Hepatitis B epidemiology: The 2006 national epidemiological survey of hepatitis B showed that the HBsAg carriage rate of the general population aged 1-59 in China was 7.18%, and the HBsAg of children under 5 years old was only 0.96%. According to this projection, the existing chronic HBV infection in China is about 93 million people, including about 20 million cases of chronic hepatitis B patients. What is hepatitis B? It is inflammatory damage to the liver caused by hepatitis B virus (HBV). It is currently the most widespread and harmful infectious disease in the world. Most of the hepatitis B can be cured after treatment in the acute stage, but a few cases are prolonged or become chronic, and some of them can develop into hepatitis cirrhosis or even liver cancer; very few cases develop rapidly, with large necrosis of liver cells and become heavy hepatitis; some other infected people become asymptomatic virus carriers. Hepatitis B classification Acute hepatitis B: the course of the disease within six months is called acute hepatitis B, generally more rapid onset, with mild and severe symptoms, most people surface antigen disappears in six months, a few can become chronic hepatitis B. Chronic hepatitis B: the course of the disease is more than half a year, called chronic hepatitis B, can have mild and severe symptoms, delayed, recurrent. If there is no history of hepatitis B and no recent laboratory results, it is sometimes difficult to determine whether the first attack is acute hepatitis B or chronic hepatitis B. Hepatitis B virus carriers: If there are no symptoms and signs, normal liver function, only positive surface antigen, whether it is “major triplet” or “minor triplet”. Regardless of whether the HBV-DNA is positive or negative, all are called hepatitis B virus carriers. It accounts for the majority of people with hepatitis B infection. It is important to note that some people are asymptomatic and even have normal liver function, but have chronic inflammation of the liver that can eventually develop into cirrhosis if left untreated, and these people are not true carriers. Therefore, if there is no evidence of liver histology, long-term, dynamic observation is required to make an accurate diagnosis. Severe hepatitis B: the disease progresses rapidly, the symptoms are severe, and can be life-threatening if not actively resuscitated. Hepatitis B transmission routes (1) Medical transmission Transmission through blood and blood products: Hepatitis caused by blood transfusion (including serum, plasma, whole blood and other blood products) is post-transfusion hepatitis. In recent years, the incidence of post-transfusion hepatitis has decreased significantly through sensitive serological screening methods. The use of medical devices that are not strictly sterilized, invasive diagnostic and surgical operations, unsafe injections, especially drug injections; others such as foot trimming, tattoos, earring piercing, accidental exposure of medical personnel at work, sharing razors and toothbrushes, etc. (2) Mother-to-child transmission Mother-to-child transmission mainly occurs in the perinatal (maternity) period, mostly in the delivery of HBV-positive mother’s blood and body fluids transmission, with the application of hepatitis B vaccine combined with hepatitis B immunoglobulin, mother-to-child transmission has been greatly reduced. (3) Contact transmission Daily life contact transmission: blood, saliva, semen and vaginal secretions with HBV enter the body through the skin and mucous membrane of the susceptible person, rather than through fecal-oral transmission, HBV is not transmitted through the respiratory and digestive tracts, so daily study, work or life contact, such as working in the same office (including sharing office supplies such as computers), shaking hands, hugging, living in the same dormitory Epidemiological and experimental studies have also not found that HBV can be transmitted by blood-sucking insects (mosquitoes, bedbugs, etc.). What tests should be done for patients with hepatitis B? Qualitative and quantitative hepatitis B two-to-one tests; quantitative HBV-DNA tests; liver function tests, prothrombin time (PT) and alpha-fetoprotein (AFP); abdominal ultrasound, abdominal CT, etc. Major tri-positive” and “minor tri-positive” “Major tri-positive” means the result of “two-and-a-half” test is positive for hepatitis B virus surface antigen, hepatitis B virus E antigen and hepatitis B virus core antibody, Hepatitis B virus core antibodies, i.e. HBsAg(+), HBeAg(+), anti-HBc(+). “Small triple positive” means the result of “two and a half” test is positive for hepatitis B virus surface antigen, hepatitis B virus E antibody and hepatitis B virus core antibody, i.e. HBsAg (+), anti-HBe (+), anti-HBc (+). HBV-DNA quantitative test HBVDNA quantitative test can reflect the level of viral replication and is mainly used for the diagnosis of chronic HBV infection, treatment, selection of indications and judgment of antiviral efficacy. positive HBVDNA indicates the presence of hepatitis B virus particles, and active replication and high infectivity. How to choose antiviral drugs Currently, there are two main categories of antiviral drugs recognized by the medical community at home and abroad as having definite efficacy in the treatment of chronic hepatitis B: alpha interferon and nucleoside analogues. Nucleoside analogs such as lamivudine, adefovir, entecavir, and telbivudine. Patients should understand the types of antiviral drugs, mechanism of action, indications, efficacy and side effects based on a clear understanding of their condition, and choose different antiviral drugs according to their condition. Chronic hepatitis B treatment is a long-term process, and the treatment time, especially for antiviral drugs, is generally longer. And for chronic hepatitis B patients need to receive a longer period of treatment. Patients with hepatitis B should establish confidence, adhere to the medication, maintain a good attitude towards treatment, and believe that they will be able to overcome the disease.