Chronic hepatitis B is a huge number in China, and many people are suffering from chronic viral hepatitis B, not only physically, but also psychologically disturbed and economically troubled. Chronic hepatitis B, if poorly controlled, can easily turn into cirrhosis or even liver cancer.
According to the sampling survey of the causes of death of malignant tumors in China over the years, the mortality rate due to liver cancer has remained the second in the top ten malignant tumors. The latest data report shows that 92.5% of primary liver cancers in China are caused by chronic hepatitis B. Clinical investigations have shown that chronic hepatitis B antiviral therapy can delay the progress of cirrhosis and reduce the incidence of liver cancer by more than 50%. Therefore, the timing of antiviral treatment for hepatitis B is particularly important.
Appropriate antiviral treatment measures must be taken if the following conditions occur.
1. Patients with big three yangs: the first point: positive for hepatitis B virus, and the second point, alanine aminotransferase exceeds normal by 2 to 5 times. Antiviral therapy is recommended as soon as possible.
2. Patients with small sanyang: (1) The viral volume is more than 10 to the 4th power. (2) Alanine aminotransferase exceeds normal by 2 to 5 times. Antiviral therapy is recommended.
3. Repeated abnormal liver function, lasting from half a year to one year, it is recommended to improve the correlation as soon as possible. To see if there is cirrhosis, it is recommended to do a liver puncture or liver elasticity test.
4. Although the liver function is normal and the amount of virus is not high, but the color ultrasound and CT examination show cirrhosis, it is also recommended to carry out antiviral therapy as soon as possible.
5. For patients with a family history of liver cancer in hepatitis B, cirrhosis or hepatitis B, and who are older than 30 years old, antiviral therapy is recommended.
6. Although liver function continues to be normal, there is an objective basis for cirrhosis, regardless of the level of alanine aminotransferase and viral volume, aggressive antiviral therapy is recommended.
7. It is recommended that patients over the age of 45, especially those with cirrhosis and a family history of liver cancer, should undergo antiviral therapy. And after the start of antiviral treatment, it is impossible to standardize the use of drugs, intermittently, and even to stop the drug without authorization.
The latest hepatitis B guidelines no longer require HBV-DNA load and advocate more aggressive antiviral therapy in patients with decompensated cirrhosis. Aggressive antiviral therapy is recommended in patients with a family history of liver cancer in hepatitis B or hepatitis B and older than 30 years of age.