According to the 2006 National Hepatitis B epidemiological survey shows that China's existing chronic HBV infection of about 93 million people, of which about 20 million cases of chronic hepatitis B patients. However, the Chinese Academy of Engineering Professor Zhuang Hui pointed out that the current status of chronic hepatitis B treatment is still not optimistic.
Antiviral therapy is the principle of chronic hepatitis B treatment, but many patients in the absence of obvious symptoms, no related treatment, up to check the liver function. About 3% to 6% of patients develop cirrhosis each year and eventually become liver cancer.
First, clear the standard of chronic hepatitis B antiviral
1, HBeAg-positive, HBV DNA ≥105 copies / m (equivalent to 2000 IU / mL); HBeAg-negative, HBV DNA ≥104 copies / m (equivalent to 2000 IU / mL);
2, ALT ≥ 2 × ULN, such as treatment with interferon, ALT should be ≤ 10 × ULN, serum total bilirubin should be <2 × ULN;
3, ALT <2 × ULN, but liver histology showed Knodell HAI ≥ 4, or inflammatory necrosis ≥ G2, or fibrosis ≥ S2.
For persistent HBV DNA positive, fail to meet the above treatment criteria, but one of the following circumstances, should also be considered to give antiviral therapy.
1, for ALT greater than the normal upper limit and age> 40 years of age, should also consider antiretroviral therapy.
2, if the liver histology shows Knodell HAI ≥ 4, or inflammation necrosis ≥ G2, or fibrosis ≥ S2, should be close to the liver, Actively give antiviral therapy.
3, dynamic observation found that the evidence of disease progression (such as spleen increased), the proposed liver histological examination, if necessary, to give antiviral therapy.
In the beginning of treatment should be ruled out by drugs, alcohol or other factors caused by elevated ALT, ALT should also be excluded after the application of ALT drugs temporarily normal. In some special cases such as cirrhosis or taking biphenyl structural derivatives, the AST level can be higher than ALT, AST level can be used as a major indicator.