Second liver turns shade is not a dream!

"Patient of liver of 103 chronic second of Chinese is cured thoroughly! " in January 2007 hair of the middle ten days of a month is in this the report on many media of countrywide, carelessness is: Through growing effect interferon cure. The exterior antigen of 103 first patients already turned shade, occurrence surface antibody, this means them to be cured thoroughly. Pick off buckle overhead to make a person this breathless " second liver cap " . Our country is a second liver big country, the population of 1/10 carries second liver virus, according to estimation, the number that comes on among them has 2000 much. "Patient of liver of 103 chronic second of Chinese is cured thoroughly " if the message weighs pound bomb with, tremendous echo is caused in countrywide each district. Somebody is filled with exultation, after thinking to experience old cold winter, can build eventually on the subway; somebody that leaves for spring uncertainty, because they suffer the harm; somebody of false conduct propaganda to appear quite indignant however for years, think this is a false news. The 3rd kind reacts, in home forum of liver of a few second thes upper part of the body be gotten now particularly intense, the card one's words of netizens is intense, the quarrelling sound. This lets a share originally glad unceasingly, the wardmate that cherishing a hope, mood in a flash as putting fire on the ice double day. Is its truth after all what kind of? Infect, the print that why must fear 　 reports so goes out can you cause the situation with public intense response? Above all, there are a such words in the newspaper that publishs this report -- " (turn successfully to these exterior antigen the patient) of shade, mean them to have infectivity no longer, also do not need to distribute food with others again. " a lot of media of domestic think this report has shock sex very much, reprint in succession, but realize this problem without a media unexpectedly. The second liver patient of our country is in the life, job get originally a lot of discrimination, the psychology of a lot of people in them is very depressive, the heart is very sensitive, this word may make their place becomes secondhand one disaster after another. The thing that has a personal experience makes reporter feeling fine much. Once the reporter is away on official business other place, visited an old schoolmate incidentally. Old schoolmate is a do the honours of, take the reporter to hall of a Western-style food. The reporter says to eat not Western-style food of be used to, the hope changes course eating Hunan. This answering advocate along with the guest, but did not think of old schoolmate insists to want to eat Western-style food. Between banquet, old schoolmate mentions recent condition with the reporter, groaned old a long time. Original, a year ago he by fish it is the person that second liver virus is carried, the eye of this kin changed completely. Result, have a meal to mother-in-law home every time, domestic person is afraid of mother-in-law greatly to be infected, do not wish to be the same as with him desk have a meal, this lets him harm suffers greatly in the heart. The word is told come here, the be readily solved of a knot in one's heart of reporter mind. Original, think so in classmate heart: Western-style food eats apart, everybody eats each each, across infects; and won't take the word of Chinese meal, everybody places dish in a dish, easy across is infected. This kind of thing is not individual absolutely, comparative however general. Neighbour Miss Yuan of the reporter, she has a good sister Xiaoyi, two people significance is immense. Home of classics haunt Miss Yuan has a meal before Xiaoyi, but from 3 months before, xiaoyi will string together the door to be done not have so diligent before. Even if came, arrive every time have a meal time, she also is met try every means looks for an excuse to leave, anyway does not agree to stay have a meal. Later, miss Yuan just is informed, the fish when the check-up before 3 months carries Xiaoyi second liver virus, her concern infects Miss Yuan, take care everywhere so, do not dine jointly with Miss Yuan as far as possible. Still have a case more " unusual " . Pair of a very short time get along, the lover with very good feeling, when the man by fish it is the person that second liver virus is carried when, the woman is extremely intense. Actually she has made second liver vaccine before, there already was protection antibody inside body, but she is hiding the truth from liver of second of assay of exsanguinate of Wan of cure of haunt of male friendly classics unexpectedly two half-and-half. To the transmission way of second liver, by China liver disease society and China affect ill society to combine formulate " guideline of prevention and cure of chronic second liver " already had very clear explanation. " guideline of prevention and cure of chronic second liver " in point out clearly: "The skin of main classics blood and hematic products, Mu Ying, damaged and mucous