According to statistics, about one in ten people in China may carry hepatitis B virus. The main reasons are mother-to-child transmission and exposure of adolescents and adults with weak immune function to hepatitis B virus.
Asymptomatic HBsAg carriers are divided into three categories: 1. I had hepatitis, and I had no idea. Because of its mild clinical symptoms, liver damage and rapid recovery, it only shows HBsAg carrying state after illness. 2. Healthy carriers, after repeated tests, have normal liver function, no symptoms and signs, no pathological damage even after liver biopsy, and complete liver tissue structure. 3. Pathological diagnosis of chronic persistent hepatitis and chronic active hepatitis by liver biopsy.
The asymptomatic HBsAg carriers of the first category should be followed up in medicine, and the liver function should be checked every three months to find out whether there is liver damage in time, and if there is liver damage, it should be treated in time.
The asymptomatic HBsAg carriers of the second kind can work, study and work as usual, and most of them have a good prognosis. After a period of time, with the improvement of autoimmune state, it can naturally turn negative.
The asymptomatic HBsAg carriers of the third category should be treated as patients with the disease in time after being diagnosed with pathological damage to the liver.
Asymptomatic HBsAg carriers are not really "healthy people". These people have viruses in their bodies, and they may copy or infect others. Therefore, they should not engage in catering services and conservation work. HBsAg carriers should pay attention to personal hygiene and public hygiene, develop good hygiene habits, and implement a separate meal system; Don't mix cosmetics with others. Women should also pay attention to menstrual hygiene to prevent menstrual blood from polluting daily necessities.
At present, there are three main principles of medical treatment for asymptomatic HBsAg carriers: 1. Liver protection: absolutely abstain from drinking, avoid overwork, keep a good mood, have reasonable nutrition, regularly check hepatitis B virus markers and liver function, and take ascorbic acid and Gan Bao Weiyang powder when necessary to enhance the body's resistance, strengthen liver nutrition and avoid blind medication. 2. Anti-HBV treatment: medication under the guidance of specialists, such as interferon, lamivudine, anti-HBV immune RNA, Chinese patent medicines, etc. 3. Family personal hygiene treatment: Other family members can be injected with hepatitis B vaccine to prevent infection. Household appliances and clothes of asymptomatic HBsAg carriers can be soaked in 0.2% 84 disinfectant (20 minutes), and tableware can also be sterilized or isolated by cooking for 30 minutes.
In short, hepatitis B virus carriers generally have a good prognosis, and a few can naturally turn negative; Most of them are persistent and stable lifelong HBV carriers (about half of the liver has slight lesions, which belong to a relatively stable low response state of persistent HBV infection and need treatment. ); But about 3% can develop into hepatitis, and the possibility of developing into liver cancer is much greater than that of non-carriers.
All HBSAg-positive "big three yang" or "small three yang" with normal liver function and no abnormality in abdominal B-ultrasound are hepatitis B virus carriers. There are about 65.438+0.2 billion people infected with chronic hepatitis B virus in China, and the carriers account for 654.38+0/4, that is, 30 million. These people have suffered a lot of unfair treatment in society and suffered a huge mental burden, which deserves our attention.
As we all know, hepatitis B virus is the chief culprit of hepatitis, liver cirrhosis and liver cancer. Why do many people get sick after being infected with hepatitis B virus, and they can't be removed? Because there is immune tolerance in human body. In China, vertical mother-to-child infection is the main route of transmission of hepatitis B virus. The vast majority of carriers are infected from infancy, and the infant's immune system is not well developed, so the virus lurks in human liver cells to survive. This kind of immune deficiency that is specific to a pathogen is called immune tolerance. At this time, the human immune system does not attack the cells where the virus is located, and the two live in peace. Although the quantitative detection of HBV—DNA shows that the virus is actively replicating, the liver function is normal and the human body has no symptoms.
After entering the green year, the immune function of HBV carriers is mature, and it is possible to attack cells containing HBV, and the original balance is broken. At this time, the human body may get sick. Among HBV carriers, some people have enhanced immune function and can completely eliminate the virus, so they heal themselves, and some people will not get sick all their lives. However, 70%-80% of HBV carriers may turn into chronic hepatitis after illness, and the disease will enter a chronic active period. At this time, it brings opportunities for antiviral treatment.
HBV carriers with normal liver function do not need treatment. There are often asymptomatic HBV carriers with normal liver function who strongly demand antiviral treatment and are eager to find a radical cure. Some seek medical treatment indiscriminately and are deceived. As a doctor, I must explain to HBV carriers that this situation is ineffective. Antiviral treatment is the best in active hepatitis, so we should seize the opportunity, otherwise it will lead to early onset.
HBV carriers should pay attention to the following matters:
Regular physical examination: although HBV carriers have no symptoms and normal liver function, they should pay attention to the law of life and not be overworked. Liver function, seven indexes and abdominal B-ultrasound were examined in a regular hospital for 3-6 months. If you have symptoms such as fatigue and anorexia, you should come to the hospital for treatment in time;
Cannot donate blood;
Special cups, separate meals, no drinking;
Toothbrushes, washing utensils and towels are used alone;
Pay attention to the protection of delivery and abortion: HBV carriers, regardless of gender, can get married and have children. Mother-to-child transmission is one of the important transmission routes of hepatitis B virus. After delivery, the contents of the newborn's mouth and pharynx should be removed in time, and the infant should be injected with hepatitis B immunoglobulin and hepatitis B vaccine within 24 hours (as required);
Traumatic bleeding should be properly handled.