How many hepatitis B patients are there in China?

According to authoritative statistics, at present, there are about10.2 billion chronic asymptomatic hepatitis B virus carriers and about 30 million chronic hepatitis B patients in China. Just from the number of hepatitis B virus carriers, it is almost one tenth of the people in the country.

When interviewed by reporters, they will not forget to add the same requirement-"confidentiality". They are usually more willing to accept the indirect communication of words and sounds, even if they are near you. A large part of their hidden worries come from social pressure.

A graduate student of hepatitis B said that it was incredible that a graduate friend who didn't know the inside story said to his face that everyone with hepatitis B should be killed. Another patient witnessed a student with hepatitis B being thrown out of the quilt by his roommate in winter at school.

Our reporter once reported a hepatitis patient named Wang Wanmin. His family paid a huge sum of money to let him travel abroad, and the tourists' fears were almost abnormal: two travelers from the same company fought for a seat far away from him and refused to put his luggage with their own. Some people even threw away all the photos about Wang Wanmin when they came back.

A patient was outraged by this: Isn't the money used every day infected with the virus? Why does everyone like it so much?

A sample survey of 808 people in Beijing, Guangzhou and Shanghai showed that 40.5% of them didn't know about hepatitis B or couldn't answer the questions. When asked how to be infected, the defect of common sense is more obvious, and 72.5% people answered incorrectly.

Liu Shijin, a doctor in the 302 Hospital of Beijing People's Liberation Army, believes that there is a blind prejudice in the society's understanding of hepatitis B virus carriers and patients. People are too afraid of the infectivity of hepatitis B. In fact, in China, the main route of hepatitis B infection is vertical transmission, that is, it is transmitted from generation to generation because of blood relationship, accounting for more than 50%; Another way is iatrogenic blood transmission, such as injection, acupuncture and incomplete disinfection during tooth implantation, accounting for 30%-40%; Other circumstances, such as sexual contact, close life contact, mosquito bites, etc. , are not clear. 302 Hospital once conducted an investigation. Among 263 couples, one was infected with hepatitis B virus before marriage, and the other was infected less than 6% five years after marriage. In addition, most adults can rely on their own immunity to keep the virus out of the body. The harmfulness of hepatitis B virus infection is inversely proportional to age. Newborns and infants are the most susceptible to infection, while the probability of adult infection is only 2%.

The actual marriage situation between hepatitis B patients and virus carriers is fragile. A question that puzzles many patients is: should I tell my lover about my illness?

Xiao Chen is the "Three Yang" with normal liver function. He chose to hide it. Because his girlfriend asked him if he was a hepatitis B patient the day after she met him. She has been living in the shadow of her father's hepatitis B, living alone in a dark room. With the deepening of feelings, Xiao Chen finally told the truth, and fear made his girlfriend walk away.

Another "Little Sanyang" patient posted his girlfriend's email address on the online forum "Overcoming Hepatitis B" after her girlfriend left, begging the experts to send her a letter and say a few words for him. In the girlfriend's view, hepatitis B will definitely lead to cirrhosis, liver cancer and death.

A sick netizen hit a wall many times and posted personals on the Internet: Non-hepatitis B patients don't get married!

In September, 2000, at the 10 National Academic Conference on Viral Hepatitis and Liver Diseases, the Hepatology Branch and the Infectious Diseases and Parasitology Branch of the Chinese Medical Association revised the Prevention and Treatment Plan for Viral Hepatitis. According to the plan, carriers of hepatitis B surface antigen refer to those who are positive for surface antigen, but have no symptoms and signs of hepatitis, and all liver function tests are normal, and there is no change after observation for half a year. Experts pointed out that hepatitis B surface antigen carriers have the right to get married, but they should inform both parties of this situation during premarital examination and check their spouses before marriage. If the liver function is normal and the surface antibody is positive, they can immediately approve marriage; If the spouse of a hepatitis B virus carrier is completely negative in the five items of "two and a half" of hepatitis B virus, she should be injected with hepatitis B vaccine and wait until protective antibodies are produced in the body for 3 to 7 months before getting married. Whether the mother or the father carries surface antigen or not, the newborn must be injected with hepatitis B vaccine within 24 hours after birth, and strengthened at 1 month and 6 months after delivery respectively. For newborns with positive mother surface antigen and E antigen, it is best to inject hepatitis B high-efficiency immunoglobulin within 24 hours after birth. Studies have shown that after vaccination, the preventive protection of newborns is above 95%.