membrane reach second liver virus the gender contacts transmission. " the blood of mother of positive of second liver virus mixes bring into contact with of the baby when childbirth humoral, it is the main way that Mu Ying spreads. And classics skin mucous membrane travels, basically happen at using the medical apparatus and instruments without strict disinfection, injector, invade operation of sexual diagnosis and treatment and operation, and vein drug taking. Other the accident in if trim aperture of the sufficient, tattoo, annulus that bind side, medical personnel,working is exposed, common razor and tooth brush also can travel. As electropositive as second liver virus person sexual contact, the person that have many sexes partner especially, the dangerous sex that its affect is apparent heighten. But, "Routine or life are contacted, if man makes handclasp, same office (include to wait for office things with the computer in all) , live together have dinner of one dormitory, same dining-room and common the toilet, without the contact that blood exposes, won't infect second liver virus commonly " . Link: Vaccinal, the liver of methodological 　 second with precautionary second the most effective liver is vaccinal, it is the method with the most effective liver of current precaution second. Because of this surface antigen (antibody of HBsAg) negative, surface (HBsAb) is electronegative person, best liver of can vaccinal second is vaccinal. At present vaccine of liver of our country vaccinal second is used more 0, 1, method of 6 months have an inoculation, hit the 1st times 1 times respectively again when 6 a month after have an inoculation, months namely, altogether is hit 3 times, produce protection antibody below a complete and vaccinal program commonly (HBsAb) . If discover the surface to antibody already disappeared or drip,spend fall to protection limit is the following, need seasonable reseed. Grow effect interferon, had mastered get used to card 　 　 " patient of liver of 103 chronic second is cured thoroughly " after news print goes out, rise the following day, the person that in succession many second liver are affected emerges person hospital, seek advice or ask to use lasting effect interferon. Many doctors point out anxiously: "There are many liver functions now of negative of normal, DNA small 3 this world person, also will ask to grow effect interferon. " why do Doctor 　 doctors worry so? liver function of negative of normal, DNA small 3 this world person what misgivings to have with lasting effect interferon? The expert tells us, whether does the person that decide liver of a second is affected need to undertake disease-resistant poison is treated, depend on 3 assay check a result: It is the liver that check second two half-and-half, seeing E antigen is masculine gender or electronegative; 2 it is to check liver function, see transaminase (ALT) is elevatory reach lift what degree; 3 it is DNA of virus of Cha Yi liver, look see virus quantity whether exceed a level. The concern of such not fathomless doctors. Small 3 this world (namely E antigen is electronegative) , liver function is normal (transaminase is not elevatory) , DNA is electronegative (virus quantity did not exceed bid) person, it is the person that second liver virus is carried merely, can not delimit the cavalcade of second liver patient, these people need treatment far from. Blind cure, not only effect of it doesn't matter, and increase economic burden, body burden and psychological burden can meaninglessly only. Even if the patient that real need has fighting virus remedial, they also are not comfortable operable interferon length effect. With nucleotide kind disease-resistant bane photograph is compared, lasting effect interferon is having more strict get used to card. Apply to the hepatitis activity with unusually fluctuant transaminase commonly period, transaminase does not exceed 400 units (normal value is 0~40 unit) , liver function is in acting countervail period, ability suffers interferon undesirable reactor, patient of the youth in be opposite especially, the effect is better. No matter be lasting effect interferon or common interferon, using a process medium can appear a few harmful response, nevertheless among them major undesirable reaction is longitudinal, may alleviate by oneself, have a few only (1%~5%) is severe undesirable reaction. So, for safe for the purpose of, have the person of following case, unfavorable use interferon: After oneself immunity disease, thyroiditis, Jia Kang, depressed disease and schizophrenia, kidney transplant, severe coronary heart disease and gravid wait. Before use interferon is treated, the doctor can ask medical history carefully commonly, the choice suits the case of illness that treats with interferon. To every the plan uses the patient that interferon treats, can hepatic to its, kidney, heart mixes the doctor endocrine function, and the harmful response that appears possibly undertakes assessment, show the action of interferon and the undesirable reaction that appear possibly to the patient in