The quantitative change of their HBsAg puzzled them: some people did not change, some people did not decline, but rose, and of course some people showed a continuous downward trend.
It can be said that several families are happy and several families are sad.
Many blood test values of human body are not constant or constant, and there will be some slight fluctuations. As a friend said, his hepatitis B virus surface antigen is quantitative, sometimes high and sometimes low.
It can be directly inferred from this phenomenon that after patients take antiviral drugs, the drugs do not affect the value of hepatitis B surface antigen.
Why is it that after taking antiviral drugs, the DNA load of hepatitis B virus is decreasing, even undetectable, and the quantitative change of hepatitis B surface antigen seems to be completely unaffected?
To understand this problem, we need to know what these two test indicators test respectively. Is there a certain correlation between them?
Hepatitis b virus DNA, HBV DNA for short. DNA is biological genetic material, also called deoxyribonucleic acid, and biological genes are composed of DNA with genetic information.
To become a complete live virus with infectious ability, it is not enough to have DNA. The original virus needs to copy a new DNA with its own DNA as a template, and then wrap it with hepatitis B surface antigen to form new virus particles of its offspring.
Therefore, the DNA of hepatitis B virus that we usually detect can explain the replication level of hepatitis B virus in vivo: the higher the DNA level, the higher the replication level of the virus; The lower the DNA level, the lower the replication level of the virus. At the same time, it can also explain the infectivity of patients.
There is no need to go further here. We just need to know that the antiviral drugs we take are actually an important component to replace or competitively inhibit the replication process of hepatitis B virus, so that hepatitis B virus cannot produce the next generation.
HBsAg and HBV DNA are not the same thing. The surface antigen belongs to protein, and the word "surface" indicates that it is used to wrap the core containing HBV DNA. If people use metaphor, it is equivalent to a person's "skin".
After the hepatitis B virus invades the liver cells, it integrates with the genes of human liver cells to form a new virus genome, and under the guidance of the new virus genome, it "produces" hepatitis B surface antigen.
If a factory produces a certain product as an analogy, the core production department produces the main body of the product, and the department responsible for packaging produces the packaging box. The packaged virus is the complete "product".
Therefore, in general, if antiviral treatment is not carried out, there is a certain correlation between HBV DNA and surface antigen, that is, more products are produced and more packaging boxes are produced accordingly.
The problem now is that after antiviral treatment, hepatitis B virus DNA does not replicate, but the drugs we use have no effect on joints produced by other viruses, including the expression of hepatitis B surface antigen, so hepatitis B surface antigen is not affected.
But don't be discouraged. After long-term antiviral treatment, not only the replication of HBV DNA was inhibited, but also the expression of HBsAg decreased due to this inhibition. The longer antiviral treatment lasts, the more obvious this change will be.
This situation, on the one hand, is due to anti-virus, on the other hand, because of anti-virus treatment, which may stimulate the human immune system to remove hepatitis B virus at some point. In other words, this clearance activity will destroy some liver cells infected by hepatitis B virus, resulting in less and less hepatitis B surface antigen.
How to deal with it? Maybe you didn't understand what I said before. Pay more attention to how to deal with this situation. Dr. Long can talk to you, too.
For chronic hepatitis B, only antiviral treatment and maximum inhibition of virus replication can ultimately reduce the risk of liver cirrhosis and liver cancer.
Interferon is not suitable for everyone. After screening, the patients are mainly young patients, and there is no taboo to use interferon. Combined interferon therapy can be considered to promote the transformation of big three-yang into small three-yang
Interferon can mobilize the immune system of human body, find the opportunity to clear the virus, and reduce the titer of hepatitis B surface antigen to some extent. With the long-term continuous decline of HBsAg titer, it is expected to achieve self-healing or clinical cure of hepatitis B.
Graphical sources of surface antigens
Use pictures to express, just ignore calligraphy. Surface antigen, e antigen, HBVDNA, etc. All of them come from cccDNA, which is the template of hepatitis B virus replication and surface antigen, and the root of persistent infection of hepatitis B virus. Antiviral drugs only inhibit the replication of HBVDNA, but have no effect on cccDNA. The level of surface antigen depends on the number of CCCDNAs involved in replication. CCCDNAs is a library. Some CCCDNAs in the library participate in replication, while others are dormant. It is dynamic, so the surface antigen will change dynamically.
