What Is a Hepatitis Carrier?
Hepatitis B virus carrier (AsC) refers to those with chronic hepatitis B virus (HBV) infection who have hepatitis B surface antigen (HBsAg) positive for more than 6 months, have few symptoms and signs related to liver disease, and have basically normal liver function. . HBV serologic marker (HBVM) is a necessary test for diagnosing hepatitis B virus infection. HBV DNA (HBV DNA) test reflects the status or level of virus replication.
Basic Information
- nickname
- HBV carriers
- English name
- hepatitis B virus carrier
- Visiting department
- Department of Infectious Diseases, Gastroenterology
- Common causes
- Mother-to-child transmission, infant infections, weaker infected persons, chronic hepatitis B
Causes of hepatitis B carriers
- It is mainly caused by Hepatitis B virus (HBV) infection, and the source is mother-to-child transmission, infantile infection, sexual transmission, weak resistance, and chronic hepatitis B infection.
- Mother-to-child transmission
- Mother-to-child vertical transmission is the main source of infection for carriers after birth. In the absence of preventive measures, mothers with double hepatitis B surface antigen and hepatitis B e antigen positive mother-to-child transmission of hepatitis B virus are almost 100%. Infants lack immune clearance ability against a large number of invading hepatitis B virus infections, and show an "immunotolerance state". Deoxyribonucleic acid that invades hepatitis B virus can be combined with chromosomal genes of infant liver cells to replicate and reproduce using infant liver cells, and to escape the attack of the body's immune system, which manifests itself as a long-term hepatitis B virus carrying state without symptoms.
- 2. Infant infections
- Young infants who have been in close contact with hepatitis B surface antigen, hepatitis B e antigen-positive mothers, babysitters, and relatives for a long time, such as breastfeeding, feeding, kissing, etc., can cause infections. Because the immune system of the infant is not fully mature, it is unable to clear the virus and tolerate Hepatitis B virus coexists peacefully with it for a long time and becomes a carrier; it can also be infected by vaccination and injection. Infants and young children are about 8 times more likely to be infected and carried in a susceptible environment than adults.
- 3. Weakly infected people
- Adolescents and adults with low or inadequate immune function may not develop disease after exposure to the hepatitis B virus, but they cannot clear the virus, leaving the virus and the body in a state of coexistence and becoming carriers of the hepatitis B virus.
- 5. Transformed from chronic hepatitis B
- Chronic hepatitis B is treated as a carrier of hepatitis B virus.
Clinical manifestations of hepatitis B carriers
- Asymptomatic hepatitis B virus carriers are those who have no symptoms and signs of hepatitis, have HBsAg positive for more than six months, and have normal liver function indicators. Asymptomatic HBV carriers have normal liver function, but patients' liver tissues will have varying degrees of disease. Asymptomatic HBV carriers will also become symptomatic patients. According to statistics, about 10% of the population in China may carry hepatitis B virus. Asymptomatic hepatitis B virus carriers do not represent absolute safety. A certain amount of hepatitis B virus still exists in this group of people, and if the hepatitis B virus in the hepatitis B carriers is in the continuous replication stage, it will lead to gradual damage to the liver tissue of the patient, and then the disease. It may develop into hepatitis, cirrhosis and even liver cancer. Therefore, carriers of hepatitis B should be reviewed regularly.
Hepatitis B carrier test
- The periodic inspection items of HBV carriers mainly include the following aspects: two and a half of HBV; liver function; HBV-DNA, liver, gallbladder and spleen color Doppler ultrasound; HBV mutation detection; HBV typing test; HBV biochip detection .
- Normal data for HBV examination
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- HBV-DNA test, pay close attention to changes in liver function and whether HBV is replicating in the body, find abnormal liver function, virus replication, give symptomatic treatment, do not miss the best treatment time.
Hepatitis B carriers complications
- Carriers of hepatitis B virus need to be actively treated. If not treated in time, it may lead to cirrhosis and even liver cancer.
Hepatitis B carrier treatment
- For HBV carriers with normal liver function and viral DNA negative, treatment is not required, as long as they usually develop good living habits and go to the hospital for regular inspections. For HBV with abnormal liver function and / or viral DNA positive Carriers need to be actively treated. If not treated in time, they may cause liver cirrhosis and even liver cancer.
- At present, the treatment of hepatitis B virus carriers in China mainly adopts antiviral, immune regulation, and anti-fibrotic therapy. The key to treating hepatitis B virus carriers is antiviral and antifibrotic therapy.
- Many factors should be considered when deciding to start treatment, including HBeAg status, ALT concentration, HBV viral load, age (40 years), and liver fibrosis status. Among these variables, ALT concentration, HBV viral load, and HBeAg status are the most important. The normal upper limit of ALT concentration in patients with hepatitis B virus (HBV) infection is 30 U / L for men and 19 U / L for women.
Hepatitis B carrier prognosis
- Regular inspection
- Chronic hepatitis B virus carriers refer to serum HBsAg positive, followed up more than 3 times a year, serum alanine aminotransferase (ALT) are in the normal range, e antigen HBeAg positive or negative, HBV-DNA positive. Some people are not stable and may even develop cirrhosis. Therefore, these carriers of hepatitis B virus should be actively mobilized for liver histological examination. If liver histological examination shows that Knodell hepatitis activity index 4, anti-HBV treatment is needed.
