If your physical examination finds two and a half abnormal, you know you have hepatitis B but don't know what to do, please read this article
When I was at work, I often received consultation applications from other departments. Some self-media also often received private messages from netizens for consultation. There is a very common question: There is an abnormality in two and a half of hepatitis B, what should I do?
As for the two and a half test results of hepatitis B, it is best for the patient himself to be able to roughly understand, because sometimes a wrong understanding can lead to wrong treatment choices.
Some treat normal results as abnormal results; some find abnormal results without further examination, which leads to aggravation of the condition; some have changes in their condition, do not pay attention, and miss the opportunity for treatment...
Dr. Long will talk about today: how to understand the results of various hepatitis B tests, and what to do next.
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1 What is Hepatitis B Two and a Half?
Two and a half of hepatitis B, also known as hepatitis B 5. Two pairs and a half of hepatitis B is a popular name. As the name suggests, there are 5 indicators in this inspection item.
Among them, 4 indicators are paired "two pairs", which are the paired combination of antigen and antibody, that is, hepatitis B surface antigen and antibody (HBsAg and HBsAb), hepatitis B virus e antigen and antibody (HBeAg and HBeAb).
There is another one that appears unpaired, that is, the "half" pair of the two and a half pairs of hepatitis B, namely the hepatitis B virus core antibody (HBcAb),
In fact, the hepatitis B virus core antibody can be paired originally, but the content of hepatitis B core antigen (HBcAg) in human blood is very small, and it is difficult to detect it with the current commercial detection methods.
However, among the 5 items of hepatitis B or the two-and-a-half test items for hepatitis B that we see now, there are some other items.
Most of these items are extensions of the original 5 items. For example, some inspection reports contain pre-s1 antigen of hepatitis B virus. This pre-s1 antigen is also a type of hepatitis B surface antigen.
In other inspection items, there are two items of hepatitis B virus core antibody IgG and LgM, both of which belong to hepatitis B virus core antibody. However, positive IgM antibodies usually indicate acute hepatitis B virus infection, or acute exacerbation of chronic hepatitis B.
When looking at the two and a half inspection reports of hepatitis B, it is necessary to distinguish the meaning of various items. In this case, it is helpful to understand the infection of hepatitis B virus (abbreviated as HBV, the following two terms may be used interchangeably, meaning the same). Status and size of contagion.
02
2 What is the significance of the five items in the two halves of hepatitis B?
The five items in the two and a half of hepatitis B have different meanings, but they cannot be understood in isolation.
Hepatitis B Surface Antigen (HBsAg)
In the hepatitis B surface antigen, there are two words "surface", as the name suggests, it is a layer of protein coated on the outer surface of HBV. Just like a person's appearance, you can identify who this person is at a glance, hepatitis B surface antigen, to put it bluntly, is the "identity card" used to identify the hepatitis B virus.
A person's hepatitis B surface antigen positive means that the person has been infected with hepatitis B virus, which belongs to the status quo of hepatitis B virus infection, that is, he has hepatitis B now.
Under special circumstances, there are also some people who are negative for hepatitis B surface antigen but are actually infected with hepatitis B virus. This situation is relatively rare and is called occult hepatitis B.
Occult hepatitis B is caused by the mutation of hepatitis B virus. Just like the hepatitis B virus that invades the human body, it uses "disguise surgery" to deceive the body's immune system and the detection reagents.
However, "the French Open is sloppy and not leaking", and they can still be found using highly sensitive hepatitis B virus DNA detection.
Hepatitis B Surface Antibody (HBsAb)
Hepatitis B surface antibody is a protective antibody, which is produced by the body's immune system after infection with the hepatitis B virus after clearing the virus. Hepatitis B surface antibodies will also be produced after being hit with hepatitis B.
The next time the hepatitis B virus re-enters the body, these antibodies will neutralize and clear the hepatitis B virus, preventing re-infection.
Hepatitis B virus e antigen (HBeAg)
Hepatitis B virus e-antigen is a protein component surrounded by the core and outer layers of HBV. Since this antigen is a protein expressed by hepatitis B virus DNA and directly surrounds the viral DNA, the hepatitis B virus e antigen will be positive when the virus is actively replicating.