Answer this question.
Because the detection method is semi-quantitative, the quantitative value of HBsAg fluctuates.
The detection of hepatitis B 2 has gone through the process from qualitative detection to quantitative detection. In the past, doing hepatitis B 2 and a half was a qualitative examination, with only negative and positive results. Later, with the development of medical examination technology, the negative and positive indicators found in clinic can no longer reflect the changes of the disease and can not meet the clinical needs. The specific values can help guide the clinic.
Why does semi-quantitative method cause the quantitative value of surface antigen to rise and fall?
At present, the semi-quantitative method is widely used in the whole country, which is more sensitive than the previous stereotype. What is semi-quantitative? This is a ratio evaluation, not accurate data. We can only say "about how much". We can pick up 2 and look at the semi-quantitative test sheet, as long as the unit behind the value is S/CO or COI, it is a semi-quantitative method. The quantitative value of hepatitis B surface antigen is not a real value, but an approximate value.
How to understand it? I have 20 sweets in my hand. The qualitative test tells you whether there is candy or not. The semi-quantitative method gives the approximate number of sweets in my hand. You can guess 15, 17, 2 1, 24, etc. It shows that for the same value, the value detected by semi-quantitative method fluctuates. And there is no fixed relationship between the value you guessed and the real value.
I hope I can solve your problem.
Different test reagent batches may cause fluctuations in the results. As long as it is not ups and downs, you can observe it. Really not at ease, you can review in the short term.
Taking antiviral drugs directly affects HBV-DNA load, which is what we often call the amount of hepatitis B virus.
After long-term antiviral treatment, the amount of hepatitis B virus continues to decrease, and the expression of hepatitis B surface antigen may decrease. The longer the antiviral treatment is carried out, the greater the possibility of achieving the goal of clinical cure and negative conversion of hepatitis B.
At present, the slight fluctuation of hepatitis B surface antigen is normal, so don't worry. Please continue to insist on treatment, come on.
If you have any questions about liver disease, please ask me.
The key is to look at DNA and fibrosis, and then at surface antigens, even E antigens. After leaving the liver disease clinic, I began to do Chinese medicine clinic. In a few years, these things will be unknown, because after three years of beauty, they will be updated. Since I have been out of the clinic for a long time, naturally a lot of knowledge can't be updated, and I gradually lose my right to speak. I think it's better to practice Chinese medicine with heart. The past, blowing in the wind. In the blink of an eye.
It doesn't work in this antiviral period. If the virus lowers its liver function, everything else will be fine. Antigen is broken by autoimmunity.
Antigen is the virus itself, and antibody refers to the antibody produced in the body, some of which are effective, some are ineffective, and some are not very effective, so the detection of hepatitis B mainly depends on antigens, including core antigens and surface antigens. Refers to the virus itself. This value will change from high to low, because the virus is propagated by a group of organisms, and it will be reduced by drugs, but it cannot be removed and killed. Therefore, for hepatitis B, it is necessary to recuperate if there are symptoms, and there is no need for treatment. Just pay attention to protecting the liver at ordinary times. Because there is no cure.
There is no medicine to clear the body of hepatitis B virus. Interferon is generally used to interfere, so that hepatitis B virus can not grow well, but the virus will also produce drug resistance, and some super viruses will be produced, that is, there are always viruses in a population that survive through various drugs and interferon, and the viruses propagated by them have developed drug resistance, so they are not afraid of similar drugs, so when they change a drug, they will reduce their usage habits, produce drug resistance, and then multiply.
There are also changes in the body's resistance, which are changing every day, and the hormones secreted are also fluctuating. Therefore, in these changes, as well as in the fluctuation of nutritious diet, the number of viruses also fluctuates, and when it is suppressed, it is necessary to increase the number of viruses. Therefore, attention should be paid to diet and liver protection. If you don't get sick, you should get vaccinated early. If you test whether the antibody is vaccinated, you will be immune. Those who have not been vaccinated should be replenished. If you are infected, you can vaccinate your family. Now I can only protect my liver and recuperate. Suppression and interference. There is also Chinese medicine conditioning. So they are all dynamic and fluctuating,