Chronic second liver treats " gold "

Mention " chronic hepatitis B " , a lot of people are not new. China is the high popular area of chronic hepatitis B, the virus in average crowd detects positive rate is about 9.09% , that is to say, china about in every 10 people, a person has contracted second liver virus. In the whole world the virus of chronic second liver of 350 million (there is 120 million to be in China in the person that HBV) of the following abbreviation is affected, occupy global 1/3. Face the person that so giant chronic HBV is affected, and many disease-resistant poison treats medicaments, make clear remedial target and choose liver of the most effective second of weapon beat back to be mixed to the doctor the person that affect crucial. Can go up in the summit of expert of second liver immunity that held a few days ago, german Han Nuowei (· of Er of Michael of Hannover) college of medicine graceful this (Professor Michael Manns) and expert of cure of liver of nearly 30 home famous second treat pertinent question development to communicate with respect to second liver, hint as a result through a large number of clinical research: In the remedial process of chronic second liver, of exterior antigen keeping clear of is the accepted first-rate terminus in be being treated at present, in the meantime, can increase the cleared odds of antigen of surface of patient of chronic hepatitis B completely through applying interferon reasonably. Exterior antigen -- slow model hepatitis B diagnoses " decisive index " 　 　 1963, american famous scientist Dr. Baruch Blumberg and Dr. Harvey Alter discover Aa(of a kind of new antigen sex material in Australian native blood first Australian antigen, change after weigh HBsAg, namely) of antigen of surface of second liver virus. This becomes the mark sex event that second liver virus is discovered. After 4 years, dr. Baruch Blumberg and his work in the same placing reported Aa participates in the formation of second liver, made clear this kind of antigen and second liver to concern. Dr. Baruch Blumberg also is obtained accordingly Nobel is physiological 1976 or medical award. Since nearly half century after second liver virus is discovered, although medical bound delivers ill mechanism and treatment around second liver,still undertaking all sorts of discussing, but had reached consensus to the diagnosis of second liver. " guideline of prevention and cure of 2005 China chronic hepatitis B " chronic hepatitis B diagnostic standard is certainly: Have hepatitis B or Shi Chao of positive of antigen of second liver surface spends 6 months, show the face antigen and (or) the person that HBV DNA still is masculine gender. This is clear in the diagnosis of chronic hepatitis B, exterior antigen is a decisive index. Exterior antigen ration is monitored with chronic hepatitis B 　 is current closely related prognosis, medical bound is to the cure of chronic hepatitis B with " utmost ground is restrained for a long time or eliminate second liver virus, relieve liver cell inflammation thereby the necrotic fiber that reach liver is changed, defer and prevent a disease to make progress, keep abreast of and decrease and prevent liver to break the happening of cirrhosis of acting countervail, liver, liver cancer and its complication, the life quality that improves a patient finally and extend patient surviving time " be a target, to reach these long-dated goals, medical bound also chose a few relevant index to undertake quantifying to the development of the disease and prognosis, biochemical index (serum ALT level) , liver organization vivid check, virus learns index (HBV DNA) and immunology index (the serum of E antigen keeps clear of and the serum of changeover and exterior antigen keeps clear of and change) the important basis that become indication disease state namely and forecasts lapse to. But, in the progress of chronic second liver and cure, after all the information that what index hints is close to the prognosis of the disease most? Professor Michael Manns studies through vivid ground is derivative this index: This one research is to be based on get together glycol interferon α - 2a is chronic to E antigen negative the cure of hepatitis B. Consider to make clear: Get together glycol interferon α - negative of antigen of 2a cure E is chronic hepatitis B, in treating ration of antigen of the 48 surfaces when week to monitor the patient of Lt;10 IU/ml, exterior antigen serum is obtained 3 years after cure ends cleared rate is amounted to 52% , and cleared rate is 3 years of its serum after the patient that monitors Gt;10 IU/ml in ration of antigen of the surface when treating 48 weeks is treating an end only 2.3% . Get together glycol interferon α - negative of antigen of 2a cure E is chronic hepatitis B, when treating 48 weeks exterior antigen