LuckCong's Health Blog

In recent years, China-related chronic hepatitis B (referred to as chronic hepatitis B) on the research point of view there have been three types of representation: The optimists The optimists predicted that chronic hepatitis B in the 3-5 years will be overcome. This perspective is linked to the United States in 1971, President Nixon initiated by the National Cancer Research Program, the intention is that in 1976 to celebrate the 200 anniversary celebrations of the founding of the United States when it announced that cancer has been overcome, the facts prove that goal is unrealistic. In recent years, put forward the slogan of "China-free hepatitis B," reflects the people's good wishes and to overcome hepatitis B virus (HBV)'s determination to be part of the anti-business to promote the use and sell its so-called signs of medicine. The optimists undesirable on the grounds that: ① anti-viral treatment so far no medicine, in which chronic hepatitis B infection as a result of a long line, the more difficult to heal completely. ② so far it has yet to be completely cured of the potential chronic hepatitis B drug, usually from the potential emergence of drug to come out to be the last 6 to 10 years, the so-called "3 to 5 years have been overcome," said the timing could not set up; ③ despite the availability of medicine, taking into account China's chronic hepatitis B patients with mainly low-income people actually can not bear the huge expenses, not to mention that these are long-term treatment. To the existing anti-HBV drugs o interferon and lamivudine, for example, chronic hepatitis B in China's application of the above-mentioned drug ratio is low, and which are less formal treatment. ④ even assuming that all chronic hepatitis B patients are able to pay the huge cost of treatment, taking into account the disease in the decades-long recurrent, has become a complex disease, in the part of the pathophysiology of the disease process, the host for HBV Immune pathogenesis can not afford to have a major role, it is pure anti-viral treatment will not solve the problem. Pessimists Pessimists pointed out that chronic hepatitis B is incurable, or at least it is difficult to cure. The reason is that existing anti-viral drugs can only inhibit, rather than clear the virus, it takes a long time, several times for treatment. This point of view of the main problems is to ignore the host immune response. In fact, as long as have a good time (that is, in the immune clearance phase) to carry out anti-viral treatment, such attacked inside and outside of the effectiveness of treatment is obvious, but also proof of chronic hepatitis B can be healed. As mentioned earlier, in China accounted for 10% of the total population of chronic HBV carriers, so far carried out anti-viral treatment systems are only a small proportion in the 1990s before the α-interferon for anti-virus Are few and far between, such as the nucleoside analogues lamivudine and 1999 before moving on to the market in China. Why develop into severe hepatitis, cirrhosis and liver cancer only a small number of patients? Host immune responses played a key role. Since the anti-viral treatment in the absence of a significant portion of cases, patients can still be self-healing, together with the more advanced of the current antiviral drugs, there must be reason to believe that more patients were cured, it also has to prove it. Both these views of the main problems is not the correct assessment of the current anti-viral chronic hepatitis B treatment status quo. The optimists led to a variety of chronic hepatitis B patients Quzhiruowu, but no real treatment effects, especially for immune tolerance in a period of chronic hepatitis B patients with no more good, with the result that the majority of chronic hepatitis B patients with high hopes from , And the final disappointed. So that the pessimists are chronic hepatitis B patients on antiviral therapy available disappointed, so to a variety of ads, taken in the final. Rational allocation Reason to send the correct point of view should be rational and wise. On the one hand, the point of view of the following fully understand the difficulties of anti-HBV therapy: ① my mother to child transmission of HBV infection in the main, easy to carry chronic form: ② perinatal infection and the infected adults, more chronic form of immune tolerance, and anti-viral effect of the treatment of the poor; ③ existing anti-HBV drugs can inhibit rather than clear the virus and its replication intermediates - covalently closed circular DNA (cccDNA) can be a long time. On the other hand, should also fully recognize that the current chronic hepatitis B antiviral treatment has the following advantages: ① nucleoside analogues - lamivudine and adefovir and entecavir, and so there is a strong role in inhibiting the virus; ② long-acting interferon - the emergence of pegylated interferon efficacy of traditional interferon improved; ③ Immunoenhancer thymosin as' a 1 has been proven to enhance the efficacy of anti-HBV; ④ joint (sequential) therapy so that the number of treatment options, the effect has also increased to varying degrees; ⑤ has shown that choosing the right time to treatment (that is, alanine transferase increased ALT, it is best for the normal limit of 2 times, 10 times less), long-term treatment (α-interferon for 6 months-1 year, and Latin America Mi Fu is scheduled for 2 to 4 years). Pulse therapy (that is, the intermittent therapy) are an effective way to enhance the effectiveness of treatment; ⑥ part of the Chinese herbal medicine has been confirmed that there is anti-HBV effect. Therefore of the opinion, the right attitude should be to make full use of existing drugs to maximize their strengths. At the same time, take full advantage of the host immune response. To the host immune response period (that is, immune clearance phase) for anti-. HIV treatment in the best period for individualized treatment, that is, 'choosing the right drug, adequate treatment, appropriate joint (sequential), a successful treatment can also choose an appropriate time to carry out further treatment. Some people may think, to discuss whether to cure chronic hepatitis B is largely meaningless. It is true that different points of view does not change the current treatment of the status quo. However, a different point of view of the attitude of physicians and patients will have a major impact. The optimists led to patients with high expectations, and ultimately disappointing; pessimists cause patients to lose hope that the existing treatment, resulting in reduced its compliance difficult to adhere to long-term treatment. The two views are the result of common cause patients to lose confidence in the classic method, "desperately trying", at the end when the false advertising. As a result, should allow doctors and patients are aware that although the current treatment of chronic hepatitis B is no medicine: but effective drugs continue to occur, each other, as long as the patient closely with active treatment is ultimately beneficial to the rehabilitation of the disease.