu here still need to re-emphasize the overall cost of treatment drugs, nucleoside drugs, although cheap, but the treatment course is long, and interferon, although expensive, but the recommended course of treatment for 1 year, and many places can reimburse a large portion of the medical insurance. When you do the math, you’ll understand what the long-term benefits are. Therefore, patients should choose drugs for their own needs, rather than choosing unsuitable drugs for the sake of immediate savings, leading to regret in the end.