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A*****d
发帖数: 82 | 1 向版上懂医的好心人咨询下我姐的乙肝该怎么治，万分感谢！
我那可怜的姐姐，上小学的时候帮助流鼻血的同学，不小心接触到同学的血液感染了乙
肝（在那很久后得知那同学和她的家人都有乙肝）。
发现患病的时候已经距离接触同学血液有一段时间了，因为我姐姐和我妈睡一起，我妈
也受到感染（后来痊愈）；但我姐姐一直为乙肝病魔折磨着，除了健康，还有精神的折
磨。
现在姐姐快要结婚了，前几天到亲戚那里准备去注射免疫球蛋白（亲戚说帮忙带她去的
，父母都不在身边，他们也东那些）；然后亲戚带我姐先去做了检查，后来又劝我姐姐
说注射免疫球蛋白没什么用，然后我姐就回去上班了。（本来我姐知道自己的情况，说
不用再检查了，她想直接去注射；检查完在我那亲戚家住了一晚，第二天他们就跟我姐
说注射那个没用，不想带她去了）今天我姐给我打电话，哭着告诉我这些，自己相当的
难过，为什么当初没有下定决心去学医（自己也清楚学医也只是懂得多一点，能给她一
些建议，治病主要还是钱的问题）。姐姐在电话中哭，一是因为自己的病，二是因为那
亲戚的态度的转变，按我姐姐和她转述我姑姑的话来说，就是因为我姐在他们家过了一
晚，他们觉得可能感染他们，受到了牵连。我清楚那家亲戚，好的时候让你感觉好关心
你，无情的时候也很绝；其他的亲戚大多不大跟他们家来往，只有我姑姑和他们来往多
些，这事我开始不知道，估计也是我姑姑“操心”弄的。
早些年，我姐和我妈查出病的时候，都去医，我妈感染的轻些，成年人体质也好些，没
多久我妈就好了；我姐却一直没好。那时国内对这个病也没什么好的治疗方法，我爸比
较偏信中医，大多时是去看的中医，吃中药。治了一段时间，我姐也没有太大的好转，
加上我爸开始走下坡路（我家是农村的，开始算是农村家境比较好的人家），三个小孩
读书（我有两个姐姐，病的是我大姐），我爸也对治好我姐的病不大抱希望，也没再花
大的功夫帮我姐治病。
我姐姐就这样一直拖着疾病读书（也曾受到学校老师的歧视），上完大专，工作了两三
年，再考研，读研……如果我姐不是这病应该会过得很不错，她小学的时候写了东西寄
到报社发表过，在我们那个小农场的学校是唯一。
好了，不说这些没用的了。
如今我姐快结婚了，她也明白自己的病难治，但是她想生小孩，希望版上懂医的人能提
供一些医疗建议和资讯。国内能够找到的一些治乙肝的咨询都不大靠谱，大的医院或许
能是，但经济条件限制没办法去治。再次感谢！ | b******a
发帖数: 704 | 2 ZZ: What is hepatitis B? — Hepatitis B is a serious disease that harms the
liver. The liver is a big organ in the upper right side of the belly. A
virus causes this disease. The virus spreads from person to person when
their bodily fluids touch. This can happen in a few ways, like having sex or
sharing needles.
It is estimated that there are more than 300 million carriers of the
hepatitis B virus in the world, with over 500,000 dying annually from
hepatitis B-related liver disease. In China, HBV carrier was estimated 10-
20%.
Fortunately, several medications are available for the treatment of chronic
hepatitis B, and hepatitis B infection can be prevented by vaccination.
Hepatitis B vaccines are safe and highly effective in preventing hepatitis B
infection and are now given routinely to newborns and children in the
United States and in many other countries.
What are the symptoms of hepatitis B? — When people first get hepatitis B,
they can feel like they have the flu. Some people’s eyes or skin turn
yellow (called jaundice). These symptoms usually get better, but it can take
weeks to months.
About 1 out of every 20 adults who gets hepatitis B ends up having the
disease for a long time. This is called “chronic” hepatitis B. Most people
with chronic hepatitis B have no symptoms. But, over time, the infection
can lead to a liver condition called cirrhosis. Symptoms of cirrhosis
include:
Swelling in the belly and legs, and fluid buildup in the lungs
Bruising or bleeding easily
Trouble breathing
Feeling full
Confusion that can come on suddenly
Coma
Chronic hepatitis B also increases the risk of getting liver cancer.
