hepatitis B virus

Hepatitis B virus carriers ask: What is a hepatitis B virus carrier?

A: Hepatitis B virus carriers (AsC) refer to chronic HBV-infected people who have been HBsAg-positive for more than 6 months. They have almost no symptoms and signs related to liver disease, and their liver function is basically normal. According to statistics, there are about 93 million hepatitis B virus carriers in China. On the morning of April 2 1 2008, the Ministry of Health announced the results of the 2006 national seroepidemiological survey of hepatitis B and other related diseases. The survey showed that the HBsAg carrying rate in Chinese population decreased from 9.75% in 1992 to 7. 18%, which was 26.36% lower than that in 1992. According to this calculation, there are still about 93 million HBV carriers in China. )

The emergence of HBV carriers in newborns is related to vertical transmission from mother to child. The perinatal transmission rate of HBV surface antigen (HBsAg) positive mothers is very high, especially more than 90% of newborns born to pregnant women with HBsAg and E antigen (HBeAg) positive at the same time. This is because HBeAg in maternal blood can enter the fetus through the placenta, inhibiting the immune response of cytotoxic T cells (Tc cells) to infected liver cells, and making the fetus in an immune tolerance state. The greater the amount of virus carried by HBeAg-positive mothers, the greater the amount of virus invading newborns, which leads to the infection of newborns with HBV, and 80% of them will develop into hepatitis B virus carriers. The chances of mother-to-child transmission between men and women are similar, but most babies become HBV carriers after infection. The investigation on the relationship between HBsAg carrier and heredity shows that the heritability of hepatitis B virus carriers is above 60%, and it is speculated that the mode of inheritance is polygene inheritance.

Infants infected with HBV carriers are mainly horizontal infection, which can be caused by blood transfusion, vaccination and close contact with family members of HBV infected people. Infants under 3 years old are easy to carry hepatitis B virus because their immune function is not yet mature.

The so-called asymptomatic hepatitis B virus carriers refer to those who are positive for hepatitis B surface antigen by simple blood test, but have no symptoms and signs of hepatitis, normal liver function test and no change after observation for half a year.

Q: Hepatitis B is basically not contagious. How are the current 65.438+0.2 billion HBV carriers formed?

A: At present, there are 654.38+0.2 billion hepatitis B virus carriers in China (note: according to the latest statistics of the Ministry of Health, this number has dropped to 93 million at present), because before the 1990s, there were no disposable syringes and blood donation, which led to blood transmission. Secondly, there was no mother-to-child blocking technology before, which led to mother-to-child transmission. With the popularization of hepatitis B vaccine and the gradual interruption of blood transmission and mother-to-child transmission, the transmission of hepatitis B will gradually decrease in the future. Therefore, although isolation measures have not been taken for hepatitis B virus carriers for so many years, the number of hepatitis B virus carriers in China has been around 654.38+0.2 billion, and there is no epidemic. The goal of the Ministry of Health is to reduce the hepatitis B virus carrying rate in China to below 1% by 2050.

(1) At present, there are no isolation measures for hepatitis B virus carriers in China. They have to use RMB, get on the bus, eat in restaurants and borrow books from the library. Everyone may be exposed to hepatitis B virus every day. If the infectivity and severity of hepatitis B virus is really as great as advertised, 20 years ago, China/KLOC-0.20 billion hepatitis B virus carriers were infected with/KLOC-0.20 billion people. The truth is simple: "Practice is the only criterion for testing truth."

The discussion on the infectivity of hepatitis B should not be blindly exaggerated and feared. One of my high school classmates is a carrier of hepatitis B virus. Several of our classmates ate together for more than two years, but they didn't infect us. I don't think hepatitis B has been publicized to the society. Many people have never seen SARS, but they are all scared and have never heard what others say. Therefore, we must seek truth from facts and have the right to speak in person, not just by imagination.

(2) The best example is the medical workers' investigation on the spouses of hepatitis B infected persons. The connection between husband and wife is the closest! However, after investigation, less than 10% of both husband and wife suffer from hepatitis B, and most of the spouses of hepatitis B infected people not only have no hepatitis B patients, but also have hepatitis B virus antibodies. This is enough to prove that as long as the human immune function is normal, hepatitis B virus will not have a foothold in the body. -Excerpted from Dr. Cai's article in ditan hospital.

(3) Is there less hepatitis B infection between husband and wife?

