Hepatitis B antiviral treatment: Why are hepatitis B patients worried that antiviral drugs will not stop taking?
2022-04-30 0 By
Antiviral therapy is the most common way of diagnosis and treatment for hepatitis B patients, and most of them need to take antiviral drugs for a long time.Recently, after a patient was diagnosed with chronic viral hepatitis B, he asked a question. He said that antiviral drugs for hepatitis B should not be stopped when they are taken.This question is not only asked by this patient, but also by many netizens and some patients.Obviously, we will have such a question, because we still lack a certain understanding of hepatitis B antiviral treatment.So TODAY I will answer these questions about hepatitis B anti-virus one by one.What is hepatitis B antiviral treatment?Can second liver patient eat antiviral medicaments to stop?Second liver is treated with antiviral, restrain virus duplication through medicaments since, control virus quantity, a kind of cure means that clears second liver virus finally.Generally speaking, delay the development of second liver virus through taking medicine namely amplify, reduce the risk of serious complications such as liver cirrhosis, liver cancer, liver failure, it is to achieve eliminate second liver virus eventually even, let the patient restore normal purpose.However, because hepatitis B virus is extremely stubborn, most antiviral treatments can only reduce the number of hepatitis B virus, improve the quality of life of patients in the long term, but can not really kill the virus.That’s why patients need long-term medication.Nevertheless this also does not mean that the patient begins to take antiviral drugs, cannot stop, actually second liver patient can stop taking second liver antiviral drugs under certain circumstances.Treatment procedures for chronic Hepatitis B virus Infection management in the United States: 2021 Revision points out that patients with hepatitis B surface antigen negative and liver fibrosis without cirrhosis can consider discontinuation of drugs.Attention should be paid to the HBV DNA test, serological test and ALT level test on a regular basis after patients stop taking antiviral drugs to avoid the further development of HBV.In addition, during hepatitis B antiviral treatment, we should also pay attention to the rational use of antiviral drugs to prevent drug abuse.Ii. How should hepatitis B patients take antiviral drugs reasonably?Hepatitis B patients during the use of antiviral drugs, the first thing to pay attention to is adverse reactions and drug resistance.After taking most antiviral drugs, some people will have some adverse reactions.For example, most hepatitis B patients are taking the antiviral drug Entecavir, some people may experience nausea, fatigue, headache and other adverse reactions after taking the drug.However, most people gradually return to normal after a few days.If you feel unwell during the medication, it is recommended to go to the hospital or consult your doctor if you need to change the medication.In addition, hepatitis B patients should pay special attention to drug resistance, many patients after taking antiviral drugs for a period of time, the efficacy will begin to gradually weaken, some or even completely lose effectiveness, that is, there is a situation of drug resistance.It is recommended that patients change medications according to their doctor’s instructions if they find that they have developed drug resistance while taking medications.If the drug can be replaced with tenofovir with a very low resistance rate, the drug can maintain its efficacy for a long time, and many patients can achieve zero resistance clinically.However, it should be noted that the drug price is higher, and the indication requirements are more stringent.It is also important to note that antiviral therapy is not suitable for everyone. Many antiviral drugs are not suitable for children and pregnant women, and these patients need to be used with caution.Due to the lack of relevant medication guidance and clear regulations on antiviral drugs for children in China, it is suggested that children patients can refer to American standards for medication.Entecavir and lamivudine for children over 2 years of age;Tenofovir and adefovir dipivoxil can be used in hepatitis B patients over 12 years of age.Pregnant women also need antiviral treatment to reduce the risk of HBV infection in their newborns.It is recommended that pregnant women with HBV DNA load greater than 2*106U/m start antiviral therapy with lamivudine, tibivudine or tenofovir at 24 to 28 weeks of gestation and stop taking lamivudine after 1 to 3 months postpartum.Of course, because the individual situation is different, specific medication time and medication rules should follow the doctor’s guidance.In addition, patients with kidney disease should also take antiviral drugs with caution.In the process of being digested and absorbed by the human body, drugs need to go through the metabolism of the kidney, which may cause some adverse effects on the kidney of patients with kidney disease. Therefore, such people should strictly follow the doctor’s advice when taking drugs to avoid further damage to the kidney.What is the antiviral course for hepatitis B patients?Treat a disease is to have certain course of treatment commonly, use medicine especially, cannot eat casually.Similarly, when second liver patient is having antiviral treatment, also have certain course of treatment.The following are some medication courses for different patients for your reference