detail, agree with asking for those who get a patient and cooperate. Such, while ability makes interferon is producing the biggest curative effect, will harmful response is decreased the smallest. Link: The harmful response 　 of interferon applies in interferon inchoate, the commonnest harmful response is calorific, shiver, have a headache, the symptom of similar flu appearance such as ache of joint of lack of power, muscle. Inside hour of inject interferon 3~8, almost all patients can appear flu appearance symptom, especially after stitch injects the most serious. But, major patient is to be able to be able to bear or endure to occurrence symptom suffer, and the symptom after the needle is counted to be able to be reduced gradually in inject, and as the elapse of time disappear gradually. Because grow effect interferon to compare stability in chroma of content of haemal Chinese traditional medicine, flu appearance is so undesirable response occurence rate is opposite commonner interferon is low. Interferon has the medullary inhibition of different level, in the patient that accordingly use interferon treats, have 20%~30% reachs 2~3 15 days in cure inside the month, meeting occurrence leucocyte is spent gently or in the tiger drops. At this moment, stimulate the medicaments that leucocyte grows through application, can make the leucocyte of major patient is maintained in the level that can accept treatment. Restrain to a few marrow serious person, ought to stop interferon treatment instantly. Additional, interferon is brought about possibly still spirit, neurological unusual, immunity and internal system are unusual wait for harmful response. These harmful response are reversible mostly. Young patient is right of interferon be able to bear or endure it is better to suffer a gender. Teach in Wu Shanming (Fudan University is accessary doctor of director of communal and wholesome center, Shanghai affects Shanghai committee member of ill institute vice director) the success in the hand turns a girl of shade, during hitting lasting effect interferon, the hair was dropped 1/3. Nevertheless, after cure ends, the girl's hair grew afresh. Although a few netizens are on forum,treat the 3 states 　 of the target one's words is intense, but the netizen of a few uncertainty still conveyed them to yearn for eagerly to what cure: "I hope this is true very much really, true him hope can resemble a normal person, true him hope can make the patient of the 104th heal. " 　 is short word, used 3 " hope very much really " , wardmate people the sort of mood that sends the hope from the bottom of the heart and rise and fall of disappointed ups and downs, let a reporter be touched. The word that has an a friend made in hospital or people who become friends in hospital says quite meaningly, he says life has 3 great rejoicing, it is respectively " liver of Hua Zhu of autograph of golden a list of names posted up, bridal chamber, second turns shade " . This makes a reporter can'ted help remembering 2007 the beginning of the year 3 inferior that one act of liver ill conference. 3 inferior one of subjects that liver ill conference discusses, it is to include to grow effect interferon inside disease-resistant poison treats plan, the exterior antigen that makes in second liver cure the patient appears turns shade phenomenon. In the meantime, discussed the immune mechanism that place of this kind of phenomenon involves, and in clinical go up how to raise the question such as efficiency. After academic conference ends, there is a communication to meet between expert and reporter. At that time, in every reporter before, putting bottle of a glass. In each glass bottle, installing ten pompon that fold with the scrip of all sorts of color. Attendant reporter pompon each spreads out, see only above writing: "The hope does not have check-up forever " , " the hope is all ' comrade-in-arms ' size 3 this world turn completely shade " , " hope next year need not take medicine again " ... 　 this one a desire, from disease of the liver on the net the cento in forum comes down, sentence an aspirations that is second liver wardmate and its family. So, treat a level with current second liver, our good cause and real cause, what be respectively? Wang Ziming is taught (committee member of vice director of institute of China feeling catch a disease, adviser of doctor of director of ill division of infection of southwest hospital of the third Military Medical University, doctoral student) humor ground made an example: If the remedial effect second liver according to the coronal, inferior, Ji Jun will award prize, so stand in Ji Jun locally is " second liver virus duplicates to be restrained " , those who stand in runner-up to get award stage to go up is " E antigen is serological changeover (namely E antigen turns shade, e antibody appears) " , and those who stand in champion to get award stage to go up is " exterior antigen is serological changeover (namely exterior antigen turns antibody of shade, surface appears) " . King Professor Yu Ming points out: "If the argue assimilate to