LuckCong's Health Blog

Ningbo University School of Medicine Affiliated Hospital of Professor liver disease, liver disease Zhejiang Medical Association vice-chairman of the credits will be Dejan Wang With the domestic and foreign research prevention and treatment of hepatitis B and the continuous progress, there is growing awareness of the chronic hepatitis B is a potentially progressive liver disease, if it is not timely and reasonable treatment, some patients will develop liver cirrhosis, And even liver cancer. Among them, particularly in recent years realize that hepatitis B virus replication and extent of the disease situation and progress is the most important independent risk factors. In other words, after a blood test, all a direct reflection of the hepatitis B virus replication of HBV DNA, the higher the concentration, for the development of cirrhosis, liver cancer, the higher the ratio. Therefore, the hepatitis B prevention and treatment guidelines at home and abroad have made it clear that in the comprehensive treatment of chronic hepatitis B, antiviral treatment is the key. China's "Guide" stressed that "as long as there are indications and conditions allow, they should regulate the anti-viral treatment." "Guide" under the impetus of China's treatment of chronic hepatitis B virus into the beginning of a new era of governance, and so have tens of thousands of patients with chronic hepatitis B benefit. However, a variety of reasons, anti-viral treatment in general is not enough standardization, and no more optimized, so that the anti-viral treatment reduced the effect of this is we must attach great importance. In view of the current problems at home and abroad in recent years, sum up new experience, as well as our clinical practice experience in this special on how to optimize the treatment of chronic hepatitis B to emphasize the following points: First, select a patient, have a good grasp of treatment, "the starting point." . Not all chronic hepatitis B patients need anti-retroviral therapy, not all are suitable for patients with chronic hepatitis B antiviral treatment, it is very important. At present, some medical units, and some expansion of the treatment of any medical personnel, would be the normal liver function has been done and liver histology of chronic hepatitis B virus carriers for the blind anti-viral treatment, the results are often difficult to be effective; more Of hepatitis B virus replication marker negative or low concentrations of non-active carriers of hepatitis B surface antigen also completely unnecessary anti-viral treatment, so that they waste a lot of money, and increase the suffering and psychological burden. This is the case, we are experts in out-patient consultations and in common. As a rule by the medical staff, eager to face the medical treatment of patients (actually a lot of patients but not carriers of hepatitis B), if even the most basic need of treatment or the suitability of treatment Dunong not clear, how can you prescribe some medicine? Knowing that if no rule or rule is not suitable to make money but to deliberately carried out the treatment should not be ruled null and void, is the essence of the hepatitis B as a money tree, is even more loss of medical ethics, it is inevitable that doctors said was a "black doctor" . As we all know, need long-term anti-viral treatment, not low cost, for most patients is a heavier burden. As a result, doctors and patients should be in accordance with China's "Guide" provides carefully selected targets of treatment. At present, domestic and international consensus, and recognized China's "Guide" provides a clear indication of the anti-viral treatment, mainly 2: HBV DNA 105 copies / ml (HBeAg negative for the 104 copies / ml); Second, alanine transferase (ALT) or 2 times the normal liver histology significant inflammatory necrosis. 2 master this indication, that is, select the most suitable for the needs of governance and rule of the object, which is to optimize the treatment of hepatitis B is a basic principle. Second, choose the right drug, the implementation of standardized and individualized treatment. On the market today was that anti-HBV drugs more and more, in particular a large number of false advertising and false propaganda, making a lot of doctors and many patients tell who is an effective drug, which is invalid or uncertain Drugs, which are made with no emphasis on fitness. We have seen many patients completely void of useful drugs and even some of the Liver is a very common Chinese medicines, have been disguising themselves as the anti-viral effects, and strange to the patients or carriers to sell high-priced so-called anti - HIV treatment. Of course, the treatment is ineffective, and spent a large sum of money wronged. Some are also strongly recommended some of the therapy is not yet mature, including some of the ongoing clinical trials, such as the treatment of hepatitis B vaccine, according to the provisions can not be any expansion of the scope of the trial, the charges should not be, but through some The legitimate supply channels so that the patient is assumed to be the pilot, assumed the cost. It is this irresponsible attitude. So who has the responsibility of doctors and patients have a rational, and should be fully aware of the current domestic and foreign anti-hepatitis B drug effective progress in the correct information, the most reliable information comes from domestic and foreign authoritative academic organizations issued guidelines for prevention and treatment of hepatitis B or Related guidance documents, most of them of a medical study, the most fully convincing scientific evidence that the evidence of evidence-based medicine, many focused on the mainstream of the collective wisdom of experts. Therefore, is to guide our direct patient services for clinicians continuously update their knowledge of the best teaching materials. At present, most of the information in a number of regular anti-liver to return to the search site, such as "net win over B" (hbver.com) is a very authoritative public can be fully trusted site. At present, at home and abroad were authentic and authoritative academic mainstream and recognized experts unanimously recommended, after the State Drug Administration formally approved the anti-HBV drug treatment, only six categories, and this is the common drugs interferon and interferon long Effect of interferon (pegylated interferon) (PEGASYS, to carry music), the nucleoside analogue drug lamivudine (Lamivudine), adefovir dipivoxil (Howe, who was in lieu of D ), Entecavir (Bo-channel) and telbivudine (than-V). These two types of drugs in six different characteristics, such as the type of interferon, on the whole course of treatment is the relative merits of fixed (generally from 6 months to 1 year), HBeAg seroconversion rate (that is, HBeAg negative, anti-HBe positive change) higher , The effect is relatively durable, less resistance variation; shortcomings of the need for injection is administered, side effects (such as fever, transient drop in white blood caused by bone marrow suppression, etc.), not suitable for those who decompensated liver function. However, long-acting