reduces the patient of Gt;2log, exterior antigen serum is obtained 3 years after cure ends cleared rate is 42.3% , and the patient that reduces Lt;2log when treating 48 weeks, its are obtained 3 years after cure ends cleared rate is serum only 2.9% . Can see from this, the inhibition that although HBV DNA ration detects,also can mirror virus circumstance and virus level, but in get together glycol interferon α - the patient that 2a treats 48 Zhou Shi HBV DNAlt;400cp/ml and HBV DNAgt;400cp/ml, of its surface antigen disappear rate without statistical difference, although HBV DNA ration detects,accordingly clew virus already got inhibition, but what it can't bring about exterior antigen is cleared, reason cannot serve as calculate index. Such, the focus of attention detects with respect to the ration that is centered in exterior antigen on. The mensurable level of antigen of the surface when cure ends and the fall in treating a process extent, with keep clear of later direct and relevant, the ration of clew surface antigen detects is those who achieve second liver to treat top end is remarkable forecast an element. Exterior antigen turns shade -- chronic hepatitis B treats " gold " 　 as to second liver foundation and clinical research gradually thorough, current and clinical on the disease-resistant bane owner that uses at treating chronic hepatitis B should have two kinds: Interferon and nucleotide analogue. Nucleotide analogue passes the inhibition of levels of pair of DNA of second liver virus, will alleviate the virus harm to liver cell, reduce chronic second liver the happening of relevant disease, be a kind fight virus effectively by force to treat medicaments. Can detect in treating a process drop what spend to virus drop apparently. While interferon is fighting virus, adjust host immunity, rise to control the function with cleared virus. Although both mechanism is different, but in nearly half century in the mankind and second liver make a stand against, it is them each victory in helping the mankind obtain second liver to treat. 2007 in American liver ill congress, the expert reachs consensus, turn E antigen shade is fought at the same time - HBe turns E antigen is called when this world serological changeover, state HBV duplicate level is inferior right now, but right now second liver virus still inside cell of consist in liver, still have a relapse likely according to the change of airframe state, because this can not express second liver,had cured. But, study the data shows, turn via interferon is treated and obtaining E antigen in the patient of shade, 60% can achieve exterior antigen to turn shade, what realize second liver thereby is clinical " cure " . Because the serological changeover of this E antigen is called,second liver is treated medium " silver medal " . So, in second liver cure " gold " what be after all? Domestic and international expert thinks consistently, in a certain number of index that evaluate second liver therapy, turn when exterior antigen only shade, appeared even exterior antibody (namely exterior antigen is serological changeover) when, just state the virus inside liver is duplicate the level is extremely low, newborn liver cell is affected no longer, because the liver cell that has been infected by virus is anile and gradually wither dies, through period of time, the virus inside possible cleared liver, obtain chronic hepatitis B consequently " heal " . Of exterior antigen turn shade or serological changeover are a patient be close to cured clinical result what achieve possibly most, should turn exterior antigen shade regards second liver patient as clinical cure optimal respondent standard. If the patient has not produce liver cirrhosis or liver cancer, exterior antigen turns the patient of shade its prognosis is best, because this is called,second liver is treated medium " gold " . The expert refers to this commentate, alleged gold or silver medal, it is the analogy of a kind of figure in fact, of its representing is the different level that second liver treats, relative to character, exterior antigen turns shade is more adjacent at " cure " result. Why to plant can means promote exterior antigen to turn shade odds? Since the prognosis of the cleared rate of exterior antigen and chronic hepatitis B is clear relevant, so clinical it is OK to go up through why be being planted does antigen of means promotion surface turn the odds of shade? Professor Michael Manns also points out: Interferon treats chronic second liver to be able to raise the serum changeover rate of exterior antigen. Like Professor Michael Manns, in Xiang Yi liver is treated " gold " in the process of sprint, a lot of experts more value interferon, outside because divide the exterior antigen nature with the extremely peculiar existence in the crowd,keeping clear of, more it is to