Many people with hepatitis B have misconceptions about their own disease, which leads to exacerbations, delays in treatment, and even unbearable blows to the whole family. Therefore, we need to get out of the misunderstanding of hepatitis B as soon as possible, and identify it early to benefit more!
Common misunderstandings are mainly in the following ten aspects:
Myth 1: Living together can infect you with the hepatitis B virus
Correct understanding: Hepatitis B virus is not transmitted through the respiratory and digestive tracts, but mainly through blood, mother-to-child transmission and sexual contact. In mainland China, mother-to-child transmission is the mainstay, accounting for 40%~50% of new infections. Therefore, daily contact for study, work or life, such as working in the same office, shaking hands, hugging, living in the same dormitory, eating together, and other contacts without blood exposure, do not transmit hepatitis B virus. Mosquito bites do not transmit the hepatitis B virus!
Myth 2: If the mother has hepatitis B, she will inherit hepatitis B to the baby
Correct understanding: Hepatitis B is not a genetic disease, but a preventable and treatable infectious disease. In mainland China, mother-to-child transmission is the main occurrence, and it mostly occurs in the perinatal period. Newborns are transmitted through blood-to-blood contact with HBV-positive mothers during an injured birth canal/cesarean section.
So can a woman with hepatitis B give birth to a healthy baby? It is completely possible to rely on modern medical technology to do a good job in maternal and infant blocking treatment during childbirth and postpartum!
Mother-to-fetal blockade therapy refers to the early injection of 100 units of high-potency hepatitis B immune globulin within 12 hours of birth, and 10 μg of recombinant yeast hepatitis B vaccine at different sites. The second and third doses of hepatitis B vaccine were given at 1 and 6 months, respectively. HBsAg and anti-HBs were tested 1~2 months after the third dose of hepatitis B vaccine to determine whether the mother-infant blockade treatment was successful.
Myth 3: Dad has hepatitis B, which will be passed on to the baby
Correct understanding: Hepatitis B is not a genetic disease and is not transmitted to the baby through the father's genetic material. As long as the mother is not infected with hepatitis B virus (hepatitis B test 5 test negative: hepatitis B surface antigen negative), the father with hepatitis B virus does not increase the risk of hepatitis B infection in the baby. After the baby is born, 3 doses of hepatitis B vaccination are completed according to the 0, 1, and 6 month schedule, which produces a hepatitis B immune response, which can effectively prevent hepatitis B virus infection. However, before the baby develops an immune response to the hepatitis B virus, the baby should avoid contact with body fluids containing the hepatitis B virus, such as lotions, blood, etc., to prevent hepatitis B infection and protect the baby's health.
Myth 4: Hepatitis B mothers can't breastfeed
Correct understanding: Newborns born to hepatitis B mothers who have received highly effective hepatitis B immune globulin and hepatitis B vaccine within 12 hours of birth have a very low risk of contracting hepatitis B. At the same time, breast milk is rich in nutrients, which can enhance the baby's immunity and enhance the emotional communication between mother and child, so we have been advocating breastfeeding for mothers with hepatitis B.
It is important to note that hepatitis B activity may occur during breastfeeding due to overexertion leading to a decrease in the body's immunity. In this case, you should seek medical attention in time and take medication under the guidance of a professional doctor. At this time, the mother's physical health should be the top priority and breastfeeding should be suspended.
Myth 5: It doesn't matter if you miss or stop taking anti-hepatitis B virus drugs
Correct understanding: Anti-hepatitis B virus drugs can only inhibit the replication of hepatitis B virus in the body, but cannot eliminate the cccDNA integrated in the nuclear genes of hepatocytes, which is also an important reason for the chronic hepatitis B virus infection. Long-term oral anti-hepatitis B virus drugs can effectively inhibit hepatitis B virus replication in vivo, reduce liver inflammation, and achieve the goal of controlling disease progression.
On the contrary, if you remember to take the drug, if you don't remember, if you don't remember it, or if the virus turns negative after taking the anti-hepatitis B virus drug regularly for a period of time, you will reduce the drug and stop the drug, which will give the hepatitis B virus the opportunity to make a comeback or induce mutation resistance, which will eventually lead to abnormal liver function, disease progression, and even liver failure, threatening the patient's life.