interferon is superior to the general effect of interferon, a weekly injection to 1 (interferon to be an ordinary day, 1 pin). Nucleoside (acid) analogues of the common advantage of oral administration of (an ordinary day, very convenient), inhibited the virus stronger, and slightly fewer side effects and can be used to decompensated liver function; shortcomings course of treatment is relatively National (generally more than 2 years), HBeAg negative serum low, the effect of not lasting long-term application of resistance variation, the drug that may arise after the condition deteriorated. One of the first application of lamivudine, the most abundant experience, have been included in the Medicare drug use, but the rate of resistance variation out on top of the list. Adefovir dipivoxil for those who have lamivudine-resistant effects, but untreated cases of slow onset, not resistance, suitable for long-term treatment. Of which 000 are domestic, on behalf of small low-price, more suitable for low-income patients in the long-term treatment. Telbivudine is listed on the new drug, anti-viral effect is better than lamivudine, lower than the rate of lamivudine-resistant variant, also may have a higher rate of HBeAg seroconversion, but the price is also higher than lamivudine . Entecavir is a nucleoside analogue in the existing curb the virus and strong, while the lowest rates of drug resistance mutation (4 newly diagnosed cases in less than 1. /.) Drugs, but also the most expensive prices, economic conditions are more suitable for long-term Treatment. In short, these two types of medicine are six first-line treatment drug, as long as we fully understand its advantages, disadvantages, in view of the patient's condition (viral load, the level of aminotransferase), conditions (economic, health insurance) and the wishes of the individual, in full and Communication between patients and reasonable under the circumstances in which application of any of the drugs should belong to the right choice. Third, the turning point of good, timely adjustment of treatment strategies. Now the medical profession has proposed a "road map hepatitis B treatment," the concept is meant to give patients anti-retroviral therapy six months (24 weeks), the virus DNA as a decision-making level, to predict the treatment of one year and two years. If the treatment six months when the lower the viral load, and a year for two years when the better effect, the emergence of drug resistance are less likely; six months if the therapy when viral load can not be reduced to a low level, said the existing treatment Program is not satisfactory, you can consider adjusting the treatment strategy. As a result, the beginning of the treatment regardless of which type of program, once implemented should pay attention to be monitored in a timely manner, particularly HBVDNA decline in the speed and range, the faster the rate of decline, the greater the range, the effect of inhibiting the virus, the better, opportunities for drug resistance mutation Will be less. Rule by doctors and patients should attach importance to the outcome of the policy-making decisions, often referred to as the "turning point." Which will enable us to more hearts of the bottom of the treatment. The treatment of hepatitis B road map Fourth, guard against resistance, early detection, early to deal with. Nucleoside analogue to receive long-term treatment of patients with resistant virus have occurred in the possibility of mutation, and with the administration time and increase the ratio. However, different drug resistance mutation probability and a greater time difference, for example, patients treated with lamivudine-resistant mutation occurred in a higher rate, the time may be earlier. In particular the treatment of patients with slow decline HBVDNA often have a higher incidence of early-resistant variant, should be closely observed. HBVDNA through regular review and early detection of the virus rebound, that is, the drop in viral load after recovery is the occurrence of signs of resistance mutations. At this point should be conditional on the virus-resistant variation of the relevant detection and timely treatment to continue to adjust and take control of virus resistance to deal with the corresponding. Of lamivudine resistance can be used to increase the preferred long-term adefovir treatment or combination therapy with adefovir effect after a single treatment to continue; also would be able to entecavir treatment, but need to increase the dosage to 1mg (2 Tablets) / day, but there have been in patients with lamivudine-resistant strains, the occurrence of entecavir a marked increase in the incidence of drug resistance. Adefovir resistance on, plus lamivudine or to switch to entecavir. Of entecavir resistance can be used to increase or switch to adefovir. Of telbivudine resistance can be added adefovir or switch to entecavir. In short, with the increasing Nucleotides drugs, the use of these drugs increase the number of patients, prevention of drug resistance mutations, in particular, early detection, early processing of vital importance. Based on our clinical practice experience in long-term treatment-resistant variation is inevitable, but unlike in the past have been terrible NA me, as long as close monitoring and the right time, and more able to achieve the desired effect. It is always worried about is that a small number of patients, in order to save time and money that he pharmacies to the purchase of medicines, or even six months, more than one year are not reviewed until the deteriorating condition was eager to visit, only one review found that the virus not only indicators rebound Pick-up, liver function and increase the rebound, then re-adjust the treatment more difficult, and certainly an increase of fees. These lessons must be learned. Fifth, adhere to treatment, with full course of treatment, to grasp "the ultimate goal." Research and clinical practice shows that the anti-viral chronic hepatitis B treatment, as in the treatment of high blood pressure, diabetes, the need for long-term treatment in order to maximize the sustained suppression of hepatitis B virus replication in order to achieve progress in disease control, prevention of the occurrence of liver cirrhosis and liver cancer goal . So for every anti-virus treatment of patients, all intended to make long-term treatment, interferon treatment for at least 6 months, it normally takes a year; the treatment of nucleoside drugs, at least 2 years, especially in HBeAg-negative Most want a more long-term treatment. Any treatment must not be interrupted, even go out to meet with the tourism also full of drugs, medication on time. Lv Jian some of our patients, for various reasons, the half-way unauthorized drugs alone, inadequate treatment or early termination of treatment, resulting in relapse and even their problems. For the treatment of "the end", there had been consensus at home and abroad, is to meet the basic requirements of HBV DNA disappeared, normalization of liver function after treatment of the consolidation of more than 1 year, preferably at the same time achieve HBsAg negative, the effect may be more lasting.