medicaments and virus is a war, so, the disease-resistant poison cure of second liver has 4 kinds of final result normally. Be over namely get the better of (full wipe out) , triumph (suffer a defeat) , keep within limits (alleviate) , not if really (invalid) . " the state with highest 　 is of course " champion target " -- be over get the better of, liver function returns to normal in those days, virus DNA turns shade, the most crucial is exterior antigen turns shade, occurrence surface antibody (HBsAb) , this is an ideal outcome, but efficiency remains to rise. The means of this word, at present we accomplish exterior antigen to turn likely shade, but efficiency is very low still, only the small number of people can come true. 103 obtain exterior antigen the case of illness of serological changeover, brought a hope to broad patient. Additional, very important is, these case of illness bring us certain enlightenment, we need further analysis to discover better program, with raising exterior antigen serological changeover produces rate. This good cause is to build in obtain E antigen serological changeover (runner-up target) on the foundation. Serological changeover, liver function mixes E antigen normally virus DNA turns shade, this is a satisfactory below current remedial level final result. According to Wang Yu bright professor introduces, current nucleotide kind medicaments, rate of E antigen changeover is average the E antigen changeover that grows effect interferon in 20% or so; is led slightly tall, it is about 32% . In other words, pass normal disease-resistant poison to treat, have near the patient of 1/3 can be achieved " runner-up target " . In the meantime, professor Wang points out, turn to realizing E antigen the patient of shade, once resist virus medicaments out of service hind, partial patient appears again likely E antigen, return afresh " big 3 this world " condition. So, stability also remains to rise. If " runner-up target " do not come true, then we can accept virus temporary by low-key " Ji Jun target " , at this moment liver function DNA of normal, virus turns shade. After achieving this goal, can consider to lengthen cure, combination other medication, or change the cure of order follow in a continuous line of other remedy, or await opportunity reentry to be treated all right. If 3 targets cannot realize above, ending is invalid. Investigate its reason, as undeserved as opportunity choice or airframe immunity cannot be aroused to concern, be about to consider to change at this moment medicaments, or await opportunity reentry to be treated all right. In cure, the doctors and patients that keeps close communicates 　 　 " a when she hides the needle around the school a small shop attached to a school that sells cold drink, oneself inject to oneself, every Monday second. " just hear this word, a lot of people will be astonied perhaps: This person is it possible that it is pothead won'ts do, hide drugs into buffet actually? This person not only not be pothead, and the female undergraduate that still is perseverance adamancy, what is she doing after all then? Old crescent is taught (accessary Beijing bless installs capital medical university committee member of vice director of chapter of Beijing of society of disease of liver of hospital director doctor, China) revealed truth for the reporter. This is a female undergraduate of 21 years old, when 6 years old by fish " big 3 this world " . Because liver function is normal, and without any unwell symptoms, accordingly, the doctor suggests to observe first temporarily, wait for transaminase to be treated high again. In the cure of second liver. Transaminase whether tower above standard, it is a very main index, it can measure second liver patient to whether lie of cure relatively beautiful opportunity. Transaminase is normal, mean airframe to be in immunity to be able to bear or endure to second liver virus suffer period, common ground is told, it is system of the immunity inside body has not been been opposite second liver virus launchs attack, rely on the disease-resistant bane of the outside only at this moment, lack " collaborate from within with forces from outside " , be hard of beat back virus, right now disease-resistant poisonous result is bad. So, the doctor does not advocate the patient is able to bear or endure in immunity commonly suffer period have treatment. When the girl reads second year in high school, transaminase appears elevatory. The doctor uses common interferon treatment to her, but used half an year to do not have how old the effect. Because girl school work compares insecurity, often give or take an injection no-go, then out of service interferon, convert rummy husband decides profess to convinced. But use,arrive when the 14th month, virus DNA quantity rebounds, this meant virus to appear mutation is able to bear or endure medicine. This is nucleotide kind a of disease-resistant bane " common fault " . Tell the truth, rummy husband restrains second liver virus surely, no matter be speed or intensity, it is pretty good, but the biggest question appears easily namely virus is able to bear or endure medicine. 