One spouse has hepatitis B, and the other rarely gets it. According to an expert's random investigation, 263 married patients with chronic hepatitis B are between 35 and 55 years old, all of whom have been married for more than 5 years and have children. There are 17 couples whose spouses are both positive for hepatitis B (surface antigen), accounting for only 6.46% of the surveyed population. This result is basically consistent with other domestic survey data. Spouses of patients with hepatitis B rarely get hepatitis B, but their previous infection rate of hepatitis B virus was high, reaching 65.3%( 172). Their test results show that the surface antigen of hepatitis B virus is positive, but the surface antibody (none of which has been vaccinated with hepatitis B vaccine) or core antibody is positive. This shows that they have been infected with hepatitis B virus, but antibodies have been produced in their bodies. Husband and wife have lived together for many years, and the intimacy of contact is unmatched by others. Sexual contact is inevitable, and there are many opportunities for infection, but the incidence of hepatitis B in spouses of hepatitis B patients is extremely low. Why? Because adults often have a sound immune system, the body has normal immune monitoring and immune clearance functions. When hepatitis B virus enters the human body, the whole body's immune system will immediately mobilize to identify and remove hepatitis B virus, leaving the virus nowhere to hide and stay.

2、

(1) Among HBV carriers, 8/9 people will never get sick, and only 1/9 people will become hepatitis B patients because of bad living habits and poor immunity.

(2) At present, there are110 civil servants who are carriers of hepatitis B virus, but a very small number of civil servants suffer from cirrhosis and liver cancer every year, and they have not caused hepatitis B epidemic among civil servants, and their work is still very good.

Please log on to "Beat Hepatitis B Network" and pay attention to the living conditions of hepatitis B virus carriers.

"Overcoming Hepatitis B Network" www.hbver.com

4 asymptomatic hepatitis B carriers can study, live and work normally (Yao Guangbi, member of hepatitis expert committee of the Ministry of Health).

This group should be treated as normal people and can live, study and work normally. In particular, there should be no discrimination in enrollment, employment, marriage, etc., and there is no need to cause psychological tension for yourself and your family. Everyone should treat it correctly.

At present, it is inappropriate for some units to set up artificial obstacles to the employment and work of asymptomatic HBSAg carriers. In principle, there should be no employment taboos for them. Only HBSAg and HBEAg positive people should not directly touch food, be nurses or engage in chemical work that is toxic to the liver.

5. Work needs a healthy body. Hepatitis B virus carriers are not completely healthy people.

It's unreasonable not to employ people with hepatitis B virus because they are unhealthy.

According to the latest survey of the World Health Organization, about 35% of people in the world are currently in sub-health state. Among these sub-healthy people, the proportion of young and middle-aged people is as high as 75%. Sub-health has become the "fourth killer" after cancer, AIDS and hypertension. The survey also shows that only 5% people are really healthy (the first state), less than 20% people are diagnosed as sick (the second state), and more than 75% people are in a transitional state between health and illness, that is, sub-health state. The Chinese Medical Association made a random survey in 33 cities in China last year, and the conclusion was that the number of sub-health people in China accounted for about 70% of the national population. This health is relative. As long as you can engage in the job you are applying for, instead of blindly pursuing complete health in medicine, then 95% of the people in the world should be laid off immediately. Therefore, it is unreasonable not to employ people with hepatitis B virus because they are unhealthy.

6.( 1) In foreign countries, such as the United States, Japan, Australia, South Korea and other countries, hepatitis B surface antigen is a personal privacy. In addition to catering and other industries, it is not allowed to check the five items of hepatitis B when recruiting, as long as the liver function is normal.

(2) Except China, no other country in the world has such severe restrictions on the employment of HBV carriers.

Over the years, people have confused hepatitis B with hepatitis A. In fact, hepatitis A is an infectious disease of digestive tract, which is highly contagious, while hepatitis B is a blood infectious disease, which will not be transmitted through tableware, and will not be transmitted in daily work and study. For example, hepatitis A often erupts, but who has heard of hepatitis B?

In the early 1990s, the first epidemiological survey in China found that the carrier of hepatitis B was about 10%. At the beginning of this century, the second epidemiological survey in China showed that the carrier of hepatitis B was still 10% (the exact figure was 9.7%). In other words, since the 1990s, China's hepatitis B carrying rate has not expanded at all, which fully shows that in terms of disposable syringes and mother-to-child blocking.

Fear of hepatitis B is actually unnecessary. Of course, everyone has the right to be afraid. If you are still afraid after knowing the common sense of hepatitis B transmission, how can you fundamentally alleviate your fear? Isolate1.200 million HBV carriers? Like apartheid? This is obviously not a good idea. In fact, there is a way to recommend it to you once and for all, that is, injecting hepatitis B vaccine.