At the same time, the plan pointed out that such carriers should not be treated as hepatitis patients, and they can work and study as usual except for not donating blood and engaging in direct contact with imported food and conservation, but follow-up should be strengthened.

The reality is that many large enterprises and companies, especially joint venture recruiters and government departments, have to check the hepatitis B index, and many outstanding talents are turned away because they are carriers. Gao Feixia, who ranked first in the recruitment of local civil servants this year, lost his scenery after being found out of hepatitis B virus in the physical examination, and finally started a business of picking up passengers on the street by motorcycle.

There are also some colleges and universities that ignore the relevant regulations of the Ministry of Education and the Health Department and force students with hepatitis B virus to drop out of school and ask them to return to school after the hepatitis B core antigen turns negative. Scientific research shows that it is almost impossible for the core antigen in chronic hepatitis B virus markers to turn negative.

Some graduate students and graduating college students will ask a helpless question: What methods can deceive employers to pass the physical examination?

When interviewed by this reporter, Liu Jiaoshou, an academician of China Academy of Engineering and Institute of Pharmacy of China Academy of Medical Sciences, hoped that the relevant administrative and personnel departments could observe people's feelings and relax the policy appropriately.

The draft "Guidelines for the Management of Hepatitis B Surface Antigen Carriers" formulated by the Hepatology Branch of Beijing Branch of Chinese Medical Association points out: Hepatitis B virus will not be transmitted to others through respiratory tract or normal digestive tract, and there is no need to be afraid of working in the same room, sitting at the same table, reading newspapers or documents together, talking or even alienating, discriminating and panicking in the workplace. According to Dr. Liu Shijin, such standardized and operable guidelines are rare at present. It is not mandatory and has low influence, but after all, it represents a new starting point for the medical community to understand hepatitis B, and also represents the voices of carriers and patients. He hoped that the relevant state departments would consider enacting laws and regulations to protect the rights and interests of HBV carriers and patients.

According to Dr. Liu Shijin, in Malaysia, Singapore and other countries, as well as Taiwan Province Province and Hongkong, it is easier to be infected with hepatitis B virus than Chinese mainland, but there are no restrictions on hepatitis B virus carriers and patients.

The expert's opinion is that reasonable prevention and popularization of hepatitis B vaccination is a powerful measure to fundamentally reduce the incidence of hepatitis. According to reports, since 1992, China has included hepatitis B vaccine in the scope of planned immunization, but it is not as mandatory as smallpox, cholera and polio vaccines. In Beijing, Shanghai and other cities, 100% of newborns were vaccinated; However, the situation at the county and township levels is far from ideal. According to a survey, only13 people in China have been vaccinated with hepatitis B vaccine.

Crazy hepatitis B drug advertisement

How to identify deceptive propaganda; Limitations and misunderstandings of existing treatment methods; Correct treatment method

During the interview, many hepatitis B patients were angry with the advertisements of hepatitis B drugs: the theory of gene therapy, the theory of unique ingredients, and even the advertisements from mysterious fields that were almost witchcraft were overwhelming.

In sharp contrast, when GlaxoWellcome introduced its new hepatitis B drug "Hepudin" (Lamivudine) to Guangzhou, it did not mention anything about the "curative effect" that patients were extremely concerned about, nor did it mention anything about the effective rate and cure rate. It just shows that the drug can inhibit the replication of hepatitis B virus, reduce the damage of the virus to the liver, and hopefully avoid the occurrence of liver cancer. Some patients put forward the question of "Yang turns to Yin", and the answer is: "Little Three Yang turns to Yin", which the medical profession can't do at present.

Ms. Qin Li, Director of the Circulation Department of the Market Supervision Department of the State Administration of Pharmaceutical Products, told this reporter: As early as 1995, the "Standards for Examination of Drug Advertisements" promulgated by the state clearly stipulated that drug advertisements should not contain unscientific assertions or guarantees indicating efficacy, and should not be proved by the names and images of state organs, medical research institutions, academic institutions or experts, scholars, doctors and patients. The Drug Administration Law, which was revised at the beginning of this year, added the contents of "If the indications or functional indications of drugs exceed the prescribed scope, they shall be punished as counterfeit drugs" and "Advertisers who illegally publish false drug advertisements shall not accept their drug advertisement declaration within one year". Among the numerous drug advertisements we actually contact, hepatitis is indeed the most confusing, and the situation of changing the contents of advertisements without authorization is still very serious. Most of the drug supervision departments are doing "useless work".