With the anti-hepatitis B virus in recent years, the constant introduction of new drugs listed, chronic hepatitis B (CHB) treatment effect than 3 years ago has been greatly improved. From 2005 listed one after another in our country Dipivoxil of nucleoside analogues, entecavir, as well as the newly listed this year, telbivudine and lamivudine in the initial together to build a nucleoside analogue treatment of hepatitis B Strong Powerful ammunition depots. In addition, apart from the nucleoside analogues, and those with chronic hepatitis B treatment of the antiviral drug interferon in recent years has also launched a long-acting form of polyethylene glycol, as compared with ordinary further enhance the efficacy of interferon. A few days ago, to be held in South Korea's Cheju Island in emerging markets strategy seminar on the treatment of chronic hepatitis B, liver disease experts in international Auckland, New Zealand, Professor Edward Gane of the proposed treatment of chronic hepatitis B individual optimization of the new strategy, that is, the combination of chronic hepatitis B treatment Road map, on a regular basis to assess the effect of the adjustment of drug treatment programs so as to enhance the treatment of chronic hepatitis B, reducing or even prevent the disease in patients with liver cirrhosis, liver cancer, and other long-term complications. Previously held in Kyoto, Japan in the Asia-Pacific Association for Study of Liver Diseases (APASL) 17th Annual Meeting, attended by international experts in liver disease combined with the treatment of chronic hepatitis B road map, as well as the United States in February by the association for the study of liver disease (AASLD) announced The latest edition of "Guide to hepatitis B prevention and treatment" had a thorough exchange of views. They reached the wishes of one of the principal is: the initial treatment for patients from the very beginning treatment should be preferred anti-virus capability, the low rate of drug resistance. In the recent publication of academic activities, a growing number of studies have shown that the treatment of chronic hepatitis B for example, when a poor effect of drugs (such as six months into the treatment can not effectively minimize the level of hepatitis B virus ), The switch to more antiviral drugs in another, to more effectively suppress the virus, such as the level of the virus less than Inhibition to detect. If the initial treatment and appropriate use of potent anti-viral drugs, to minimize the level is an effective way to promote the resumption of regular transaminase and serum HBeAg conversion, to reduce the incidence of resistance in order to achieve sustained effect. Experts said that the existing 4 nucleoside analogues and interferon agents for the treatment of chronic hepatitis B to address a variety of difficulties, such as poor efficacy, HBeAg negative rate on the low side, the emergence of drug resistance, as well as Security concerns, and so on, provides a wide range of application portfolio means. Doctors can change in patients with specific conditions, the use of individualized treatment. For example, patients with a higher baseline level of hepatitis B virus, hepatitis B virus in the body that is to copy a large number of the option potent anti-viral drugs, such as telbivudine, entecavir; patients, "Dasan Yang", faced with further education, employment, etc. , Will need to HBeAg negative, "Xiao Sanyang," could be considered a higher rate of negative interferon or telbivudine; taking into account the long-term anti-viral treatment of security, not only to consider the option of using a longer time, Application of experience or more nucleoside analogues lamivudine in the United States was the only FDA pregnancy that the B-class telbivudine, or choose a low incidence of drug resistance and side effects of the low incidence of entecavir. Turning to interferon treatment, Gane, a professor pointed out that the treatment of patients with a baseline of a number of conditions, such as age, sex, level of aminotransferase, the level of hepatitis B virus, and so on, the effect of interferon can have a significant effect, this view has been Wide range of academic accreditation. The application of nucleoside analogues in the treatment of chronic hepatitis B clinical study results showed that telbivudine treatment, "Dasan Yang," The patients in the treatment of baseline level of aminotransferase is greater than twice the normal patients, a better effect; drug Six months can reach 49% of patients with hepatitis B virus detection level of less than; treatment for two years, 86% of patients with hepatitis B virus levels remain negative, 49% of patients achieved a "Dasan Yang" to the "Three Yang ", 85% of the patients with normal transaminase. Based on a number of recent studies, as well as relevant guidelines of the view that for the hepatitis B virus genotype A and Type D patients, interferon is superior to the effect on B-and C-type patients; patients with genotype of nucleoside Analogues did not affect the basic effect. In addition, although chronic hepatitis B require long-term anti-viral treatment, but "Dasan Yang" and the treatment of patients, "Xiao Sanyang," and patients are different, so if you need long-term treatment, the drug's long-term security must be considered as a One of the important factors; the treatment of choice in the process of potent drugs can quickly detect the virus less than Inhibition, and the high rate of the e antigen negative / conversion rate is the attending doctor must first focus of attention.

Source: Sohu health Zhuang Hui Academy of Sciences: the basis of Peking University School of Medicine professor of biological pathogens, and doctoral tutor, the Chinese Academy of Engineering. Zhuang Hui Sohu Health Channel recently invited on the basis of Beijing University School of Medicine professor of biological pathogens, the Chinese Academy of Engineering and Professor Zhuang Hui users on the treatment of hepatitis B-related issues. Moderator: You mean the virus is not down the level of treatment of hepatitis B is one of the main signs? Zhuang Hui Academy of Sciences: Yes. The first, we asked the general what is, first, down to the level of the virus. Second, the resumption of normal transaminase, the drug is not a normal down, because the virus is a small, drop transaminases, both linked. Light drop transaminases, the virus did not do it. Third, Dasan Yang is the original e antigen-positive to become the e antigen negative. And e-positive, this is the third. Moderator: This refers to the so-called Da Sanyang it? Zhuang Hui Academy of Sciences: Dasan Yang. Xiao Sanyang there will be no conversion of the problem. Meet three criteria, can not stop immediately, but also to continue treatment, six months after a search but also, if unchanged, could stop. Six months later another two or three times a check or change, you can stop. Moderator: How many patients can be treated to meet you just said these standards. Zhuang Hui Academy of Sciences: 20 to 30 per cent of patients. Zhuang Hui Academy of Sciences: But according to the treatment of patients with time, the patient's condition. Xia Bulai also some five years, six years have had to eat, everyone's situation is different, generally average about 30%. But one might get the drug.

The vast majority of patients with resistance to its own circumstances, such as Mangranbuzhi not adjust treatment will eventually lead to worse Chinese hepatitis B is a big country, a total of 120,000,000 people living with hepatitis B, in which Guangdong is the "hardest hit." According to the latest version of the "guidelines for prevention and treatment of hepatitis B", in order to achieve the goal of the treatment of hepatitis B, hepatitis B patients must adhere to the long-term anti-viral treatment. However, the Guangdong Provincial Institute of Infectious Diseases director, hospital infection in the South of internal medicine Professor Hou Jinlin pointed out that the anti-viral treatment, although the effect was recognized by the medical profession, but after taking the virus mutation and drug resistance has become a clinical problem can not be avoided. According to estimates, since the anti-viral drugs in China has been used in clinical, it is estimated that 100 million patients have used or are in use antiviral treatment, which has an estimated 100,000 drug resistance of hepatitis B patients, and The vast majority of their situation Mangranbuzhi ultimately delaying treatment led to the deterioration of the condition. Antiviral drugs Yizhi virus mutation Hou Jinlin, recognized at home and abroad and effective anti-viral drugs, including the main types of interferon and nucleoside (acid) analogue two broad categories. Oral nucleoside (acid) analogues can inhibit virus replication, in the short term can play a significant effect, but its drawback is the need to maintain long-term treatment, such as "Da Sanyang" Patients want to eat at least two