2005 of Adefuwei appear on the market, solved what partial rummy husband decides to be able to bear or endure medical problem. The favour later replaces Ka Wei, have in respect of disease-resistant poisonous intensity rise further, be able to bear or endure property of a medicine also is reduced greatly. Of course, this is hind word. The girl the circumstance at that time is not to have medicine to be able to be used at all. After old crescent professor accepted this case, via relapsing balance, decision first husband of rummy of out of service is decided, although such doing,have the risk that virus rebounds. But because stop drug for some time, the part is able to bear or endure surely to rummy husband medical patient, can restore the sensitivity that decides to rummy husband afresh. Right now, the girl is tall already 3 graduation, take an examination of an university of the other place. Every month goes to girl of Professor Chen requirement exsanguinate of local normal hospital checks the index such as liver function, let the girl fax the assay sheet that examines every time to her, narrate illness calls in the meantime. Every month checks first half an year, every time normal, check with respect to 3 two every months later, all the time stabler. But stop medical hind surely from rummy husband, passed one year about half, the girl's transaminase lifts again to 300 many units. Professor Chen decision is used to her " lasting effect interferon + rummy husband is decided " associated therapy. Because do not want to let teacher and classmate know, the girl thought a way, to a few save cost, lasting effect interferon the needle is put aside around the school one sells a small shop attached to a school of cold drink, oneself note element of blackberry lily faze regularly, inject to oneself like diabetic patient insulin is same. Although such doing very troublesome, but the girl abides by a doctor strictly enjoin, held to near two years, obtained E antigen to turn eventually shade, the serological changeover that still realized exterior antigen finally (namely exterior antigen disappears, exterior antibody occurrence) . Professor Chen says: "Good communication is very important between doctor and patient. The patient should understand two 3 needles cannot solve a problem, and this needle is hit may appear have a fever, leucocyte is reduced... if the patient does not have psychology to prepare, would rather not treat. " who has 　 more turn the hope 　 of shade should speak of exterior antigen turning when the case of shade, professor Chen says: "A successful case ignited the patient's hope, also gave a doctor more encouragement and confidence. In treating a process, the doctor is to staring at E antigen changeover not just, if the patient appears good suggestion of a new development, can continue to go after taller hope, namely exterior antigen changeover. " 　 after all what kind of patient does antigen of hopeful occurrence surface change? What person will make favorite likely? Teach the introduction according to Wu Shanming: "Two each months detect regularly the drop of E antigen and exterior antigen is spent. If E antigen has from Gao Shuiping the trend to low-level change, that explains this patient realizes the serological changeover of E antigen very likely. Among the patient that in successful implementation E antigen changes, 9% control what can realize exterior antigen to turn the occurrence of shade and exterior antibody. " 　 considers to show, e antigen changeover is the foundation that realizes exterior antigen changeover. Inside the half an year that treating (24 weeks of) , if can realize E antigen changeover, the probability that will realize exterior antigen changeover that henceforth will be relatively hopeful. Look, half an year is a bank. The exterior antigen that lasting effect interferon obtains is serological changeover, happen on average in E antigen serological changeover continues to treat 4~6 after the month. Tall ALT value and low virus carry the patient of the quantity, produce E antigen and exterior antigen the time of serological changeover is shorter. Among them young patient, remedial effect is apparent. 103 obtain the person that exterior antigen is changed, average age is 30 years old. Common interferon also can make exterior antigen turns shade, but the time that grows effect interferon to achieve this goal is shorter. Will solve this now by wardmate people the problem of a focus of doubt, namely these 103 patients, choose from inside how many patient. To this problem, bright professor says Wang Yu: "These 103 patients are be collected from domestic share hospital and come, use lasting effect to interferon is treated and obtain exterior antigen to turn of shade. But this meantime, shared how many patient to use lasting effect interferon after all, exterior antigen turns how much is the per cent of shade, because do not have extensive investigation, we return this number temporarily more difficult statistic. " bright professor