A doctor who signed "Hong" collected many years' experience and analyzed several iconic features of such advertisements in health newspapers: it can turn HBsAg negative (according to Professor Xu Daozhen, a famous infectious disease expert, whoever can turn HBsAg negative to 65,438+00% will be eligible for the Nobel Prize); Can make all antigens turn negative and antibodies turn positive; Can completely remove or kill hepatitis B virus; Create a new "theory" or "theory"; Advertisements are hyped up, but regular hospitals are hard to find.

If unfortunately suffering from hepatitis B, where is the way out for patients' treatment?

Experts pointed out that, first of all, having "big three yang" or "small three yang" does not mean that it is a hepatitis B patient; Whether treatment is needed depends on whether there is liver injury and the severity of liver injury. Because both of them can only reflect the existence of the virus in the body, or reflect the strength of infectivity, but can not reflect the severity of liver damage. Because the level of virus replication is not directly related to the severity of liver injury, more viruses may not cause serious liver injury, and less viruses may not cause mild liver injury. In other words, patients with "big three yang" are not necessarily heavy, and patients with "small three yang" are not necessarily light.

For patients with hepatitis B, experts remind us that we must first make clear what situation we are in. There are four stages of chronic hepatitis, namely mild, moderate, severe and severe, and there are different treatment schemes at different stages. Most patients are in a mild stage. At this time, patients must find a regular hospital and a regular doctor, use less drugs, use enough courses of treatment, closely monitor and review regularly; Don't use drugs indiscriminately, and pay attention to the indications. For example, interferon is only suitable for some patients in China, and it is ineffective for patients with blood-related infection to take interferon. Lamivudine is effective, but it does not help to change or eliminate the virus carrying state.

Professor Xiong Sidong, director of Fudan Medical College and Shanghai Center for Genetic Immunity and Vaccine Research, believes that the international community has not yet reached a clear understanding of the key mechanism of hepatitis B, which gives the so-called mixed drug in China the opportunity to "conquer hepatitis B". Rebuilding immunity to hepatitis B virus may be a more fundamental and effective strategy to solve chronic hepatitis B infection. According to this new idea, they developed a new biological preparation-solid matrix antibody complex, which aims to eliminate the immune tolerance of hepatitis B virus and has been approved for clinical trials.

Liu Jiaoshou believes that a considerable number of hepatitis B virus carriers may carry the virus for life, but their liver function is normal. At present, there is no recognized drug that can turn surface antigen negative at home and abroad. Blindly taking a large number of therapeutic Chinese and western medicines after turning negative will only increase the burden on the liver or lead to adverse consequences. For patients with hepatitis B, there are drugs that make transaminase return to normal, the effective rate is above 50%, or the negative rate of E antigen is about 30%, but the recurrence rate is high and the price is high after stopping the drug, which is inconvenient for long-term injection. Some hepatitis prevention and treatment medical staff use antiviral drugs regardless of whether the virus replication index is positive or not; Or "three-dimensional tactics" for patients, while applying 10 drugs, intravenous drip, intramuscular injection, oral administration and external use together, which is harmful and useless. The administrative department of health should strengthen the clean-up of unqualified "medical points" and "places specializing in hepatitis". Patients should continue to pay attention to self-protection and regular review, "three-point treatment and seven-point care", have good living habits, regular daily life, proper physical and mental exercise, maintain optimistic mood, have a light diet, enhance their physique, improve their immunity and prevent the occurrence of cirrhosis and liver cancer.

Noun interpretation

Hepatitis B "two and a half"

It refers to HBsAg (surface antigen), anti-—HBs (surface antibody), HBe(e antigen), anti-HBe (e antibody) and anti-—HBc (core antibody). In addition, HBc (core antigen) will appear on the hepatitis B checklist. The outer membrane of HBV particles is called surface antigen, and the inner core is divided into core antigen and e antigen.

Hepatitis B virus carriers

According to the Prevention and Treatment Plan for Viral Hepatitis, HBsAg carriers (hepatitis B virus carriers) refer to those who are HBsAg positive, but have no symptoms and signs of hepatitis, and all liver function tests are normal, and have not changed for half a year.

"Small Sanyang" and "Big Sanyang"

In the "two-and-a-half" test of hepatitis B virus index, people are used to calling HBsAg, HBeAg and anti-—HBc positive at the same time as "three big positives". Those who are positive for HBsAg, anti-HBe and anti-HBc at the same time are called "Xiao Sanyang".