pass such as to get together glycol interferon α - function of immunity of 2a adjustment host and obtain. Its argument is one chose 97 to be in 1987-2000 year the research of the patient of chronic second liver of the E antigen positive that gets interferon treatment secondhand. These patients are become two groups by cent, one group to produce E antigen serological changeover and detect inside 24 months the patient that is less than HBV DNA, another group is the patient that did not produce these situations. In these 97 patients that treat through interferon 25 (26%) generation cure is respondent, 24 months after treating an end namely and along with E antigen lasts during visitting serological changeover and detect in serum be less than HBV DNA. In following 11 years when visit on average subsequently, share 28 (the patient of 29%) produced exterior antigen serological changeover. Further analysis discovers, obtain respondent patient's more respondent than was not being obtained patient to produce exterior antigen more easily serological changeover, two groups are in statistical on show notable difference (Plt;0.0001) . In 97 case of illness although 5 produce cancer of the liver, but the patient that doing not have among them is changeover of exterior antigen serum. Study clew, through interferon cure obtains E antigen serological changeover and detect inside 24 months the patient that is less than HBV DNA, because be in,get disease-resistant poison is treated while, function of host oneself immunity also got excitation, because this is in the following follow for a long time in visitting appear more easily the serological changeover of exterior antigen, dog 10 years to be led along with the serological changeover that visits exterior antigen for 60% . In the meantime, the serological changeover of exterior antigen also reduced the happening of cancer of the liver significantly, brought better prognosis to the patient. The choice of disease-resistant bane content should not ignore interferon 　 nearly 10 years to come, as the development that medicaments studies, nucleotide analogue serves as fight virus medicaments effectively by force to be able to be in short-term inside restrain virus effectively duplicate, reduce drop of the virus inside body to spend, because this is in clinical on receive wider and wider application. Face clinical the current situation that uses drug, liver ill expert points out, according to the evidence of abide card medicine that masters at present, to young, female or the patient of chronic second liver that send newly, because airframe immunity force is more powerful, via exterior antigen is being obtained to turn after interferon is treated shade is achieved then clinical " cure " probability is otherer the crowd is fast, if use nucleotide analogue drug as onefold first selection,should regard first selection as; interferon cure, make these young not only the opportunity that delivered a patient newly to lose an immunity of ultra hair oneself to heighten curative effect, and pay possibly still all one's life take medicine or cure to be able to bear or endure medical cost, drop the black hole that treats into second liver from now on. To this, the expert expresses: To the second liver patient of our country, if do not have other and special situation, should cure of first selection interferon. Course of second liver patient gets together glycol interferon α - the serum changeover that the cure of 2a can achieve E antigen not only, return the serological changeover that can achieve exterior antigen, this brought new hope to us. 2007 is interferon discovery 50 years, famous liver disease and immune expert Michael Manns are in Germany the appeal on international liver ill congress everybody: "HBsAg of – of Destination of 　 of Right of 　 of The of 　 of Heading 　 For! " (side with exterior antigen push forward! ) this is medical bound build up date, also lighted the hope with the new person that 350 million chronic HBV is affected. Ill division of liver of Guangzhou Chang'an hospital invites disease of liver of ill expert of countrywide famous liver, China to learn Guangzhou chapter director, Guangdong to save hepatic disease to learn academic committee member Professor Wang Dongfeng to be course leader. Use develop a school of one's own " immunity is triplex therapeutics " remedial second liver is big, small 3 this world, extremely tall reputation is enjoyed in home. To each model the cure of liver of cirrhosis of virus sex hepatitis, liver, fatty liver, alcohol can achieve favorable result. Implementation is accorded with " 3 old standards " , namely standard of check-up of enter a school of acceptable standard of check-up of officeholder of Guangdong province employ, the university entrance exam and hire a standard. (the exercitation edits: Plum apricot)