years or more, "Xiaosan Yang" is a longer course of treatment of patients, continue to have poor efficacy of drugs. In addition, the use of nucleoside antiviral drug therapy is likely to occur, the disease is easy to stop after a rebound. It is learned that in clinical practice the most widely used nucleoside analogues lamivudine is, statistics show that patients taking the drug a year after the virus mutation rate of 14%, 38% for the second year, third year 49% , The fourth year of up to 66%. The new out of adefovir dipivoxil treatment before the 3-year low although the rate of drug resistance, "Xiao Sanyang" to the treatment of patients with Article 5, the virus mutation rate may reach 29%. In addition, was recently approved for clinical telbivudine, although more than lamivudine suppression of the virus and improve the ability of e antigen seroconversion dual role, but after the second year in the use of virus mutation rate is not Low. It is due to the existence of these problems in the long course of treatment, patients and doctors must have felt at the end, attach great importance to the resistance, the use of antiviral drugs to a patient's full understanding of this important information. B preferred to deal with anti-retroviral therapy In order to prevent hepatitis B virus outbreak in the human body, is the most effective way to carry out anti-viral treatment. In the just-concluded Asia-Pacific Association for Study of Liver Diseases 17th Annual Conference of the thousands of international disease experts called on the United States the use of association for the study of liver disease in 2007 released the latest version of "hepatitis B prevention and treatment guidelines." The guide is of the view that patients with hepatitis B should adhere to long-term anti-viral treatment. Although anti-retroviral therapy has been recognized by the medical profession, however, pointed out that Hou Jinlin, early single type of anti-viral drugs, in the event of resistance and response to virus mutation, it can not substitute for the use of drugs in the treatment of hepatitis B This is the most prominent issues . Worst of all, not only this Mangranbuzhi patients, many doctors are not aware of the problem. According to estimates, China is at least 100,000 of the emergence of drug resistance in patients. Despite the anti-viral drugs continues to introduce new patients with drug resistance, the use of alternative drugs or more of the drug has become a reality, the need to attach great importance to the specialist, do not miss the treatment of patients with the "turning point" and lead to further deterioration. In the treatment of drug resistance can be prevented Although the issue of hepatitis B in clinical resistance to the doctor brought a lot of problems, but fortunately, the types of antiviral drugs is increasing. It is reported that as early as the only antiviral drug lamivudine, but now the "family of antiviral drugs" has been "growing", 6 kinds of drugs have been approved by China for the treatment of anti-hepatitis B virus. According to the present level of anti-viral treatment, if patients with drug resistance, fully replacing the drug or drugs, the treatment of joint. Hou Jinlin said that the choice of future anti-viral treatment for hepatitis B, the drug may have some mixed use, could play a "cocktail" therapy, can effectively reduce the resistance, but also enhance the effect. Optimization of treatment can not keep up The number of antiviral drugs, this is a good thing, but now there is an additional problem: In the past few drugs, compared with single treatment, the drug is more, treatment should relevant diversification, as a result of both diagnosis and treatment of people, As a result of diagnosis and treatment when they should be. What is the time to start anti-retroviral therapy? How to determine whether the emergence of drug resistance in patients with HIV and mutation? Emergence of resistant virus and how to deal with variation? When treatment can come to an end? This requires a doctor to determine the appropriate and processing, which currently do not have a unified specification. Anti-retroviral therapy is the most crucial part, Hou Jinlin be summed up as a starting point to find a treatment, the inflection point and end point. Only by grasping the treatment of hepatitis B three points in order to achieve the treatment of the "four transformations" - to maximize the efficacy and minimize resistance, cost-effective and individualized treatment. The so-called "starting point", is a doctor to decide when to start anti-retroviral therapy, the treatment is not a problem, in accordance with the norms, as long as the virus and the level of aminotransferase index reached a certain target, they should start antiviral therapy. Hou Jinlin, said the most troublesome patients to determine whether there is a turning point of the treatment. What is meant by "turning point", he played a vivid metaphor: the Yangtze River in the south have been the source of torrents, if there is no "turning point" will flow to South Asia, but fortunately in the territory of Yunnan Province, the Yangtze River to the east and break, making only in the Yangtze River Now the lower reaches has become a fertile land of fish and rice. To receive anti-retroviral therapy for patients, if treated early in the resistance will be able to find the clues, and in the scramble in front of a timely replacement therapy and drug treatment programs, do not give the virus the opportunity to make a comeback, and this is the treatment of captured " Turning point. " And found that attention to the "turning point", will embark on the rehabilitation of the road condition, to the neglect of the "turning point", it is likely On the contrary, will eventually become irreparable consequences. Doctors found that "turning point", its significance as a farmer sowing seed in the spring, summer harvest will be able to forecast and decide whether to replant some crops. However, Hou Jinlin regret that, despite the "turning point" is so important, but in the actual treatment, liver disease, many non-professional doctors did not realize that this did not advise patients on a regular basis to carry out quantitative virus, drug resistance and liver function tests Lead to the treatment of patients with missed opportunities in vain. Medication can decide on the next six months treatment How to find the treatment of the "turning point"? Hou Jinlin said that the medical profession has proposed a "road map hepatitis B treatment," the concept is meant to give patients anti-retroviral therapy six months (24 weeks), the virus DNA as a decision-making level, to predict the treatment of one year and two years at the time of Effect. If the treatment six months when the lower the viral load, and a year for two years when the better effect, the emergence of drug resistance are less likely; six months if the therapy when viral load can not be reduced to a low level, said the existing treatment Program is not satisfactory, you can consider adjusting the treatment strategy. Young people preferred initial treatment immune anti-retroviral therapy For some young patients with newly diagnosed, such as children, young people in particular to prepare children, as well as the use of nucleoside (acid) analogue-resistant patients, but also considering Immune regulation of interferon-type anti-viral drug treatment. Hou Jinlin, some young patients when infected with hepatitis B virus, due to the virus in the body longer, so that the immune cells it resulted in paralysis, is the misconception that the body's normal cells, the bad guys do not take a pro-active " Brought to justice. " Immune-based anti-virus treatment is the body in the reconstruction of the internal confrontation of the hepatitis B virus defense mechanisms, first of all, "wake up" immune cells, it keep their eyes open and identify the disorder in the body for hepatitis B virus, and then further to eradicate these invasive , To protect the body's normal operation. The human immunodeficiency virus, hepatitis B and the "battle" consists of two phases: First, the eradication of the virus in the blood, in order to clear the period of serum; Second, the eradication of the Organization of the virus, the hepatitis B virus replication Zhi Dao "Lao Chao", which is Removal of immunity period. Young people are in the immune clearance phase, based on the use of immune clearance of interferon-type anti-viral treatment than other age groups of patients better. Need to be reminded that the use of some types of interferon patients did not take an early response to emerging or effect on the drug on its own. Hou Jinlin reminded that this was not recommended for the treatment of some types of interferon response of patients a few months after the emergence of e antigen negative, followed by the withdrawal of about 10% of patients follow-up effects, not only will affect the free drug efficacy Will ultimately affect their treatment process.