How did I get the disease? — There are a few ways to catch the hepatitis B
virus. All of them involve mixing bodily fluids with other people.
Perinatal infection is the predominant mode of transmission in high
prevalence areas such as China. In comparison, horizontal transmission,
particularly in early childhood, accounts for most cases of chronic HBV
infection in intermediate prevalence areas such as Japan, while unprotected
sexual intercourse and intravenous drug use in adults are the major routes
of spread in low prevalence area such as USA.
You might have caught the disease by:
-horizontal transmission : Children may acquire HBV infection through
horizontal transmission via minor breaks in the skin or mucous membranes or
close bodily contacts with other children. In addition, HBV can survive
outside the human body for a prolonged period; as a result, transmission via
contaminated household articles such as toothbrushes, razors, and even toys
may be possible. Although HBV DNA has been detected in various bodily
secretions of hepatitis B carriers, there is no firm evidence of HBV
transmission via body fluid.
Contaminated needles — Using contaminated needles can spread the hepatitis
B virus. This includes tattooing, acupuncture, and ear piercing (if these
procedures are performed with contaminated instruments). Sharing needles or
syringes can also spread the virus.
Sex — Sexual contact with someone who is infected is one of the most common
ways to become infected with hepatitis B. If you are infected with
hepatitis B, make sure your spouse or sex partner gets vaccinated.
Mother to infant — Hepatitis B can be passed from a mother to her baby
during or shortly after delivery. Having a Cesarean delivery (also called a
C-section) does not prevent the virus from spreading. Experts believe that
breastfeeding is safe.
During pregnancy, all women should have a blood test for a marker of
hepatitis B virus, called hepatitis B surface antigen (HBsAg). Normally, the
HBsAg should be negative.
If the mother's HBsAg test is positive, the infant should be given a shot
soon after birth (called hepatitis B immunoglobulin or HBIG). HBIG provides
immediate protection to the infant, but the effect only lasts a few months.
The infant should get the hepatitis B vaccine at birth, at 1 to 2 months,
and at 6 months. Finishing all three doses is important for long-term
protection. The infant should have a blood test for hepatitis B infection
and for hepatitis B antibody at 9 to 18 months of age; if the antibody test
is negative, a fourth dose of the vaccine should be given at that time. In
some cases, the mother is also given a medication that reduces the amount of
virus in her blood for several weeks before giving birth.
Is there a test for hepatitis B? — Yes. If your doctor or nurse suspects
you have hepatitis B, he or she will do a routine exam to check for other
problems. But he or she will probably also order a blood test to check for
the virus. Your doctor might also want to remove a small sample of your
liver to see if it is damaged. This is called a “biopsy.”
If you want to know more detailed information, a number of tests that can
be used to diagnose or monitor hepatitis B infection. Most of these tests
are blood tests and include those that detect:
Hepatitis B surface antigen (abbreviated HBsAg) – HBsAg is a
protein on the surface of the hepatitis B virus. This protein shows up in
the blood 1 to 10 weeks after exposure to the hepatitis B virus and before a
person starts to show symptoms of the infection. In people who recover,
this protein usually disappears after 4 to 6 months. Its continued presence
suggests that chronic infection has developed.
Hepatitis B surface antibody (abbreviated anti-HBs) – Anti-HBs
is a protein that helps the body's immune system attack the hepatitis B
virus. This protein is usually present in people who have recovered or who
have been vaccinated against hepatitis B. People with this protein are
usually immune to hepatitis B.
Hepatitis B core antibody (abbreviated anti-HBc) – Anti-HBc is
a protein that helps the body's immune system attack the hepatitis B virus.
This protein is usually present throughout the course of infection and stays
in the blood after recovery. It is not present in people who have been
vaccinated against hepatitis B.
Hepatitis B e antigen (abbreviated HBeAg) – HBeAg is a protein
whose presence indicates that the hepatitis B virus is continuing to make
copies of itself (replicating). Its presence usually indicates a high level
of circulating virus and a high chance of transmission of infection.
Hepatitis B e antibody (abbreviated anti-HBe) – Anti-HBe is a
protein that helps the immune system attack the hepatitis B virus. Its
appearance usually signifies that virus replication has slowed down, but in
some variants of hepatitis B, the virus continues to replicate at a rapid
rate, and high levels of virus can be found in the circulation.