still expresses 　 Wang Yu, 3 inferior the purpose of liver ill conference, just include to grow effect interferon to discuss these 103 patients to use inside disease-resistant poison treats plan, get exterior antigen the phenomenon of serological changeover, the hope studies from which and fumble a definite pattern and reason, let more patients will achieve this cure goal henceforth. The media that reports this news above all regrettablly did not write the expert's explanation go in, as a result caused the misunderstanding of a lot of wardmate. Exterior antigen turns the patient of shade, stable have a relapse no longer? Bright professor tells Wang Yu the reporter, according to the circumstance that observes at present, the stability of these patients is very good, basically like normal person. This kind of condition and the patient after acute affects second liver to get be controllinged effectively are identical. Also the report says, "Already kept clear of when antigen of surface of patient of chronic second liver, DNA of virus of liver of the second in blood already cannot be measured, when liver organizes inflammation to already disappeared, inside the liver organization of the person that the second liver that still has 37% restores, still low-level CccDNA exists " . CccDNA is the pattern plate with second liver duplicate virus, the CccDNA of this kind of low-level content, whether can bring recrudesce of the liver that send second, still remain long-term observation just has affirmative verdict. Exterior antigen turns shade, 　 of unfavorable and beyond the mark apply colours to a drawing has we needed to emphasize here at 2 o'clock: The first, lasting effect interferon can increase exterior antigen to turn really the probability of shade, but look with current condition, present exterior antigen turns shade rate is very low still, can turn of shade is a small number of people only. We ought to be made clear, our real cause is to restrain virus DNA, realize E antigen changeover. Exterior antigen is changed, can go after the patient that changes to already obtaining E antigen, but do not importune. And the remedial cost of lasting effect interferon is very high, stitch 1300 multivariate, hit stitch every week, period of treatment of a year should hit 48~52 needle, grow effect interferon only this one expenses for medicine exceeds 60 thousand. Plus other examination fee, handle the remedial cost of harmful response, not 779 next it is very difficult to be afraid getting come. And, of lasting effect interferon the course chooses get used to a crowd strictly. So, the patient needs to make thorough communication with doctor in charge of a case, once the understanding; that the harmful response that appears to treating the likelihood in the process wants to have profundity is resolved use, must cooperate with the doctor with all one's strength, maintain very good comply with sex, such ability obtain first-rate result likely. The 2nd, hepatitis activity period the patient should undertake disease-resistant poison is treated, cannot shake at this o'clock. " guideline of prevention and cure of chronic second liver " middle finger goes out, the Chongzhongzhi that refusing ill poisonous treatment is second liver cure is heavy. And the cent of disease-resistant bane content that already appeared on the market in home at present and already gained international to approbate is two kinds big: One kind is with rummy the husband is decided, the nucleotide that Adefuwei, favour is a delegate for Ka Wei kind medicaments, another kind is interferon kind, include common interferon and lasting effect interferon. Nucleotide kind it is medicaments of profess to convinced, use convenient; interferon kind it is inject sex medicaments, common interferon is to lie between a day to hit stitch commonly, lasting effect interferon is OK a week hits stitch. One is in our country the research of the progress of disease of second liver virus that Taiwan has in 11893 males and liver cancer shows, if normal person (ALT of acerbity transaminase of ammonia of exterior antigen negative, E antigen negative, third is normal) the risk that gets liver cancer is spent it is the word of 1 surely, so, e antigen positive, ALT is elevatory (namely common says " big 3 this world " ) second liver patient, its get the danger of cancer of the liver to spend is 109. If can turn E antigen shade, if making ALT returns to normal, its danger is spent can fall for 10.3. Why should this fall ALT to namely normal, turn E antigen into feminine account. This also is the main reason that disease-resistant poison should popularize energetically. Note: Article part content consults Xu Daozhen is taught (group of prevention and cure of hepatitis of professor of doctor of director of hospital of Beijing ground altar, Beijing University epidemiology, Ministry of Public Health and committee member of expert advisory committee, SFDA is clinical director of medicaments research base) chief editor, in September 2006 by people sanitation press, thanks here! (responsibility edits: King sea E)