Experts warn: Do not easily be cured of hepatitis B, not to cure hepatitis B credulity Recently, a "country of the first hepatitis B patients with hepatitis B removed the hat," the reports have aroused considerable public concern. Reported that the adoption of long-acting interferon antiviral treatment, has 103 domestic patients with chronic hepatitis B surface antigen conversion, remove the hepatitis B "hat." A report published by the media, immediately aroused the concern of many experts, hepatitis B and patients with questions. To that end, reporters around the treatment of hepatitis B-related issues in an interview with the China Institute of Integrated Traditional and Western Medicine liver disease professional members of the Commission, the People's Liberation Army 302 Hospital of Integrated Traditional and Western Medicine director of liver disease, the chief physician Dr. Liu Shijing. Dr. Liu said that the clinical cure 103 people devoid of any meaning, clinical cure and complete cure hepatitis B is different from the two concepts; In addition, immune reconstitution is a complicated systematic project, rely on one or two drugs be difficult to achieve. As we all know, the treatment of chronic hepatitis B drug effects have not yet, but the hepatitis B disease can be controlled. The hepatitis B treatment is bound to be a long-drawn-out battle of Marathon. ≠ completely cured of hepatitis B clinical cure Liu Jing of the view that the abnormal liver function, hepatitis B replication positive indicators, there are clinical symptoms of hepatitis B patients, more objective scientific criteria to determine the effect can be divided into two types: one is the real goal - clinical cure, and the other is Ideal goal - to clear the virus. In accordance with current medical standards, complete cure chronic hepatitis B is very difficult, only a very small number of patients through the correct treatment can achieve complete cure. According to China's "clinical diagnosis based on improved standards of cure" and treatment of hepatitis B clinical cure it easier to achieve a level, the standard is: The main symptoms disappear; hepatomegaly disappeared, no liver tenderness or pain call; liver function Back to normal. But in order to meet the standard cure is very difficult. As a result, tens of millions of patients with hepatitis B can not be cured completely cured and confused. Hepatitis B cure what is the standard? (1) completely cured. Through proper treatment, patients with liver function blood tests check series are entirely normal, hepatitis B virus HBV occurred series of indicators DNA, HBV surface antigen, e antigen negative, liver puncture organizations immunohistochemical examination of hepatitis B virus core Antigen on the surface antigen disappear, so that the results of more than two years to keep time. (2) the basic cure. Through proper treatment, patients with liver function blood tests check series are entirely normal, hepatitis B virus HBV occurred series of indicators DNA, e antigen negative and e antigen and the emergence of e-Serological conversion (B "Da Sanyang "To" Xiao Sanyang "), liver puncture organizations immunohistochemical examination of hepatitis B virus core antigen disappear, so that the results of more than two years to keep time. Dr. Liu pointed out that at present there are 8 percent below a thorough patients can be cured, there are about 30% of patients can be cured basic. This is part of the viral replication in patients with negative indicators, normal liver function and liver tissue virus core antigen also disappeared, inflammation of the liver biopsy or minor static, almost no infectious, disease basic block, the occurrence of liver cirrhosis or liver cancer Significantly reduced the probability; more than 70% of patients can be active in the right treatment, the slow pace of progress in the disease, access to clinical improvement. How do we get the standard cure? Grasp the timing of the treatment. When patients with hepatitis B screening tests appear alanine transferase increased, it is best for the normal limit of 2 times, 10 times, indicators of hepatitis B virus replication (HBV DNA, HBV e antigen) positive, Liver function in compensatory stage, this time for the treatment of hepatitis B in the best time; correct and reasonable use of drugs; patients must be treated seriously the implementation of the program should not stop without authorization or termination of treatment, the drug can not be replaced frequently. So that there is no HBsAg negative ideal drug Dr. Liu believes that the treatment of hepatitis B virus is the core of the treatment of hepatitis B, from 1992 to 2005, there are 5 kinds of antiviral drugs in the international community have been approved for the treatment of HBV. 5 this drug are: general interferon α-2b, lamivudine, pegylated interferon α-2a, entecavir and adefovir. One common use of interferon α-2b longest, more than 10 years, 7 years has been the use of lamivudine, pegylated interferon α-2a and two years after the use of adefovir, entecavir less than A year. At present, entecavir and adefovir, and other new nucleoside analogues are increasingly used for clinical, as the two long-term drug use, the less likely the virus mutate more lasting effect. Entecavir suppression of hepatitis B virus, the fastest, early response rate as high as 90% of patients receiving treatment in the majority of hepatitis B virus DNA was negative, the use of the drug within two years, no variation of the virus, the use of 3 years, about 2% Variability in patients with the virus. From the suppression of the virus, the speed and effectiveness, entecavir most effective. However, entecavir listed on the official use of a relatively short time, is currently hard to confirm the drug's long-term effects. Adefovir relatively low price, but less than the effectiveness of anti-viral drug entecavir, the initial use of anti-viral drug treatment option for patients, about 60% in the treatment of six months to a year after the emergence of hepatitis B virus DNA can be negative, but If the drug replacement therapy with lamivudine treatment failure cases, the effect of a lot worse. In addition, large doses of the drug or with the potential to cause long-term use in patients with renal damage. Interferon alone can be difficult to achieve treatment of hepatitis B immune reconstitution Liu Jing of the view that medical scientists have long committed to the Hepatitis B immune regulation of research will have thymosin, interferon, IL, as well as the treatment of hepatitis B vaccine for hepatitis B treatment to try and break the hopes of hepatitis B immunization Tolerance, the reconstruction of hepatitis B patients immune system. But these attempts have not achieved satisfactory results. Hepatitis B infection due to the continued is still the basis of a number of issues not yet clear, for example, the genetic type of virus, the immune genetic characteristics of the virus, immune factors, cytokines, and antigen recognition, such as liver cell apoptosis. Reconstruction of the body's immune system can only be an ideal, but the distance is too early to success. In addition, the use of interferon, the body's immune cells can improve the ability to identify and enhance the ability to remove T cells, but the antiviral effect of interferon is limited to replication of hepatitis B virus DNA, and can not be present in the liver to remove the nucleus of the hepatitis B virus Copy template cccDNA, after stopping the virus can reproduce again, and has been unable to clear the host DNA integration of viral genes, it is difficult to express the disappearance of HBsAg. Despite the variety of interferon treatment of hepatitis B will play some role in immune regulation, but regulation is very limited. China promulgated the latest "Guide to prevention and treatment of chronic hepatitis B," pointed out that the regulation of immune therapy treatment of chronic hepatitis B is one of the important means, but is still a lack of specific immune hepatitis B treatment. Only through long-acting interferon treatment of hepatitis B, it is impossible to achieve reconstruction of the human immune system. Moreover, interferon treatment of hepatitis B and not everybody can use, if the improper use of the time, it will lead to the deterioration of the disease.