Hepatitis B vaccine is very cheap, as long as it costs 30 yuan RMB, which is much lower than the cost of blood test every year.

Injected with hepatitis B vaccine and produced hepatitis B antibody, then you don't have to be afraid, even if you accidentally input the blood products of hepatitis B carriers (forgive me! ), it will not be infected.

The large increase of hepatitis B carriers in China is related to the planned immunization (that is, children's vaccination) after the founding of the People's Republic of China. After the founding of the People's Republic of China, with the development of medical and health undertakings, children began to be injected with vaccines such as vaccinia, BCG and DTP on a large scale, which is of course a good thing.

But because there is no disposable syringe, you can often see a syringe, and children queue up to inject in turn, some change needles (needles are not disposable), and some don't even change needles. In this way, if one child in the queue is a carrier of hepatitis B, many other children may be infected. Most people born after 60 grew up in this danger.

Another question, doesn't carrying hepatitis B mean that the liver is sick? Will it definitely affect people's normal work and life? Is it necessary to develop into "hepatitis-cirrhosis-liver cancer" advertised by some black-hearted hepatitis B advertisements?

The following is an article published by Professor Wei Lai from Peking University Institute of Hepatology, Peking University People's Hospital on the website of China Hepatitis Prevention and Treatment Foundation on September 9, which answered this question:

The result of hepatitis B infection is another important issue that people are concerned about. According to the epidemiological survey in China, the positive rate of HBeAg in HBsAg positive population is 3 1.94% (that is, the three major positive). HBeAg positive is a sign of virus reproduction, and HBsAg positive is not necessarily contagious. At the same time, even if there is virus reproduction, it does not necessarily damage the liver tissue. So there is a difference between HBsAg positive and liver disease.

At present, it is also found that the annual conversion rate from liver cirrhosis to liver cancer is 2.8% ~ 3.5%, the annual conversion rate from chronic hepatitis B to liver cirrhosis is only 0.83%, and the conversion rate from HBsAg carriers to liver cirrhosis is even lower, about 0.27% ~ 0.47%. Therefore, hepatitis B does not necessarily develop into cirrhosis or liver cancer. Patients with hepatitis B can work like normal people, but don't forget to check regularly. Once problems are found, they should be dealt with in time.

Also remind friends that dental instruments that are not disinfected in place are the easiest to spread hepatitis B (and other diseases).

According to the report of Beijing Evening News on March 27th, 2004, nearly 80% of stomatological institutions did not completely disinfect or falsely disinfect the handpiece. This poorly disinfected dental instrument greatly increases the probability of hepatitis B transmission.

So please be sure to go to a regular dentist's office and try to use disposable instruments.

The World Health Organization has never claimed that hepatitis B can be cured. It only lists some drugs, but they can only be controlled and cannot be completely cured. Even in the United States, where modern medicine is so developed, there is no way. Otherwise, Chinese mainland would have imported it!

The media and pharmaceutical companies in China are extremely irresponsible, which is of course related to the incompetence of our government!

Curing hepatitis B can only rely on its own resistance at present! Drugs can only assist! In fact, there are very few people who naturally turn negative, and many of them have been back for a lifetime!

At present, there is no specific medicine in the world that can completely turn hepatitis B into negative. However, with the rapid development of medical technology in recent years, there have been better methods to control the condition of patients with hepatitis B. Patients with hepatitis B go to the hepatitis B department (or gastroenterology department) of a regular big hospital, and their illness can be better controlled through regular mainstream therapy.

As for the overwhelming hepatitis B medical advertisements, it is forbidden by the state. In 2003 1 month, the Ministry of Health, the State Administration for Industry and Commerce, the Food and Drug Administration and the Administration of Traditional Chinese Medicine jointly issued OrderNo. 17, which clearly stipulated this.

The harmfulness of hepatitis B medical drug advertisements can be simply summarized as follows:

1. Exaggerated and deceptive.

At present, it is recognized that there is no cure for hepatitis B conversion, but there are a large number of advertisements for hepatitis B conversion in newspapers, magazines, television, radio and websites. Many hepatitis B carriers who are eager to seek medical treatment listen to these anti-scientific propaganda and go to see a doctor. The result, of course, is that they spend a lot of hard-earned money but can't cure the disease! Therefore, many advertisements for liver diseases have become synonymous with "cheating advertisements".