only.1, HBeAG-positive chronic hepatitis B According to the recommendation of hepatitis B guidelines, hBeAg-positive chronic hepatitis B patients, need to take antiviral drugs for at least 4 years, as for whether to stop taking drugs, according to the doctor’s opinion and hepatitis B virus detection and ALT performance, a comprehensive judgment.When ALT of HEPATITIS B virus returns to normal, HBeAg turns negative, and hepatitis B virus test is below the lower limit, it is generally recommended to take antiviral drugs for more than 3 years for consolidation treatment.If the follow-up test is in good condition for a long time during this period, you can choose whether to consider discontinuing the drug according to the doctor’s guidance.2, HBeAg negative chronic hepatitis B HBeAg negative chronic hepatitis B patient, namely small 3 Yang or small 2 Yang hepatitis virus carrier.Generally speaking, such patients because of the high recurrence rate after drug withdrawal, the general treatment course is relatively long.However, there is no specific course of medication for reference. The specific course of medication can be taken according to your own diagnosis and treatment and the guidance given by your doctor.At the same time, attention should be paid to regular review during the medication.As for when to stop your medication, follow the guidelines given above, but follow your doctor’s advice.4, relapse after second liver patient stops medicine, how should do?Because antiviral basically is to inhibit virus replication, cannot clear second liver virus completely, a lot of second liver patients may appear the situation of relapse after stopping medicine.If hepatitis B patients relapse after drug withdrawal, according to the “nucleoside (acid) drugs combined treatment of chronic hepatitis B expert advice”, should be actively re-antiviral treatment, regular use of antiviral drugs.Some patients need to add drugs or combine drugs according to their own specific situation.Whether this is necessary or not depends on whether the patient has met the withdrawal criteria at the time of withdrawal.If the patient meets the criteria for discontinuation of the drug at the time of discontinuation, it is generally recommended to continue taking the previous drug for a period of time to consolidate.If discontinuation is due to discomfort or apparent resistance, it is generally recommended to change medication.For those who have not met the criteria for discontinuation and relapse after discontinuation, it is generally recommended that appropriate addition or combination of drugs can be used.Special attention should be paid to the combination of drugs in patients who have been discontinued due to the development of resistance.Studies have shown that lamivudine combined with adefovir dipivoxil can reduce resistance to lamivudine and improve its drug duration.Additional, see the level of DNA of its second liver virus even discretion.If there is a significant increase in its level, it indicates that the condition is aggravated after recurrence, and drugs can be appropriately added or combined;If hepatitis B virus DNA is lower than 2000~20000 IU/mL, and in this level for a long time, can not be processed, regular observation is ok.Does hepatitis B affect marriage and fertility?Is it true?For boyfriends and girlfriends or couples with hepatitis B, some people may worry about marriage and fertility problems.Actually, patient of second liver is not cannot marry and bear, it is to need us to notice to be on guard only, do not infect second liver virus to him.Additional, oneself of second liver patient also can be pregnant bear, just need to make prevention, avoid to infect new student.If hepatitis B patients find that they are pregnant, they need to go to the hospital for a regular pregnancy test to know their physical condition, especially the health of their liver function.During pregnancy, patients with hepatitis B should pay special attention to their daily nutritional needs and a balanced diet, while ensuring that their sleep quality is maintained.When a baby is born, special attention should be paid to the injection of hepatitis B immunoglobulin as soon as possible within 12 hours of birth, and the injection of hepatitis B vaccine at 1 month and 6 months of age.After the age of two, the baby should also go to the hospital for blood tests to see if the baby has been infected with hepatitis B virus, and annual tests are recommended to give the baby adequate protection.Statistical data in 2018 showed that 6.1% of the population aged 1-59 in China showed surface anti-hepatitis B positive, and about 86 million people were infected with HEPATITIS B virus, among which about 32 million were chronic hepatitis B patients.According to an article published in The Lancet in 2021, there will still be about 70 million chronic hepatitis B patients in China in 2021, and 20 to 30 million of them will need treatment.At present, the more effective way for these chronic hepatitis B patients is antiviral treatment, but can not achieve a radical cure.As for the prevention and treatment of hepatitis B, it is still a long way to go.Resources: “world hepatitis day special interview | China still has 20 million – 30 million chronic hepatitis b patients need treatment” the lancet, gastroenterology and hepatology, 2021, “when to stop antiviral treatment patients with chronic hepatitis b?New reference standard comes……”Digestive liver Disease channel in medical circles 2021 “Guidelines for chronic Hepatitis B prevention and Treatment in China” 2015 edition