How to stay away from liver troubles? Please take this liver guide

July 28, 2024 is the 14th World Hepatitis Day. According to data, there are about 86 million hepatitis B carriers in my country, of which 28 million are hepatitis B patients who need treatment, and about 10 million are hepatitis C patients, and more than 200 million are fatty liver patients. How to stay away from "liver" disturbances? What is the prevalence of hepatitis B and hepatitis C in Henan Province? On July 26, Dahe.com invited Zhang Xiaoxiao, deputy chief physician of the Immunization Program Institute of Henan Provincial Center for Disease Control and Prevention, and Ji Xiaoyu, chief physician of the AIDS Prevention Institute of Henan Provincial Center for Disease Control and Prevention, to share "liver" goods with netizens.

Hepatitis B virus infection can easily lead to liver cancer

The occurrence of liver cancer is closely related to hepatitis B, and prevention of liver cancer depends largely on prevention of hepatitis B.

"Hepatitis is a general term for inflammatory diseases of the liver, which can be caused by a variety of factors, including bacteria, viruses, parasites, alcohol, drugs, chemicals, autoimmunity, etc." Zhang Xiaoxiao said that viral hepatitis is the most common type. It is a group of systemic infectious diseases caused by various hepatitis viruses and mainly causes liver damage. Both children and adults can get sick. Clinically, the main symptoms are fatigue, loss of appetite, aversion to oil, abnormal liver function, and jaundice in some cases. According to the type of virus infected, it can currently be divided into five types: hepatitis A, hepatitis B, hepatitis C, hepatitis D, and hepatitis E.

Zhang Xiaoxiao introduced that my country used to be a "hepatitis B country", but the number of patients has dropped significantly after measures such as hepatitis B vaccination and the implementation of mother-to-child transmission prevention projects. At present, according to the results of serum epidemiological survey, it is estimated that there are about 1.8 million hepatitis B carriers in the province, of which 600,000 are hepatitis B patients who need treatment, and the peak of hepatitis B epidemic is gradually shifting back.

"Our province ranks first in the country in terms of the number of existing hepatitis C cases. According to the latest data as of June this year, there are still 295,100 existing cases in our province, and the number of reported hepatitis C cases is about 20,000 each year." Ji Xiaoyu reminded that hepatitis C patients are generally older, generally between 45 and 75 years old, accounting for about 83%. With the development of hepatitis C prevention and control work, the reported incidence of hepatitis C has been declining year by year, and in the past two years it has been about 20/100,000.

Zhang Xiaoxiao said that hepatitis B is caused by the hepatitis B virus (HBV), and is an infectious disease characterized by liver inflammation and necrosis. The clinical manifestations are mainly digestive tract symptoms (such as loss of appetite, general fatigue, nausea, vomiting, abdominal pain, jaundice, etc.), accompanied by other systemic symptoms. The course of the disease is prolonged and can easily turn into chronic hepatitis, cirrhosis and liver cancer. Hepatitis B is mainly transmitted from mother to child (including intrauterine transmission, transmission during delivery and postpartum transmission), blood transmission (such as blood and blood products contaminated by HBV, etc.), sexual contact, etc. Daily contact such as working together, eating, shaking hands, etc. will not spread hepatitis B.

Relevant research shows that 60% to 80% of primary liver cancer cases in my country are caused by hepatitis B virus infection.

Hepatitis C is curable and the cure rate is high

"Hepatitis C is divided into acute hepatitis C and chronic hepatitis C." Ji Xiaoyu said that the main symptoms of acute hepatitis C are similar to those of a cold, such as general fatigue, loss of appetite, nausea and right upper abdominal pain. There are no characteristic manifestations and it is easily overlooked.

Ji Xiaoyu believes that chronic hepatitis C is more hidden and has no obvious symptoms. Most patients seek medical treatment due to extra-hepatic manifestations. Some may be discovered to have hepatitis C when they seek medical treatment due to joint pain, hyperthyroidism, etc. If not treated in time, it can easily develop into cirrhosis and liver cancer.

"Many people have the impression that 'direct contact in daily life can lead to infection with hepatitis C', but this is incorrect." Ji Xiaoyu said that there are three main ways of transmission of hepatitis C: blood transmission, sexual transmission and vertical transmission from mother to child.

Ji Xiaoyu said that both hepatitis B and hepatitis C patients will experience fatigue, nausea, vomiting, loss of appetite, and abdominal distension after meals, while the clinical symptoms of hepatitis C are milder than those of hepatitis B. Most hepatitis C patients have no obvious symptoms and signs and are easily ignored. After long-term chronic development, 5% to 15% will develop into cirrhosis. Once cirrhosis develops, the annual incidence of liver cancer will reach 2% to 4%. Therefore, hepatitis C is commonly known as the "silent killer."

"At present, the World Health Organization recommends the use of direct-acting antiviral drugs, that is, small-molecule antiviral drugs, for people infected with hepatitis C. Small-molecule antiviral drugs are oral drugs, usually taken orally for 12 to 24 weeks. In fact, the standard says that hepatitis C can be cured in 84 days, and the cure rate is still very high, reaching 90% or even more than 95%." Ji Xiaoyu said that many therapeutic drugs can be reimbursed by medical insurance, and patients only need to bear a small part of the treatment costs to be cured. The reimbursement rate for general employee medical insurance is about 80%, and that for urban and rural medical insurance is about 70%. After the entire course of treatment is reimbursed, the drug costs borne by individuals are between 2,000 and 3,000 yuan.

Vaccination protects both yourself and your family

"Currently, there is no vaccine available for hepatitis C, but a vaccine can be given to prevent hepatitis B." Zhang Xiaoxiao said that the vaccination procedure for the hepatitis B vaccine is "0-1-6", with a total of three doses, with the second dose being one month apart from the first dose, and the third dose being six months apart from the first dose.

Zhang Xiaoxiao reminded that newborns should be vaccinated with hepatitis B vaccine in time after birth. Generally, the first dose should be given within 24 hours after birth. For newborns whose mothers are hepatitis B virus carriers, the first dose of hepatitis B vaccine and immunoglobulin should be given within 12 hours after birth to ensure mother-to-child transmission.

Secondly, people in special occupations, such as medical and health workers, who may frequently come into contact with the hepatitis B virus, should check their antibody levels regularly. For those with low or no antibodies, they should be given hepatitis B vaccination in a timely manner.

At the same time, some people with immunodeficiency or low immunity, or other special groups, such as those who often need dialysis or blood transfusions, should be vaccinated with hepatitis B vaccine in a timely manner.

In order to reduce the risk of liver cancer caused by hepatitis B, Zhang Xiaoxiao recommends that hepatitis B patients undergo regular liver function tests and liver imaging tests to detect signs of cirrhosis or liver cancer early. At the same time, hepatitis B should be actively treated to control viral replication and reduce liver damage. For patients who have already developed cirrhosis, closer monitoring and management are required.

In daily life, people should avoid drinking alcohol and contact with potentially contaminated blood or body fluids, and maintain a healthy lifestyle, such as eating a healthy diet, exercising moderately, and avoiding excessive fatigue. In addition, she suggested that patients and their families receive popular science education to understand the transmission routes and prevention measures of hepatitis B, and reduce discrimination and misunderstandings against patients.

Ji Xiaoyu said that there is still a long way to go in the prevention and control of hepatitis. Screening should be expanded to find patients who need treatment as early as possible. Individuals should have regular physical examinations to test liver function and serological indicators of hepatitis B virus, such as surface antigen, core antibody, surface antibody, etc. Through these tests, you can find out whether you are infected with hepatitis B virus in time.