The hepatitis B virus e antigen in the two and a half pairs of hepatitis B is positive, which is a sign of active virus replication, and is also called "hepatitis B big three yang".
The "big" in Dasanyangli means that the virus is actively replicating, which can be understood as the meaning of a large amount of virus replication.
Hepatitis B virus e antibody (HBeAb)
The hepatitis B virus e-antibody is produced at the same time or after the e-antigen disappears. The e-antibody is not a component of the virus, but is also produced by the human immune system, but this antibody has no protective effect.
The existence of hepatitis B virus e antibody indicates that the replication of hepatitis B virus has changed from active to inactive.
HBV e-antibody-positive and e-antigen-negative hepatitis B virus infection is called "small three yang of hepatitis B". But there is another thing, that is, in the case of hepatitis B virus mutation, even if it is a small Sanyang, there will be big problems.
Hepatitis B virus core antibody (HBcAb)
Hepatitis B virus core antibody is also produced by the body's immune system, not a component of the virus. We often see that some people have only one HBV core antibody positive, which means that the patient has been infected with HBV.
Almost all people who have been infected with hepatitis B virus will produce hepatitis B virus core antibody. Generally speaking, once this antibody is produced, it can be detected for life.
There are also a small number of people who have been infected with hepatitis B who cannot be detected. This may be because the antibodies have been metabolized after a long time, or the amount is very small and cannot be detected by ordinary examinations.
No matter how many core antibodies of hepatitis B virus are, whether it is positive or not, the antibody itself is not harmful to people.
Some people who have "cleanliness addiction" in the test report hope that all tests are negative, which is what they think is normal, but this is really unnecessary.
People will continue to deal with various pathogens. For example, after some viruses are infected, they will leave traces of the virus in the human body, that is, antibodies. We do not need these antibodies to turn negative, because the Existence allows us to know what our bodies have experienced in the past.
As soon as it comes, let it rest, don't ask for trouble.
03
3 What are the results of the five tests of hepatitis B?
The above is the significance of each individual inspection among the 5 hepatitis B inspections, but to judge a person's hepatitis B virus infection status, it is necessary to combine these 5 items to analyze the true meaning.
common results
We number the 5 items of the 5 hepatitis B items as 1, 2, 3, 4, and 5: the first item is hepatitis B surface antigen, the second item is hepatitis B surface antibody, the third item is hepatitis B virus e antigen, and the fourth Item is the hepatitis B virus e antibody, and the fifth item is the hepatitis B virus core antibody.
Well, all HBV-infected people will present a variety of outcomes. It should be noted that these results have little to do with the severity of the disease.
Some people say that the big three yang of hepatitis B is more serious than the small three yang of hepatitis B. Usually, you can think so, but don’t underestimate the small three yang of hepatitis B. Sometimes the small three yang of hepatitis B caused by virus mutation, if you don’t pay attention and don’t actively treat it, it is easy to cause cirrhosis and liver cancer.
The more common results are: 1, 3, 5 positive, hepatitis B big three yang; 1, 4, 5 positive, hepatitis B small three yang; 1, 5 positive, hepatitis B small two yang, 1, 3 positive, hepatitis B big two yang.
Among them, hepatitis B big three yang and big two yang have similar meanings, and hepatitis B small three yang and small two yang have similar meanings. represent active replication and inactive virus replication, respectively.
good result
Here are some good results stating that there is no hepatitis B.
Two yang, indicating that there are antibodies: 2, 4, and 5 yang are usually transformed from small three yang, which means that they have healed themselves, and there are antibodies; The meaning is similar to that of 2, 4, and 5 positive.
Four or five positives, and a single positive for five items are also good results, but there is no antibody, and the United States and China are slightly insufficient. But it is also safe and does not belong to hepatitis B.
uncommon results
There are also some uncommon two-half results of hepatitis B, for example, some people will have the coexistence of hepatitis B surface antigen and hepatitis B surface antibody.
This representation may have the following meanings:
The first is that after infection with hepatitis B virus, the human body heals itself by clearing the virus. At this time, the hepatitis B surface antigen has not completely disappeared, and the hepatitis B surface antibody has "rising".
