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Journal of Clinical Hepatobiliary Diseases,1-4[2024-04-20].
Hepatitis B is a disease in which the hepatitis B virus causes liver lesions. According to statistics, there are currently 100 million people in the mainland who are carriers of hepatitis B virus, and 20 million of them are hepatitis B patients. However, hepatitis B virus carriers are different from hepatitis B patients, who have normal liver function, while hepatitis B patients often have abnormal liver function.
Liu Han is the general manager of a company, 31 years old, he has a successful career, a happy family, and is a successful person in the eyes of others. He has a secret that he never tells anyone else, and he is a carrier of the hepatitis B virus. He was born with the hepatitis B virus because his father had hepatitis B, which was sexually transmitted to his mother, who transmitted it to him from mother to child. In the old days, people didn't know much about hepatitis B, they didn't know how contagious hepatitis B was, and they didn't know about the dangers of hepatitis B.
In addition to the above two common modes of transmission, hepatitis B is also transmitted through blood and body fluids, such as the use of contaminated surgical instruments and dental instruments, because hepatitis B is not transmitted through the digestive tract, so accidentally eating with hepatitis B patients and sharing utensils in life will not transmit hepatitis B, so there is no need to worry too much.
On October 11, 2021, Liu Han participated in the company's physical examination, and as soon as he got the physical examination report, Liu Han immediately carefully checked where the liver function was. When he saw ALT 21IU/L, AST 36IU/L, and other indicators and B-ultrasound were all abnormal, Liu Han showed a happy smile.
Aminotransferases are an important indicator of liver function tests, and normal transaminases mean that the liver function is normal. Normal liver function means that he does not need medication or treatment. In his early years, when he learned about the dangers of hepatitis B, he was afraid that he would get liver cirrhosis or even liver cancer, so he went to consult a doctor to find out.
On December 1, 2022, because the company received a big customer that day, Liu Han, as the manager, had to accompany him, although Liu Han tried to avoid drinking at the dinner table, he still had to drink a few glasses. After three rounds of drinking, Liu Han's upper abdomen had a faint pain, but he thought that he didn't have a stomach pad before the meal, which caused the alcohol to stimulate the gastrointestinal tract to protest, and after quickly stuffing a few mouthfuls of food, he continued to talk and laugh.
On June 12, 2023, Liu Han found that he had increased the frequency of his stool, once a day before, but now two or three times a day, and he had no appetite at all, resulting in a lack of energy when he went to work. Liu Han thought that his enteritis was aggravated by his irregular diet during this time, so he went to the pharmacy to buy probiotics and oral anti-inflammatory drugs. After eating for two or three days, although the number of diarrhea decreased, the appetite became worse and worse, and in just one month, I lost 5 pounds. I planned to go to the hospital for a gastrointestinal endoscopy.
After arriving at the hospital, the doctor first briefly inquired about Liu Han's symptoms, and carefully observed that the whites of Liu Han's eyes were yellow, and his skin was also yellow, and the most common yellowing of the skin was liver problems. After inquiry, it was learned that Liu Han was a carrier of hepatitis B virus and had not been treated with medicine before. It is recommended that Liu Han do not rush to do gastrointestinal endoscopy now, and check the liver function and abdominal B ultrasound first.
Although Liu Han thought it was strange, he still did it. The ultrasound results came out quickly, showing that the liver volume was slightly smaller, the edges were rounded and blunt, and the jagged changes were present, and the diffuse thickening of the echogenicity of the liver parenchyma was enhanced, which was consistent with the sonographic changes of cirrhosis. Blood images showed ALT 441IU/L, AST 453 IU/L, and hepatitis B virus DNA values reached 100.0e3cps/ml, and replication was very active. Diagnosis of compensated cirrhosis.
Cirrhosis is a chronic, progressive liver disease that is a persistent form of liver damage caused by long-term or repeated action for a variety of reasons. It is divided into two stages according to the compensatory capacity of the liver. The first is the compensatory period, when the symptoms are mild, often due to gastrointestinal congestion, secretion and absorption dysfunction, resulting in fatigue, loss of appetite and indigestion such as diarrhea, abdominal distension and other manifestations. Because there is no specific manifestation, this is also the reason why Liu Han thinks that he has gastrointestinal problems.
Regarding this news, Liu Han expressed disbelief. The hoarse voice asked the doctor with difficulty: "Although I am a carrier of hepatitis B virus, I have not had a seizure in the past few decades, not to mention that the test results were normal half a year ago, how could it suddenly become liver cirrhosis?"
The doctor regretted telling him that hepatitis B carriers often have weakened immunity due to factors such as drinking alcohol and staying up late, causing the hepatitis B virus to become active and progress to hepatitis B. Persistent inflammation will lead to damage and even necrosis of liver cells, and over time, fibrosis of liver cells will lead to the destruction of the normal structure and blood supply of the liver, which can lead to liver cirrhosis and even liver cancer. This is also the reason why he progressed to cirrhosis.
After listening to this, the doctor sighed regretfully and said: "This is because your indicators at that time were not abnormal, if you had come to the hospital for treatment earlier, it would not have progressed to the point of cirrhosis, and there is indeed a saying that hepatitis B carriers do not need treatment, but it also needs to be divided into these three conditions......
First, the condition is mild
Viral hepatitis B is an infectious disease caused by hepatitis B virus, mainly liver lesions, if the patient's condition is relatively mild or the liver function is not significantly impaired, usually do not need to take medicine, Liu Han is in this situation.
The second is drug allergies
If you are allergic and allergic to drugs used to treat hepatitis B, you usually do not need to take medicine to avoid allergic reactions to drugs, such as itching, redness and swelling of the skin.
The third is the reference viral load
If the viral load in the body is found to be negative during the examination, or if the viral load in the body gradually stabilizes, the activity may be relatively low, and the damage to the body will be relatively mild, so there is no need to take medicine. However, it is necessary to follow the doctor's instructions for regular follow-up and daily protection.
For hepatitis B carriers, they should not let their guard down when they do not have abnormal liver function, and hepatitis B carriers often have decreased resistance due to factors such as drinking alcohol and staying up late, causing hepatitis B virus to become active and become hepatitis B patients. Therefore, for hepatitis B carriers, maintaining a reasonable and scientific lifestyle and regular life are the primary prerequisites to prevent the accelerated progression of liver disease.
One is to get enough sleep. Everyone knows that staying up late hurts the liver. The liver is generally detoxified at 21 to 23 o'clock, and staying up late will cause the burden on the liver to increase. Second, alcohol must be banned. The ethanol in wine is decomposed into acetic acid and acetaldehyde in the liver, which can directly damage liver cells and hinder liver metabolism, so drinking alcohol is a taboo for patients with liver disease.
The third is to keep the diet light. A high-sugar and high-fat diet will increase the burden on the liver, resulting in high blood lipids in the body, which cannot be metabolized by the liver, and will be deposited in the liver and become fatty liver. Therefore, we should try to eat less of these foods in our daily life. Eat more fruits and vegetables, supplement more vitamins and protein, protein is of great significance for the repair and regeneration of liver cells.
And vitamins have the effect of protecting the liver, for example, vitamin B has the effect of repairing liver function, preventing fatty liver, and enhancing alcohol resistance, among which eggs, meat, vegetables, cereals, etc. are rich in vitamin B, vitamin C can promote liver tissue metabolism, improve liver function, prevent and treat liver steatosis, promote liver tissue detoxification, common fruits are tomatoes, kiwifruit, etc.
Of course, it is also important to maintain a positive and healthy attitude, as the saying goes, anger is easy to hurt the liver, and the regulation of mood is important to protect the liver.