2. Harm to patients' health.

Because most of these hepatitis B advertisements are low-priced non-mainstream therapies or non-mainstream drugs that have not been strictly scientifically certified, they can not cure the disease, but increase the burden on the liver of hepatitis B carriers, damage the health of patients, cause diseases, delay the illness, and even aggravate and worsen the illness. There are countless examples!

3. Contributed to "hepatitis B discrimination".

In order to scare off many healthy carriers who didn't need treatment to join the ranks of doctors, hepatitis B advertisements generally exaggerate the harmfulness and infectivity of hepatitis B, the so-called trilogy of "hepatitis B-cirrhosis-liver cancer" and the infectivity of hepatitis B, thus creating a "hepatitis B panic" among the public. It is from these advertisements that most people know about hepatitis B and get the so-called "common sense of hepatitis B". After being instilled with such knowledge, the public will inevitably have fear and rejection of hepatitis B carriers, which provides a social cognitive basis for the growing "hepatitis B discrimination"!

Q: Should hepatitis B patients wear condoms during sexual life?

A: I am a hepatitis B patient. Last year, I talked about a boyfriend who was 8 years older than me and was very considerate to me. From his appearance, others will think that he is not worthy of me, because he is plain and looks old, while I look young and beautiful. But in my heart, I don't think I deserve him because of this disease.

To be fair, our relationship is ok, we have sex occasionally, and we use condoms for contraception every time. He said that this will not lead to unwanted pregnancies, but also prevent the spread of diseases. In this respect, he is really at home. No matter how intimate we are, he can "brake" to get the condom in time. Because I am sick, although we have the closest contact, we always feel that there is a gap between the two people. You may not believe it, but we have never kissed each other, just symbolically touching each other's forehead or cheeks with our lips. Do you blame him? No wonder, I think it's my fault. Really, I sympathize with him.

This incident has brought a heavy ideological burden to both of us. Although he was vaccinated and had antibodies, we were still very careful when we got along. We try to avoid touching each other's body fluids. During sex? I'm not afraid of your jokes. We all laugh at ourselves as "bathing in raincoats". He said it was difficult for him to reach orgasm. I think so too. With such a heavy psychological burden, what passion can there be?

Expert comments:

Shooting needs guns, bullets and targets, and shooting and shooting process cannot be completed without any of them. The spread of hepatitis B is the same, and it must have three basic links at the same time: 1. The source of infection, that is, people infected with hepatitis B virus (equivalent to people who provide bullets); 2. Transmission routes such as blood transfusion and sexual intercourse (equivalent to the role of a gun); 3. Susceptible population, that is, the object that may be infected by hepatitis B virus (equivalent to the target). Without one of these three links, hepatitis B will not spread.

Xiao Bing is infected with hepatitis B virus. Her blood, vaginal discharge, saliva and other body fluids may contain hepatitis B virus, so she is the "source of infection" of hepatitis B. It is indeed possible for her to import hepatitis B virus into her boyfriend through kissing or sexual intercourse, but it is one-sided and incorrect to assume that she will infect her boyfriend.

Because her boyfriend has been "vaccinated and has antibodies", it shows that her boyfriend is resistant to hepatitis B. In other words, her boyfriend is not sensitive to hepatitis B. As a result, among the three links of hepatitis B transmission, the susceptible group is missing, and even the target is gone. Where can the bullet go? So hepatitis B virus will not spread among them.

If they believe in science and correctly understand the relationship between the three links in the process of hepatitis B transmission, they can put aside their worries and enjoy rights and happiness like ordinary people without having to "take a shower in a raincoat".

The "Fate Curve" of HBV Carriers

According to the epidemiological principle, there are five infection states after human body is infected with pathogens, namely transient infection, recessive infection, dominant infection, latent infection and pathogen carrying state. The pathogen carrying state means that the pathogen and the immune state of the human body keep in balance, that is, the tissue damage and dysfunction caused by the pathogen are slight, so there is no obvious clinical manifestation; But at the same time, the immune function of the body is not enough to remove pathogens, so pathogens exist in people for a long time.

Specific to "hepatitis B virus carriers", there are two main situations:

First, hepatitis B virus surface antigen (HBsAg) and E antigen (HBeAg) are positive, the level of hepatitis B virus (HBV DNA positive) in serum is high, and transaminase (ALT) is normal. This manifestation is common in perinatal infection with hepatitis B virus, and the spontaneous or treatment-related HBeAg clearance rate is very low because of the immature immune system in childhood, long-term immune tolerance and long-term virus carrier.