58th Session of the United States for the study of liver disease reported that the annual meeting (Nov. 2-6) Your Liver, Your life care of the liver, the value of life Participate in the study of liver disease in the United States will be felt Zhu Yun dove our reporter Liver, carrying the weight of life. It per minute in silence to the completion of more than 5000 kinds of important functions, in order to maintain the normal operation of the body. However, the vital organs, is often overlooked. Perhaps it is because of the damage, often unknowingly taken place, it is perhaps the course, is often a long and gradual ... .... "Your Liver, Your life", this is my liver disease in the United States this year will see the field, the deepest feelings of a slogan. In the current President of the General Assembly and Gregory J. Gores, a professor of communication, I am even more deeply into the study of liver disease in the United States is committed to raising public awareness of liver disease in its efforts. By the same token, I also shared with him this shows the annual meeting of the diagnosis and treatment of liver disease research and achievements in the field. Liver disease at this annual meeting, regardless of non-alcoholic fatty liver disease (NAFLD), viral hepatitis, liver fibrosis / sclerosis, or liver cancer targeted therapy, the treatment after liver transplantation and other fields, there are new The results of the research and development of new drugs and the report, which reflects the latest developments in the field of liver disease. As the Gores, a professor talking about some of the findings of the disease so that people understand the concept has changed, and some of the results of our new means of treatment, or bring new hope. Gores, a professor talking about, NAFLD has become a chronic liver disease and liver enzyme abnormalities of the main causes of the continuing, but the impact on the survival rate of patients with NAFLD and quality of life of the main factors is not their own liver disease (cirrhosis), but the metabolic syndrome and its Related complications. More and more studies confirm that, NAFLD is usually combined with the existence of glucose and lipid metabolism disorder, and even some academics have suggested, NAFLD can be used as metabolic syndrome and type 2 diabetes in the early predictor. As a result, monitoring of serum liver enzymes (ALT, AST, GGT) is not only the traditional sense of liver function monitoring, the significance and importance, like on blood lipid and blood pressure monitoring, and other health indicators. "Know Your ALT" is a 2006 U.S. study of liver disease will be launched a campaign aimed at arousing the Government, the medical profession and public health importance of the liver. Gores also introduced to the professor, viral hepatitis has been the world's countries, particularly in Asia, the heavy burden of disease, but in recent years as anti-HBV and anti-HCV drug research as well as anti-HBV vaccine widely used, the incidence of liver cancer has Lower. According to the Organ Transplant Center to register the data statistics, in recent years as a result of HBV infection need for liver transplantation has been to reduce the number of people, which reflects one aspect of an effective anti-HBV treatment in recent years with results. In the report on the annual meeting of entecavir for 4-year resistance, anti-interferon in the treatment of HBV and HCV in the area continued to deepen, as well as studies SHARP Sorafenib in the treatment of advanced liver cancer achieved a breakthrough effect Have enabled us to be more confident in the future of the treatment. Have a healthy liver, healthy body is an important foundation. Your Liver, Your life. Care of the liver, liver to maintain health, stay away from those affected liver health habits and behavior of the bad habits that promote a healthy lifestyle may reduce liver disease and enhance human health in a short-cut.

Following the 2006 Andy Lau as the Chinese Foundation for Hepatitis B prevention and control publicity ambassador, Andy Lau also recently shot public service announcements, write "Baby darling," the promotion of performing arts at the same time focus on the promotion of social care and hepatitis B patients. With the heat away gradually, is about to usher in another high school and employment. Some of us, or our children, friends, but also because of illness and confusion. We believe that understanding can only understand in order to allow the community more harmonious big family happy. Here, we are invited to the Shanghai Ruijin Hospital Director Professor Xie Qing Chuan Ranke and the community together to talk science. According to statistics, China's hepatitis B virus, about 120,000,000 people living with chronic hepatitis B patients about 30,000,000 cases each year, about 350,000 patients die of HBV-related chronic diseases, how to effectively reduce the infection rate of hepatitis B virus, at the same time Further improve the treatment of patients with hepatitis B is a topic of great concern, and the scientific understanding of the hepatitis B virus-related knowledge to solve this problem is a prerequisite. Immune a seesaw battle between the virus and When the hepatitis B virus into the human body, the hepatitis B virus, only to the liver, "Qingyouduzhong" medically known as the tropic of the liver virus, the virus through our circulatory system to quickly gather the liver, liver cells into the substantial copying. Typically, the foreign substances such as viruses and bacteria invasion, the body's immune system will immediately begin just outside of biological warfare, hoping to completely remove the invaders. In the adult period, this mechanism is very sound, even if infected with the hepatitis B virus, most people can rely on the immune system and clear the virus, which was recovered. However, in infants and young children during the course of this encounter will be a big problem. As the host immune newborn is not fully developed, easily mistaken for the hepatitis B virus itself, and thus the immune system can not identify and clear the hepatitis B virus and human immunodeficiency virus in a state of relative calm, no disease outbreak, that is, in a medical "immune Period of tolerance. " With the host immune system constantly increased, the body's immune system gradually began to identify hepatitis B virus and its clearance to enter medical "removal of the immune period." This time the virus replication and host immune confrontation between the on-going process. If the host can not be completely immune powerful enough to control the virus, the virus continued for 6 months who have not yet been cleared for the development of chronic hepatitis B virus infection. Patients can not fully suppress the host immune virus replication, the virus removal process as a see-saw in the war, continuing the see-saw process leading to damage to liver cells. As a result, for the treatment of hepatitis B patients to pay attention to not only inhibit virus replication, the need to regulate the immune host for the disease continued to ease. Correct understanding of the disease with a normal life Hepatitis B virus is the major route of transmission of blood and body fluids such as blood transfusions, surgery, injections, to share with teeth, such as razor may have come into contact with contaminated blood virus, so the current guidelines are recommended for high-risk groups should be vaccinated with hepatitis B vaccine In order to be effective against hepatitis B viruses. At the same time, countries have more stringent screening of blood donors, blood transfusion and blood products caused by the hepatitis B infection has also been a few. In China, hepatitis B transmission is the main way to mother to child transmission, that is, by the hepatitis B virus with the mother transmitted to their children, the process is usually due to contact with the birth mother's hepatitis B positive blood and body fluids due to . As the neonatal immune system is not yet mature, in the hepatitis B virus infection after the virus is difficult to remove, and thus suffer from chronic Hepatitis B high risk, usually as high as 90%; and adults infected with the hepatitis B virus, the immune system due to the body than Strong, and generally able to completely clear the virus, its chronic to the possibility of less than 10%. It should be noted that, as in patients with urine, feces, sweat, tears, the milk of hepatitis B virus were very low, so the day-to-day life or in the process of contact, such as shaking hands, hugging, sharing a dormitory, In a restaurant meal with shared bathrooms and no exposure to blood contact, not the transmission of hepatitis B virus. We need not refuse to hepatitis B patients at arm's length. At the same time, along with the development of medicine, a variety of new antiviral drugs used in clinical treatment, the effect has also made considerable progress in hepatitis B patients as long as the correct understanding of the disease, a doctor with the appropriate choice of anti-viral treatment, most of them can effectively control the disease Development of the normal work and life.