Myth 6: Anti-hepatitis B virus drugs can be replaced at will
Correct understanding: At present, the drugs used in clinical practice against hepatitis B virus are mainly interferon and nucleos(t)ide analogues, and nucleos(t)ide analogues include: entecavir, tenofovir, tenofovir alafenol, emitenofovir, etc. Long-term regular anti-HBV therapy can delay the progression of hepatitis B to cirrhosis or liver cancer. Long-term use of some nucleoside drugs may cause hepatitis B virus resistance mutations, and when hepatitis B patients are regularly taking drugs and regular re-examinations, specialists can find hepatitis B virus resistance in time according to the patient's examination results, and switch to other types of antiviral drugs according to the patient's own situation, so as to avoid the harm caused by drug-resistant mutations and improve the efficacy of antiviral therapy.
However, some people with hepatitis B change their anti-HBV drugs at will at random to avoid antiviral resistance, and will switch to another drug at regular intervals. This practice is both unscientific and harmful. Frequent drug changes due to excessive worry about drug resistance mutations not only cannot reduce the occurrence of drug resistance, but also easily lead to the early arrival of clinical drug resistance, and even the emergence of no cure!
Myth 7: Hepatitis B is an incurable disease
Correct understanding: Although there is no specific drug to eradicate the hepatitis B virus, there is an effective drug that inhibits the replication of the hepatitis B virus and slows down the progression of hepatitis B patients. Patients with chronic hepatitis B treated with some nucleos(t)ide analogues belong to the dominant population (the dominant group refers to patients with HBVDNA below the lower limit of detection, HBsAg <1500IU/ml and HBeAg-negative patients), and the combination of interferon can achieve clinical cure for some patients.
Therefore, chronic hepatitis B is not an incurable disease, but a preventable and treatable disease, and some patients with chronic hepatitis B can even achieve clinical cure - surface antigen turns negative and surface antibody turns positive. Patients with chronic hepatitis B can effectively prevent the progression of hepatitis B to cirrhosis and liver cancer by following the arrangements of specialists, taking medication regularly, and having regular check-ups.
Myth 8: People with hepatitis B virus do not need regular monitoring
Correct understanding: hepatitis B virus carriers refer to hepatitis B virus infection patients whose liver function has been normal, although these patients do not have hepatitis symptoms such as fatigue, loss of appetite, nausea, liver discomfort and liver function are also normal, but about 70%~80% of hepatitis B virus carriers may have liver histological lesions, and some patients even develop liver cirrhosis, liver cancer and other end-stage liver diseases. Therefore, hepatitis B virus carriers should regularly recheck liver function, abdominal color ultrasound, hepatitis B virus quantification at least every 6 months ~ 1 year, and if necessary, liver biopsy should be performed to assess whether the patient should start anti-hepatitis B virus therapy.
Myth 9: Hepatitis B is more dangerous than a small one
Correct understanding: The five markers of hepatitis B include: HBsAg, HBsAb, HBeAg, HBeAb and HBcAb, the big three positives refer to the positive items 1, 3 and 5 of the five markers of hepatitis B, and the small three positives refer to the 1st, 4th and 5th positives. It is generally believed that hepatitis B has undergone seroconversion (i.e., the e-antigen turns negative and produces e-antibodies) and becomes hepatitis B small three positives, so it is considered that the hepatitis B three positives are more dangerous than the small three positives.
However, which of the two is more dangerous refers to which is more likely to cause cirrhosis or liver cancer. In fact, the risk of liver cirrhosis or liver cancer is the same, and even some patients with small Sanyang think that their condition is stable, too blindly optimistic, delay treatment, and are even more likely to develop liver cirrhosis or liver cancer than patients with big Sanyang. Both should be taken seriously by patients, and antiviral therapy should be initiated as soon as possible when antiviral therapy is indicated.
Myth 10: The more hepatoprotective drugs, the better
Correct understanding: In patients with hepatitis B who have abnormal liver function (usually ALT (alanine aminotransferase) above the upper limit of the detection value), anti-hepatitis B virus therapy should be actively initiated after other causes of abnormal liver function have been ruled out. Antiviral therapy is the key to the treatment of hepatitis B.
For patients with obvious liver inflammation or significantly elevated ALT levels, on the basis of antiviral therapy, 1~2 kinds of drugs with anti-inflammatory, antioxidant and hepatocyte protection effects can be used as appropriate, including: glycyrrhizic acid preparations, silymarin preparations, polyunsaturated lecithin preparations and bicyclic alcohol. However, it is not advisable to combine multiple combinations to avoid aggravating the burden on the liver and adverse reactions caused by drug-drug interactions. Therefore, hepatoprotective drugs should be used with caution under the guidance of a doctor, and the more they are taken, the better.