Some netizens asked me, let me help look at the examination, the patient's condition is very good, hepatitis B five qualitative only the fifth (core antibody) positive, liver work transaminases slightly elevated. Viral DNA is less than 1000, alpha-fetoprotein, abdominal ultrasound, and blood routine are normal.
At this time, some patients said congratulations on your recovery!
So if the surface antigen is negative, does it mean that hepatitis B has really recovered? The answer is indeterminate.
There are exceptions to anything.
Take a look at this case.
Patient, male, 39 years old, repeated abnormal liver function for more than 10 years, ALT 40-80 U/L, multiple times checked for hepatitis B five items 245 positive, ordinary hepatitis B DNA can not be detected, no hepatitis C, fatty liver and other diseases. Local hospitals give symptomatic treatment such as hepatoprotective drugs, and the condition is often repeated. Half a year ago, I developed cirrhosis of the liver, came to our hospital for examination, checked the high-sensitivity hepatitis B DNA 54 IU/mL, and the five hepatitis B items are still three antibodies positive.
In this patient' condition, although the surface antigen is negative, but the high-sensitivity DNA can detect a small amount of virus, the disease is also progressing repeatedly. This is what we often call occult hepatitis B.
So what is occult hepatitis B?
Occult hepatitis B is an extremely insidious, well-disguised form of hepatitis B, in which patients have a two-and-a-half-turn-negative HBsAg result, so even some specialists sometimes assume that patients do not have hepatitis B.
However, under the existing test conditions, hepatitis B virus DNA can be detected in the liver, and some patients can detect hepatitis B virus DNA in serum at the same time, and the DNA is quantified
These patients are not aware of HBV infection, so they often do not check regularly, even if they find abnormal liver function, they do not use antiviral therapy, resulting in sustained aggravation of the disease, cirrhosis, and even liver cancer.
Occult hepatitis B virus infection has a complex mechanism and may involve host factors, factors of the virus itself, and other viral or nonviral factors. It also carries the risk of transmitting the hepatitis B virus, which can be reactivated and can lead to worsening liver disease.
The prevalence of occult hepatitis B virus infection in different countries and regions is related to the local prevalence of hepatitis B virus infection, and the prevalence of occult hepatitis B virus infection in Asia is relatively high. The prevalence of occult hepatitis B virus infection in different populations is also different, and some reports can even be as high as 20% to 40%;
The onset of occult hepatitis B is occult, and how to identify these patients as early as possible has attracted increasing clinical attention.
Occult hepatitis B can be divided into two types: seropositive and seropositive, the former is two-and-a-half negative results, and the latter is positive for HBeAb, HBcAb or even HBsAb, as we mentioned earlier.
Occult hepatitis B patients often find low levels of elevation by examining serum HBV DNA, and some patients even test for peripheral blood with negative HBV DNA and require hepatitis B virus testing in liver tissue.
In recent years, with the increasingly wide application of high-sensitivity HBV DNA detection methods, the possibility of missing tests has been minimized, and more and more patients with occult hepatitis B virus infection have been discovered, which has provided an effective boost to block the further spread of HBV infection.
For the patients mentioned in the opening paragraph, the best situation is to check the high-sensitivity DNA first, if negative, you can rest assured, but still pay attention to the regular review once a year.