Hepatitis B DNA (abbreviated HBV DNA) – HBV DNA is the genetic
material found in the hepatitis B virus. HBV DNA usually disappears from the
blood after a person recovers. HBV DNA is a measure of the concentration of
virus in the circulating blood. Doctors use the levels of HBV DNA to decide
who is a candidate for treatment with antiviral medicines and to track how
well treatment is working.
Other tests – There are many other tests that can reflect the
health of the liver but are not specific for hepatitis B. Examples include
liver enzyme tests (ALT and AST), bilirubin, alkaline phosphatase, albumin,
prothrombin time and platelet count.
A liver biopsy is not routinely needed to diagnose hepatitis B. A liver
biopsy is used to monitor liver damage in people with chronic hepatitis,
help decide if treatment is needed, and find signs of cirrhosis or liver
cancer.
How is hepatitis B treated? — For people who have chronic hepatitis B,
treatments include:
Medicines that fight the virus. There are several types. Your
doctor will choose the right one for you, based on your symptoms.
A liver transplant. In severe cases, people with hepatitis B
need a new liver.
Having an ultrasound test every 6 months to make sure they are
not developing liver cancer. An ultrasound creates pictures of the inside of
the body.
Is there anything I can do to protect my liver? — Yes. You can:
Avoid alcohol
Get vaccinated for hepatitis A and other diseases, including the
flu and pneumonia
Ask your doctor or nurse before taking any over-the-counter pain
medicines. (These medicines can sometimes damage the liver.)
How can I avoid giving the disease to other people?
PREVENT INFECTION OF FAMILY — Acute and chronic hepatitis B are contagious.
Thus, people with hepatitis B should discuss measures to reduce the risk of
infecting close contacts. This includes the following:
Discuss the infection with any sexual partners and use a latex
condom with every sexual encounter.
Do not share razors, toothbrushes, or anything that has blood on
it.
Cover open sores and cuts with a bandage.
Do not donate blood, body organs, other tissues, or sperm.
Immediate family and household members should be tested for
hepatitis B. Anyone who is at risk of hepatitis B infection should be
vaccinated.
Do not share any injection drug equipment (needles, syringes).
Clean blood spills with a mixture of 1 part household bleach to
9 parts water.
What if I want to get pregnant? — If you want to get pregnant, talk to your
doctor or nurse first. If you are infected when you give birth, your baby
should get a special shot right away. This shot helps protect your baby from
infection. You might also need treatment with a medicine for several weeks
before giving birth. Plus, your baby will get a vaccine shot at 1 or 2
months old, and another one at 6 months. A test between 9 and 18 months will
show if the baby has the disease. If not, he or she will get another
vaccine shot then.
What will my life be like? — Many people with hepatitis B are able to live
NORMAL lives. It is still safe to:
Hug and kiss
Share forks, spoons, and cups
Sneeze and cough around other people
Breastfeed
不是专家，只是顺口说说，对中国的医疗系统也不是很了解。希望在泱泱乙肝大国，普
通的疾病得到控制，患者能有正常的医疗随访和生活。
1. 首先确定你的姐姐的慢性肝炎的情况，有无传染性。是否是活动期，是否肝功能受
损，是否需要药物治疗。
2. 如何判断是否是病毒活性期，基层医院应该做乙肝的血液检验就可以得到结论。乙
肝HBV一套抗原抗体，肝功能（ALT，AST），如果活动期，病毒DNA拷贝数（PCR）；没
有传染性的乙肝病毒携带者应该不需要特别的隔离。也不需要有精神负担。如果是病毒
活跃期，为了自己的家人和接触者，注意防范。
3. 如果精神负担如此大，花一些钱到比较正规的医院做检查和治疗，应该利大于弊。
坦诚自己的疾病，接受疾病的事实，积极治疗，延缓肝硬化的进展，预防或及早诊断
HCC。
4. 家人，配偶和亲戚们没有保护性的乙肝表面抗原抗体的，接受乙肝疫苗免疫（3次）
并查抗体水平。
5. 如果想生孩子，先诊断和控制疾病。 新生儿及早抗体治疗，疫苗免疫。 | A*****d
发帖数: 82 | 3 谢谢你！
之前都觉得老姐很强大，理智，乐观；但即将步入婚姻是却还是显示出女人的柔弱。 |
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