Let’s talk about what is hepatitis B?

The big three positives are actually used to detect three indicators of human immunity to hepatitis B virus. Many people do not understand the big three positives and think that this is a more serious disease. In fact, the big three positives only indicate the activity level of hepatitis B virus in the human body.

Disease Introduction

In the new edition of "Guidelines for the Prevention and Treatment of Hepatitis B in China", there should be two standard medical names for "Big Three Yang", namely chronic HBV carriers and chronic hepatitis B with positive e antigen.

Chronic HBV carriers: Most of them are HBsAg, HBeAg and HBV DNA positive in the immune tolerance period. Continuous follow-up for more than 3 times within 1 year showed that serum ALT and AST were within the normal range, and there were no obvious abnormalities in liver histological examination.

Chronic hepatitis B with positive e antigen: serum HBsAg and HBeAg are positive, anti-HBe is negative, HBV DNA is positive, ALT is continuously or repeatedly elevated, or liver histological examination shows hepatitis lesions.

To thoroughly understand what e-antigen-positive hepatitis B and e-antigen-negative hepatitis B are, we need to understand the structure, replication, mutation and natural history of the hepatitis B virus in the body. The following explains these aspects.

Clinical manifestations

1. Chronic HBV carriers are mostly asymptomatic and are often in the immune tolerance period. Except for the "big three positives" and positive virus tests, other growth indicators and even pathological indicators are normal. Although no drug treatment is required during this period, regular testing and observation are required to detect disease progression in time. Studies on carriers have also shown that a small number of carriers have normal liver function, but the disease still progresses. After several years, it can also progress to hepatitis, cirrhosis and even liver cancer. Therefore, regular check-ups are required to detect disease progression in time and intervene in time.

2. Chronic hepatitis B: It can be divided into three types: mild, moderate and severe according to the condition.

Mild: The condition is relatively mild, with recurrent symptoms of fatigue, dizziness, loss of appetite, aversion to oil, yellow urine, discomfort in the liver area, poor sleep, slightly enlarged liver with slight tenderness, and mild splenomegaly. Some cases have no symptoms or signs. Only 1 or 2 liver function indicators were slightly abnormal.

Moderate: Symptoms, signs, and laboratory tests are between mild and severe.

Severe: There are obvious or persistent symptoms of hepatitis, such as fatigue, poor appetite, abdominal distension, yellow urine, loose stools, etc., accompanied by liver disease face, liver palms, spider nevi, splenomegaly, repeated or persistent increase in ALT and/or aspartate aminotransferase (AST), decreased albumin, and significantly increased immunoglobulin G.