It is reported that in recent days, 90 patients with liver cancer have a history of hepatitis B, hepatitis B have been suffering from the disease than others, the risk of liver cancer as much as 10.7 times that of people suffering from hepatitis B virus to carry the risk of liver cancer is a healthy population of 6.37 Times! Why hepatitis B virus is prone to lead to liver cancer? In a few days ago with "viral hepatitis and hepatocellular carcinoma in Asia" as the theme of the 17th annual meeting of liver disease in the Asia Pacific region, China, South Korea, Japan, Australia and the Asia-Pacific region, such as liver disease prevention and control large number of experts and scholars opened this "The answer." Patients: non-standard treatment of hepatitis B liver change 51-year-old Mr. Zhang Huan Yigan for 12 years, long-term use of certain drugs, he resistance occurred, resulting in a rebound condition. Recently, the company's business in a row because of his business, entertainment, Tilibuzhi feeling, liver pain, quickly check to the hospital, doctors said reluctantly, has advanced liver cancer, missed the best time for treatment ... ... It is understood that similar Cases are not uncommon, due to irregular treatment, combined with the liver and neglect their own health, many patients with hepatitis B unknowingly "shot", the change of hepatitis B liver cancer, died in the tragedy of young elite frequent. Experts say that 90% of patients with liver cancer have a history of hepatitis B, hepatitis B virus infection continued to suffer from liver cancer is the main reason. Such patients are similar to the performance of the following: laboratory examination is "Dasan Yang" or "Xiao Sanyang", normal liver function; liver cancer before the disease was found hidden, no obvious symptoms, liver or no sign of any discomfort zone ... ... The performance of both doctors and patients to a knock on the alarm: hepatitis B patients in a timely manner, if not the norm hospital treatment, away from liver cancer may be just one step away! Experts: more choice of drugs should be cautious "Scientific and standardized treatment is effective in preventing hepatitis B into the key to liver cancer. Hepatitis B need individualized treatment, medication, doctors also need to adjust the anti-viral treatment." At the 17th Asia-Pacific region liver The annual meeting of the disease, experts said, have developed anti-HBV drugs, has formed a nucleoside (acid) analogues, the two long-acting interferon drugs to choose from. In the face of an increased range of drugs, experts say patients should be careful to choose, the 2007 edition of "Guide to Prevention of Hepatitis B" is the international treatment of chronic hepatitis B treatment in the field of the latest regulatory guidance documents, with a high reference value. "Guide" recommends that the nucleoside untreated patients, treatment from the very beginning it is necessary to preferred anti-virus capability, the low rate of drug resistance, and should ensure that the medication compliance, thereby reducing the incidence of drug resistance. Choose from based on the best evidence in support of evidence-based medicine, but also to consider the price of drugs as well as the cost difference between the way (such as medical insurance, at their own expense, etc.). China's renowned liver expert, Shanghai Huashan Hospital, Professor Weng Xinhua that the need for a clear understanding that "we should not only anti-virus capability, but also easy to take and the low rate of drug resistance and side effects of small and cheap prices, such an ideal drug , There is no market. " Reminder: hepatitis B liver cancer become big incentive to open If you are infected with the hepatitis B virus, or your doctor is a hepatitis B patients have to bear in mind the following 4:00 away from the risk factors in order to stay away from hepatocarcinoma invasion: 1. Drink. Long-term drinking of hepatitis B surface antigen-positive can promote the occurrence of liver cirrhosis or liver cancer; 2. Rotten food oil. Well-worn animal and plant oil is toxic and may cause cancer; 3. Moldy food to eat. When they find food, oil, dairy products have mold contamination, the ban on consumption; 4. Let matters drift. Hepatitis B patients and their families to the hospital on a regular basis should be checks on a regular basis to review serum aminotransferase, six months to a year "half-and-half", once a fetus fetal globulin, an annual inspection super-B. Otherwise, let matters drift, persistent infection of hepatitis B virus replication, inflammation to fibrosis of the lesion, will inevitably lead to cirrhosis or liver cancer incidence.

Hepatitis B patients can get married and have children carry large Xiao Sanyang only reflect the situation of HIV Many people think that hepatitis B is a contagious disease and should stay away from those sources of infection. In fact, hepatitis B is not so terrible, not by any means hepatitis B can be transmitted on, so we should not discriminate against hepatitis B carriers. "Xiao Sanyang," only reflects the situation of the virus Q: I would like to consult, "Dasan Yang" and "Xiao Sanyang," What's the difference? A: The so-called "Xiao Sanyang" means "antigen of hepatitis B 2 pairs of semi-inspection" of the two different results. 2 pairs of half of the first pair refers to the surface antigen (HBsAg) and surface antibody (anti-HBs), the second right yes E antigen (HBeAg) and E antibody (anti-HBe), another third on this core antibody ( Anti-HBc) and core antigen (HBcAg). As the cells in the liver, the heart of antigen has been assembled into a full hepatitis B virus, the serum is not free of the core antigen, so they are around in the blood can only be detected on the third and a half in the right, that is, the core antibody, so that 2 pairs And a half. "Dasan Yang" refers to the surface antigen, E antigen and core antibody were positive. It is generally believed, "Dasan Yang," the relative strength of infectious and at the same time develop into chronic hepatitis B is also the possibility of more. "Xiao Sanyang" refers to the surface antigen, E antibody and core antibody were positive. "Dasan Yang," and it is the difference between the former E antigen positive. It is usually from "Da Sanyang" change from the human body is against E antigen produced a certain degree of immunity. It is generally believed, "Xiao Sanyang" less infectious. But for some of the E and E antigen antibody were negative, it may be infected with the hepatitis B virus is already infected with mutant strains of the virus, which can not be expressed by E and E antigen antibody, but if you check hepatitis B virus DNA ribose Nucleic acid is still positive, that the existence of viremia, is still infectious. No matter, "Dasan Yang" or "Xiao Sanyang," only reflect the human body to carry the virus, the situation can not be reflected in the normal liver function or not, and therefore can not be used to determine the severity of the disease. In order to understand the situation in liver function, preferably on a regular basis (3 months to 6 months) to the hospital for a liver function and hepatitis B two pairs of semi-check. Hepatitis B patients can get married Q: I would like some advice, too, if a liver disease, can not be like normal people, like marriage, children's health? A: Hepatitis B patients can get married, of course, there is no provision can not be married. As long as the right to take measures to block and is also able to reproductive health of the baby. Male patients with hepatitis of the newborn less affected, and in patients with hepatitis in pregnant women, through mother to child transmission, the hepatitis B virus to their children. However, through the birth within 24 hours of playing pin the first hepatitis B immune globulin and the hepatitis B vaccine 10ug (in different parts of the body), the sooner the better; and then over a month and 6 months respectively, and then Two more shot injection. This efficient method of blocking up to 85% to 95%, but can not say 100%. After 3 years to strengthen the immune 1 vaccine Q: How long does hepatitis B vaccine injection is better? A: Hepatitis B vaccination after the antibody levels decreased gradually over time. General vaccination, the injection needle 3, after a month of 97% of people would be able to test the antibodies on the surface; the first 2 years remained at this level; dropped to No. 3 in about 74%, antibody titers also fell. Once again the need for vaccination, mainly in the determination of hepatitis B surface antibody titers, to decide when to play hepatitis B vaccine. Hepatitis B surface antibody titers equal to or less than 10 IU / ml, should be inoculated within six months, the antibody titers of greater than 10 IU / ml in 6 years, multiple cropping. Most of the scholars in China within 3 years after immunization recommendations to strengthen the 1st better.

