Most of the patients with hepatitis B are converted from chronic carriers, and after the onset of the disease, the viral load is relatively high, and the degree of hepatitis is also relatively severe. Most of the people in the group who are sick are young and have three yangs, and many of them hope to turn yin as soon as possible. This not only clears the virus faster, but also helps to reduce inflammation in the liver.
In fact, there are 3 types of hepatitis B turning negative, what is the probability of these 3 types turning negative?
1. Negative conversion of viral DNA load. As long as everyone follows the doctor's instructions and actively treats antiviral, this kind of negative can be achieved 100%, the original viral load is less than 500, and the latest guidelines require ultra-high sensitivity testing to be less than 20 to be considered standard. However, it should be noted that the viral load turns negative, which does not mean that hepatitis B is completely cured, and it is necessary to continue to take antiviral drugs on time to prevent the viral load from rebounding.
2. E antigen turns negative. That is, the big three yang turns into the small three yang, and the probability of this turning yin is about 40%. The transformation of the big three yang into the small three yang only indicates that the replication of the virus is inactive, but it is still easy to cause liver inflammation, so this kind of negative transformation must also adhere to the treatment and must not be relaxed.
3. Hepatitis B surface antigen turns negative. That is, the first of the five items of hepatitis B turns negative, which is the most desired to see the negative turn, and the probability of turning negative is only about 2% in people with chronic hepatitis B. However, in the dominant group with surface antigen lower than 1500, the conversion rate can be increased to about 30% after combined with interferon therapy. Once the surface antigen turns negative, the antibody also appears one after another, and the drug can be stopped after observing and consolidating for a period of time. This third type of negative conversion is what hepatitis B patients are most looking forward to, and of course, it is also the direction of our efforts.
So, what problems should we pay attention to if we want to improve the effectiveness of hepatitis B treatment?
1. Choose antiviral drugs
Among the nucleoside drugs, the main anti-HBV drugs are entecavir and tenofovir, both of which have good antiviral activity and a high threshold for resistance. According to studies, for hepatitis B patients on initial antiviral therapy, choosing drugs with good antiviral effect and high resistance threshold can reduce the HBVDNA load in the body in a short period of time, reduce hepatocellular inflammation, and effectively reduce the incidence of liver cirrhosis and liver cancer!
2. Appropriate timing of treatment
In terms of optimizing the treatment of hepatitis B and improving the efficacy, it is very important to choose the appropriate treatment period, and only after the body's immune status reaches a certain level, the method of immune regulation can be further strengthened to achieve a better treatment effect.
3. Regular follow-up and review
Regular re-examination of transaminases and hepatitis B DNA can observe the early efficacy of hepatitis B drugs; when transaminases and hepatitis B DNA are normal, regular re-examination can help to understand whether the drug can continue to be effective; HBsAg and HBeAg titers in hepatitis B two and a half pairs will gradually decrease with the extension of treatment time, and regular testing can provide continuous data, which is conducive to judging the time of "big three yang" to "small three yang", and is also of important help to judge whether the drug can be stopped.
Although hepatitis B conversion is not possible for everyone now, a small number of patients achieve it every year, either self-healing or cure. In other cases, treatment is also needed, and the main purpose of treatment is to avoid further deterioration to cirrhosis and liver cancer, and to maintain the relative health of the body, so it is not appropriate to simply leave treatment because hepatitis B is difficult to completely cure.