- Inactive HBsAg carriers refer to serum HBsAg-positive, HBeAg-negative, e-antibody positive, HBV DNA negative or below the lower limit of detection. Serum alanine aminotransferase ALT is within the normal range for more than three consecutive follow-up visits a year. Liver histological examination showed that Knodell hepatitis activity index was <4, and this part of carriers of hepatitis B virus generally do not need special treatment.
- The annual incidence of cirrhosis in patients with ALT-normal HBV infection is about 0.5%. The prevalence of liver cancer in HBsAg and HBeAg double-positive and pure HBsAg-positive individuals is 1169 and 324 per 100,000 people per year, while the incidence of liver cancer in HBsAg and HBeAg-negative patients is only 39 per 100,000 people per year . It can be seen that the risk of cirrhosis and liver cancer in "carriers" is slightly higher than that in non-carriers.
- Knowing the status of "HBV carriers" and future outcomes, it can be said that it is difficult to completely remove HBV infection, and it requires long-term dynamic observation and long-term inhibition of virus replication. Patients with inactive HBV status should be closely monitored regardless of whether their treatment is appropriate.
- 2. Hepatitis B virus carriers and patients with hepatitis B should be treated differently
- Hepatitis B is quite common in China, and about 10% of the population is affected by the hepatitis B virus. In this huge population, the vast majority of people should not be regarded as patients with hepatitis B, strictly speaking, they are carriers of hepatitis B virus. Most of them only have HBV in the body, but liver function tests are normal, they can work and study normally, and they have no impact on life. Therefore, carriers of hepatitis B virus and patients with hepatitis B should be treated differently. Relevant Chinese authorities have now issued a series of policies to protect HBV carriers and safeguard the rights of HBV carriers. It is also clear that hepatitis B carriers are not patients with hepatitis B. China is about to lift restrictions on HBV carriers in school and employment. Various circles are studying and discussing this issue, hoping to reach a consensus to better protect the rights and interests of hepatitis B virus carriers.
Hepatitis B carrier prevention
- Mother-to-child transmission is the main route of transmission of hepatitis B in China. 60% of children born to hepatitis B mothers can be infected with hepatitis B virus within two years. The risk of neonatal infection of mothers with "big three positive" hepatitis B is about 70% to 90%, and that of mothers of "small three positive" is about 10% to 40 %. The blocking rate of hepatitis B vaccine alone to block mother-to-child transmission was 87.8%. For newborns of HBsAg-positive mothers, hepatitis B immunoglobulin (HBIG) should be injected as early as 24 hours after birth (within 12 hours after birth) at a dose of 100 IU, and 10 g of recombinant yeast or 20 g Chinese Hamster Oocyte (CHO) Hepatitis B vaccine, vaccination with the second and third doses of Hepatitis B vaccine at 1 and 6 months, respectively, can significantly improve the effect of blocking mother-to-child transmission. It is also possible to inject 1 dose of HBIG within 12 hours after birth, and then inject a second dose of HBIG 1 month later, and inoculate a 10 g recombinant yeast or 20 g CHO hepatitis B vaccine at different locations at the same time, with an interval of 1 month and Hepatitis 2 and 3 vaccines were given at 6 months.
Precautions for hepatitis B carriers
- Hepatitis B virus carriers should pay attention to the following five points:
- 1. Pay attention to balanced diet
- Carriers of hepatitis B virus should not overeating or being hungry. This hunger and uneven eating habits will cause abnormal secretion of digestive juices and cause liver function disorders. Therefore, the diet of HBV carriers should be balanced, and the proportions of protein, carbohydrates, fats, vitamins, minerals, etc. in the food should be maintained accordingly; try to eat less spicy food and eat more fresh vegetables and fruits.
- 2. Liver nourishing the liver needs more water
- Drinking more water can replenish body fluids, enhance blood circulation, and promote metabolism. Drinking more water can also promote the secretion of glands, especially digestive glands and pancreatic juice, bile, to facilitate digestion, absorption, and elimination of waste, and reduce metabolism and toxin Damage to the liver.
- 3. Liver nourishing liver and drinking less
- The liver's energy to metabolize alcohol is limited, and drinking too much can hurt the liver. According to medical research, a healthy person weighing 60 kilograms can only metabolize 60 grams of alcohol per day. If it exceeds the limit, it will affect liver health and even endanger life.
- 4. Keep your mood comfortable
- Optimism makes people healthy. Because the liver is comfortable, the anger is prone to lead to liver qi and blood stasis. In order to have a strong liver, you must first learn to control anger. Even if you are angry, do not exceed 3 minutes. Try your best to be peaceful, optimistic, cheerful, and carefree, so that the liver extinguishes, and the liver qi develops normally and smoothly.
- 5. Right amount of exercise
- Hepatitis B virus carriers should do more outdoor activities, such as walking, walking, playing basketball, playing Taijiquan, etc. These activities can not only popularize blood, promote body vomiting and rejuvenation, strengthen physical fitness, but also can nourish the liver and achieve liver care Purpose.
- In winter, patients with hepatitis B should exercise consciously as a degree of body warmth in the summer, and in the summer should be slightly sweaty, without consciously increasing their heart rate.