In clinical diagnosis and treatment, because many treatment principles of hepatitis B involve very specialized medical knowledge, it will be very difficult to communicate with patients with these specialized languages, while if we use some common and easy-to-understand languages to visualize the abstract knowledge of hepatitis B diagnosis and treatment, the patients will be very easy to understand, and the patients’ compliance will be very good, and the treatment effect will be better, so we decided to take time to do some scientific lectures on the diagnosis and treatment of hepatitis B and hepatitis C in common languages, hoping to provide some useful knowledge to the majority of liver disease patients, and less in the fight against the disease. Therefore, I decided to take some time to do some popularized lectures on hepatitis B and C in some common language, hoping to provide some useful knowledge to the majority of patients with liver disease, so that they can take less detours in the fight against the disease. Previously, I have also written some knowledge of liver disease on the network intermittently, but due to the clinical work usually take up most of my time, I can only use the night time to organize the content of the lectures, this time, I decided to do a whole series of popular science lectures on hepatitis B and hepatitis C diagnosis and treatment knowledge, the content of the continuous updating, please pay attention to. After hepatitis B invades the human body, it will go through several stages to affect the human body. The first stage: generally people infected with hepatitis B virus mostly occurs in mother-to-child transmission or 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 the HBVDNA coexist peacefully, people don’t commit crimes I don’t commit crimes, I don’t commit crimes, the HBVDNA replicates in the body in a large number of cases, and the HBVDNA is not able to cause any harm to the human body. HBVDNA replicates heavily in the body, and hepatitis B is shown to be triple positive, but because of the peaceful coexistence of the virus and the body, liver function is basically normal, and at this time the hepatitis B virus does not cause harm to the human body, and does not require treatment, and regular review can be done, and this period of patients is called the healthy carriers. At this time, patients are easily scared by the astronomical viral load on the checklist, coupled with the misunderstanding of hepatitis B by people around them, talk about “triple sun”, which brings great psychological pressure to patients, in fact, it is not necessary, at this time, hepatitis B virus is just like the bacteria parasitized in human intestinal tract, which does not cause harm to human body, although it cannot be removed temporarily, but they themselves do not cause harm to human body. Although it can’t be removed temporarily, they themselves are not harmful to the human body, so don’t be too concerned. Don’t be deceived by some quacks or unscrupulous advertisements and spend a lot of money. Some patients may ask, “The virus is so high, why don’t we have antiviral treatment at this time? As I said before, 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 cannot completely replace the immune system, and antiviral treatment at this time is not necessary, and the effect will not be good. The second stage: with age, when the body’s immune system gradually develops and matures, gradually breaking this equilibrium state, the immune system of hepatitis B virus recognition, found that the HBVDNA is a foreign invasion of foreign objects, it is necessary to fight the HBVDNA, the body’s immune system to clear the HBVDNA, and due to the HBVDNA partially in the liver cells, so the removal of the virus at the same time, but also harmed or damages the liver cells and there is a rise in transaminases. At this time, the immune system and HBVDNA are fighting with each other, the immune system is constantly clearing the virus, and HBVDNA is constantly replicating, and the main battlefield is the human body’s liver, and the results of the war, there will be the following endings: 1, the immune system wins: relying on its own body’s powerful immune system to quickly take advantage of the HBVDNA from the body (at this time, there are still remnants of CCCDNA in the hepatocytes, but replicating There is CCCDNA, but the amount of replicating virus is very small), and the major triple positive is converted to minor triple positive, and the patients only have or even do not have transient transaminase elevation, and some patients turn to minor triple positive without feeling. After the emergence of this situation, the patient’s Hepatitis B five shows small triple positive, normal liver function, HBVDNA negative, called: quiescent slow hepatitis B, which is the best state that a patient with hepatitis B can achieve (there are also a very small number of patients who will be surface antigen negative, that is, completely back to normal, but this situation is extremely rare, and the probability of winning the lottery is almost the same, so we omit it here). The vast majority of patients, if they do not drink, do not exert themselves, good habits, basically able to maintain this state for life, and normal people are not very different. However, if tobacco and alcohol are not in moderation, poor living habits, there may be a resurgence of HBVDNA in the future. 2, the immune system and the virus is not victory and defeat: due to the immune system is not enough to fight the virus from the body completely removed, so there will be a protracted war: war, aminotransferase increased, HBVDNA slightly decreased. Stopping time: normal transaminases and positive HBVDNA. At this time, the patient mostly shows intermittent elevation of aminotransferases, and hepatitis flares up again after taking hepatoprotective drugs to normalize for a period of time. We call it active chronic 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 be antiviral treatment, in the immune system and drugs under the dual role of the immune system, to help the human body’s immune system to clear the virus, can be able to put an end to the battle. When the battle is over, the liver, which is the main battlefield, is calm, liver function returns to normal and HBVDNA turns negative. Patients with better luck will have E antigen turn negative, patients with worse luck can maintain normal liver function and HBVDNA negative status 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 omitted here. And if you don’t choose antiviral treatment or irregular treatment during repeated liver inflammation, there will be repeated liver inflammation, and each liver inflammation is a damage to the liver, and in the decades of repeated struggles, there is a possibility that liver fibrosis and liver cancer will form. At the same time, the virus in a long time and the immune system in the fight, the survival of the fittest, some of the virus will appear in the pre-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 the E antigen-negative slow hepatitis B. At this time it is like what it is, for example, we understand: the immune system is the police, the hepatitis B virus is the robbers, at the beginning of the robbers with a hood, it is very good to identify, the police see a one to catch a one, and these robbers themselves will replicate new robbers, in a state of dynamic equilibrium, there is a more intense inflammation of the liver. And intense liver inflammation patients and doctors are naturally more aware of and pay attention to, will take the appropriate treatment (antiviral and liver protection), after treatment, liver inflammation calmed down, the disease will not naturally forward progress. And over time, the robbers become more cunning, they remove the hood (pre-C region or promoter mutation, E antigen turns negative, HBVDNA positive), this time the immune system is not good to identify which are robbers, which are civilians, and this time the robbers (replication capacity deteriorated, slightly weaker disease-causing ability) come to guerrilla warfare, after a period of time out of the thief a little bit, to harass the immune system, and the immune system is once again launched to clear the strong, and the immune system will not be able to take care of the liver, and the immune system will not be able to take care of the liver. The immune system then launches another battle to get rid of the robbers, and while fighting, inflammation of the liver occurs, and at this time the robbers can’t beat the immune system due to their weakened pathogenic ability, so they soon have to run away, and once again go underground, waiting for the immune system to get tired or their ability to decline to come out to commit crimes again. So at this time the inflammation of the liver are generally more mild, intermittent, insidious, from the laboratory tests mainly manifested as intermittent mild elevation of liver function, the patient’s self-awareness of the symptoms is not obvious, patients and doctors are not easy to notice the progress of the disease, coupled with the patient is prone to paralysis at this time, feel that their own condition is not a big deal, and began to pay attention to the life of the drinking alcohol to stay up all night taboos, the time to go to the doctor and lazy to see a doctor. To go to the doctor and lazy to go, in the long run, although the inflammation of the liver progresses slowly, but with the accumulation of several years to decades, slowly will appear cirrhosis, liver cancer.