1. Does liver function be normal, just look at transaminase levels?
The liver is a large chemical plant, plays a very important role in human metabolism. Speaking of liver function, most people think that liver function is good, just look at transaminase (ALT and AST) on the line, but in fact, reflect the liver function indicators more than these two projects, including albumin, globulin, choline ester Enzymes, coagulation function and serum bilirubin and so on. Some patients have normal levels of transaminases, but protein electrophoresis shows that globulin is elevated, albumin is falling, and white-blood ratio is inversion (normal range is 1.5-2.5, less than 1.5 is inverted), indicating that chronic hepatitis may have developed to cirrhosis; Cholinesterase levels decreased, also indicating that the liver has been damaged.
So, whether the normal liver function, must not only look at transaminase, but also to determine the other indicators of integration.
In addition, different hospitals with the detection of different reagents, biochemical analyzer is different, the measured transaminase normal values are also different. In You'an Hospital, men with a normal upper limit of ALT of 40, 35 women. In the liver function indicators, ALT levels change the most sensitive, because it is in the cytoplasm of liver cells, AST is located in the mitochondria of liver cells, once the liver cells are destroyed, ALT will be the first leak to the blood was detected. However, some patients with cirrhosis, check the normal ALT normal, AST is elevated, but also that liver dysfunction.
2. Liver function is normal, indicating that hepatitis B is not serious?
This is not absolute, there is a saying before: "flexible motor transaminase, terrible yellow, stubborn T". Why is it called a flexible transaminase? For patients with chronic hepatitis B, may be tired will lead to increased viral replication, elevated transaminase levels, but because the liver itself is very strong compensatory capacity, with some liver medicine or simply do not deal with, a few days of transaminase will be able to own down The Therefore, the level of transaminase is very easy to change, a single liver function test results are normal, and can not explain the hepatitis B condition is not serious.
In addition, "terrible yellow" refers to: patients with jaundice, serum bilirubin increased, indicating that the condition increased; "stubborn T" refers to the past used to determine the plasma level of TTT experiments (thyme Turbidity test), has now been replaced with protein electrophoresis, which can be judged by chronic hepatitis is mild, moderate, or severe, or has been developed to the extent of hepatitis cirrhosis.
3. Liver function is normal, the risk of progress is lower?
As mentioned above, liver function is normal, can only explain the current compensatory capacity of the liver is not bad, does not mean that the disease will not develop. It was 10 people (liver cells) to work, now reduced to 5 people (virus activity destroys part of the liver cells), although the fight strength, the effort can also complete the liver of the chemical plant work, but this situation is not absolute No, because the virus is still continuous replication, damage to normal liver cells. If the delay is not treated, the future will certainly continue to develop the disease, the development of cirrhosis, liver cancer risk will not be reduced.
4. Liver function is normal, is not that hepatitis B is a carrier state?
Usually we say that carriers should be in the immune tolerance of chronic hepatitis B virus carriers, that is to say the body and the virus in a peaceful coexistence of the state, the immune system has not launched an attack on the virus, liver cells did not appear Had obvious damage. In addition to normal liver function, the patient also to meet the following conditions, can be regarded as a real carrier:
1) hepatitis B five e antigen positive, often on behalf of the infection time is relatively short;
2) viral load is relatively high, generally 10 of the 7 power, 8 times or so;
3) patients with no more than two levels of liver inflammation and more than two liver fibrosis;
4) patients can do regular review, every 3 to 6 months to check once, did not find ALT elevated!
If a 50-year-old, older patients, liver function is normal, but the viral load is not very high, about 10 of the 3 times or so, then he may have long been infected with hepatitis B virus, has been with the virus Years of struggle. If the liver cells can not be restored, the liver stellate cells will produce fiber cord, fill the damaged liver cell space, and slowly will develop into hepatitis cirrhosis of the liver. The Therefore, the above patients do not belong to the real chronic carriers.
5. Liver function is normal, do not have Antiviral treatment?
The patient's liver function is normal, if the judge is indeed in the carrier state, the body has not started the immune system against the virus, then do not need, nor is it suitable for antiretroviral treatment; but if the patient has developed to cirrhosis, we believe that As long as the virus can be found, even if the liver function is normal, have anti-viral treatment.
Some patients with liver medicine or reduce the enzyme medicine, liver function test results are normal, that the disease control, and no need to be Antiviral. In fact, this idea is wrong, it is similar to bacterial infection caused by pneumonia, antipyretic analgesics is to alleviate the symptoms, palliative, and antibiotics is a cure, you can clear the bacteria in vitro; hepatitis is caused by the virus Of the liver medicine, reduce the enzyme can only transaminase down to reduce liver damage, the same is a temporary solution, Antiviral treatment is the key.
So, do not Antiviral, must not just look at transaminase, just look at liver function, must be comprehensive judgments, or it is easy to delay the disease. In addition, the patient must remember that early Antiviral early benefit, late Antiviral late benefit, no Antiviral no benefit!