Year of the Pig birth of an upsurge of "catch up" to describe is not an exaggeration. However, in the face of brewing time, "Rob-B-Hood", a number of hepatitis B mothers how it was also not happy with. Maiqi bottle of milk, nutrition supplement of folic acid, but their bodies do not seem to have the perfect preparation. "B" virus is usually spread through exchange of body fluids, including vertical transmission between mother and child play an important role. Statistics show that among the crowd of about 40% HBsAg-positive mother to child transmission is caused. In our country, "B" virus infection among about 6 million women. Therefore, the hepatitis B virus carried by women, from a planned pregnancy, pre-pregnancy health checks to the need to accept scientific guidance and careful plan must not be careless in haste. [A pre-Memo] Hepatitis B common sense to know For chronic hepatitis B, we need to master the basic knowledge of what? In this regard, the capital of Beijing Medical University hospital liver disease friendship Research Professor Jia Jidong, director of the Center, 2002 National Hepatitis B serum epidemiological survey showed that China's chronic hepatitis B in the general population of about 30,000,000 cases, die every year And hepatitis B-related liver disease in about 300,000 cases. Hepatitis B is usually spread in the following ways: the dissemination of blood and blood products; mother to child transmission (perinatal period in which the dissemination of mother to child transmission is the main way for more access to birth HBV-positive mother's blood and body fluids); damaged by the Skin and mucous membrane spread; not strict disinfection of medical equipment, syringes; invasive surgical operations and treatment; intravenous drug abuse; sexual contact, and so on. [Pre-secondary Memo] Science and early detection screening The potential risk of pregnant women suffering from hepatitis B, doctors must determine their own under the guidance of the current situation of hepatitis B patients. If it is simply "HBsAg" positive, or "Xiao Sanyang", and hepatitis B virus DNA (HBV-DNA) negative, that the virus in the body in a steady state. Although this type of virus can be carried for life, do not affect the normal life, so this type of pregnant women. If the diagnosis shows that the "Da Sanyang," At the same time, HBV-DNA positive, then there is obviously infectious, and may also be associated with liver cell injury. The study by pregnant women HBsAg, "hepatitis B" e antigen-positive at the same time, almost 100% of neonatal infection, and most of them become chronic carriers. As a result, women such a good idea to consider the treatment of rest, to be the "B" virus e antigen, HBV-DNA negative for good after pregnancy. In addition, the acute phase of hepatitis C and cirrhosis can not be pregnant after childbirth, chronic hepatitis B should not be pregnant, which is to the health of the mother and at the same time to avoid pregnancy will be transmitting the virus to the fetus. [Three-level pre-Memo] Nissan found in time to avoid the risk of If pregnant women belonging to the liver disease itself, the high-risk groups, then as soon as possible to receive prenatal care is essential. While a normal pregnancy will not increase the damage to the liver, but a number of obstetric complications, such as gravidarum, hypertension during pregnancy, may lead to serious liver disease. To start earlier inspection, early detection and help to deal with the disease, to avoid or mitigate its further development. Once diagnosed, for the treatment of hepatitis B should be a two-pronged, potent inhibition and virus e antigen seroconversion equally important. For example, under the guidance of doctors choose to telbivudine, such as drug treatment. In addition, some of the symptoms of hepatitis B and certain physiological responses during pregnancy and other liver and gallbladder diseases are very similar, the same would develop fever, weakness, oil tired, nausea, vomiting, anorexia, right upper quadrant pain, yellow skin and eyes, and so on, so Hepatitis B in pregnant women, early pregnancy (3 months) to go to hospital for treatment, rule out the possibility of the existence of the disease.

It does not matter to eat together, do not share toothbrushes, razors, etc. "Doctors, patients with hepatitis B and I eat rice, will not be infected with hepatitis B virus?" "Doctors, patients with hepatitis B and I lived together, as if infected with the hepatitis B virus." On the mere mention of these people who came to the hepatitis B digestive internal medicine consultation, for fear that their infected with the hepatitis B virus in Henan Province People's Hospital director Dr. YANG Yu-xiu said that the health concerns is a good thing, but on some unreasonable to ask. Hepatitis B virus of the most dangerous route of transmission was human blood and body fluids. Patients with hepatitis B and eat together, except in patients with the virus in saliva get food, you have been eating into the mouth, and you just suffering from mouth ulcers, which also happens to the virus in the ulcer site, you can be infected with hepatitis B Virus. Mother to child transmission are in the process of birth mothers have the virus in the body fluids into the child in the child inside her mother's nutrition absorption, it is normal for the majority. Foreign scholars have made an interesting experiment. Two gorillas, one carrying hepatitis B virus, no one, Huan Yigan gorillas stomach food transferred to a normal gorilla of the stomach, only to wait until the normal gorilla to digest the food, did not It was detected in the blood of hepatitis B virus. However, the danger is that with a toothbrush to brush their teeth Huanyi Gan gorilla, the toothbrush is not treated, and then it is normal for the gorillas brush their teeth as a result, it's normal gorillas have unfortunately been infected by hepatitis B virus. This reminds us of the experiment, and do not have to live with hepatitis B patients make a fuss, and patients should be careful not to share toothbrushes, razors, and other body fluids and blood can lead to the spread of dangerous goods can be a