The other state is called inactive HBsAg carrying state, which shows that HBsAg is positive for more than 6 months, HBeAg is negative, and anti -HBe is positive, the level of hepatitis B virus in serum is low (that is, HBV DNA is negative), and transaminase continues to be normal. No obvious chronic inflammation was found in the liver histological examination of this part of the carriers.

The first case of long-term follow-up showed that about 29% of adults had elevated and fluctuating transaminase, about 3% had elevated bilirubin level, and even 5% had fluctuating transaminase more than twice. It shows that the long-term carrying status of some virus carriers is unstable, and the balance between virus and immunity may be broken, which may lead to hepatitis. In the inactive HBsAg carrier state, about 4% will be HBeAg positive again, and about 24% will always be HBeAg negative, but the transaminase will fluctuate and become chronic hepatitis B with HBeAg negative, so once infected, it is difficult to completely eliminate hepatitis B virus.

Among the terms related to hepatitis B, people are most familiar with "Big Three Yang" and "Little Three Yang", but what are "Big Three Yang" and "Little Three Yang" is not clear. The so-called "Big Three Yang" refers to HBsAg positive, HBeAg positive and anti-HBc positive, while the difference between "Small Three Yang" and "Big Three Yang" lies in HBeAg negative and anti-HBe positive. "Big three-yang" is common in the first situation mentioned above, while the so-called "small three-yang" may be due to the inactive HBsAg carrying state or the mutation of the virus during the infection, with HBeAg negative but anti -HBe positive.

In fact, "Big Sanyang" and "Small Sanyang" are not medical terms. HBeAg is a sign of active replication of the virus, and HBeAg positive indicates that the virus is still active. Please note that it is a virus, not necessarily a disease. Previously, because hepatitis B virus (HBV DNA) could not be determined, we could only indirectly reflect whether the virus was active through the determination of HBeAg. Now, because hepatitis B virus can be directly detected, we should not focus on "big three yang" and "small three yang", but should know whether hepatitis B virus (HBV DNA) is positive or not.

In patients with hepatitis B virus infection with normal transaminase (ALT), the annual incidence of cirrhosis is about 0.5%. The incidence of liver cancer in HBsAg and HBeAg positive population and HBsAg positive population were 1 169 person-years and 324 people/100000, respectively, while the incidence of liver cancer in HBsAg and HBeAg negative population was only 39 people/100000. It can be seen that the risk of "carriers" suffering from cirrhosis and liver cancer is slightly higher than that of non-carriers.

Knowing the current situation and future outcome of "hepatitis B virus carriers", it can be said that it is difficult to completely eliminate hepatitis B virus infection, and long-term dynamic observation and long-term inhibition of virus replication are needed.

So is there any medicine that can help clear the virus? Unfortunately, there is no effective drug to eliminate the virus in the "vector" at present. Because the carrying state is the result of the balance between the virus and the immune function of the body, and the external cause of antiviral treatment depends on the internal cause of the body to play its role. Only when the transaminase of the infected person rises, it shows that the body itself has attacked the infected liver cells, and at this time, the application of antiviral drugs often has certain effects.

In view of the fact that "carriers" may have inflammatory activities, which may lead to the risk of liver cirrhosis and liver cancer, we should check the transaminase 1 time every 6 ~ 12 months for inactive HBsAg carriers and every 3 ~ 6 months for HBsAg positive and HBV DNA positive people, so as to find out the disease activities in time and treat them in time.

Five measures to keep HBV carriers away from harm

Medical experts say that as long as the following five points are done well in daily life, hepatitis B virus carriers can stay away from harm:

1, careful medication can protect the liver.

The liver is the organ responsible for detoxification. Any drug may increase the burden on the liver, so try not to use it if you don't use it. You really need to use it. You should choose carefully under the guidance of an experienced doctor.

2, moderate rest and rest, to ensure rest.

In work and study, we should avoid working overtime, sleeping less and staying up late; Moreover, excessive entertainment is also harmful. Playing cards all night, traveling and hiking, or taking part in strenuous physical exercise are all bad for the liver.

3, light diet, quit smoking and alcohol.

Everyone's daily diet should be clear but not dry, light but not salty, and try not to be contaminated with all alcohol and alcoholic beverages.

4, contentment is always happy to adjust the mentality

Emotion also has a great influence on the liver, so it is best to keep a contented attitude in daily life, which is also a favorable measure to protect the liver.

5, regular inspection always be vigilant.

Check once every 3-6 months, and observe the five items of liver function and hepatitis B at any time, so as to be prepared.