The second significance is that the amount of hepatitis B surface antibody is not very high, but the amount of hepatitis B surface antigen is very high, which may indicate that the human body may be infected with two subtypes of hepatitis B virus.
The human body removes one of the subtypes of the virus and produces antibodies, but this antibody cannot act on the other mutated subtype, so it is still a hepatitis B virus infection.
There are also some people who are all positive for the 5 items of the two and a half of hepatitis B. This situation is usually in the dynamic change of the two subtypes of infection. It takes a period of time to review, and the final result cannot be determined.
04
4 What other tests should be done to identify patients with hepatitis B infection?
When a person is found to be positive for hepatitis B surface antigen by checking two and a half pairs of hepatitis B, it can be determined that the person is infected with hepatitis B virus.
Using the concept of infected person is more suitable than using hepatitis B patients, because many hepatitis B virus infected people can actually be called healthy carriers of hepatitis B virus, and their physical conditions are not much different from ordinary people. They are equivalent to healthy people.
Hepatitis B patients are different. Hepatitis B patients generally refer to people who are infected with the hepatitis B virus and also have hepatitis attacks, or people who have liver cirrhosis. These people have abnormal examinations.
After learning that you are infected with hepatitis B, you need to do the following tests to determine whether the current liver is healthy.
Liver function test
Liver function test is a package test that indirectly reflects the status of liver function. Some of the items included in the test have different meanings.
Alanine aminotransferase is one of the most important indicators in liver function tests. Elevated alanine aminotransferase often indicates inflammation of liver cells. This is an immune clearance response caused by the hepatitis B virus stimulating the body's immune system.
Elevations of aspartate aminotransferase and glutamyl transpeptidase can also indicate liver damage, but they are not so commonly used. They are usually used together with alanine aminotransferase to assess which factors are related to this inflammation.
Usually hepatitis B attack, alanine aminotransferase increased the most, followed by aspartate aminotransferase, followed by glutamyl transpeptidase. If the increase of aspartate aminotransferase is greater than that of alanine aminotransferase, it may indicate that the condition is more serious or caused by alcohol consumption.
Hepatitis B virus DNA quantification (HBV-DNA)
The quantitative detection of hepatitis B virus DNA represents the activity of hepatitis B virus replication.
The high quantification of hepatitis B virus DNA indicates strong infectivity.
Generally speaking, the hepatitis B virus DNA is high in patients with big sanyang, while the hepatitis B virus DNA in small sanyang is generally low, so the infectivity of hepatitis B big sanyang is stronger than that of hepatitis B small sanyang.
Ultrasound
B-ultrasound is an inspection item that looks at the shape, internal structure of the liver, and whether there is a tumor inside.
Some people say that I have checked liver function and hepatitis B in half, why do I need to do B-ultrasound? Because they look at the problem from different angles.
Blood tests generally look at function, while imaging tests can directly see structure.
Just like when we judge a person, we not only look at whether his appearance is normal, but also his way of dealing with others, including her actions and expressions, and so on.
other checks
There are many other tests, such as blood routine, alpha-fetoprotein, "liver bomb" test, liver puncture, CT, MRI, etc. These tests are optional and not required every time.
05
5 Summary
On Dr. Long's self-media, some patients often ask some questions. Many people will send me the two-half test report for hepatitis B, asking what kind of treatment is needed.
Dr. Long invites you to read this article, because to decide whether or not to need treatment, you cannot rely solely on the test results of two and a half pieces of hepatitis B, but also combine liver function, hepatitis B virus DNA, B-ultrasound and alpha-fetoprotein examinations. Comprehensive judgment and consideration.
If there is no problem in the follow-up further examination, it means that there is only a hepatitis B virus infection, or a carrier, and some people are even healthy hepatitis B virus carriers. In this case, only regular review is required, there is no need Confused every day.
If there is an indication for treatment in the follow-up examination, it must be actively treated. Because for the disease, if you pay attention to it, you will seize the initiative. If you do not pay attention to it, hepatitis B will develop quietly, and it may be too late to regret it.
Well, today's popular science is here. Did I make it clear? Welcome to leave a message in the comment area!
This article is aimed at those who are new to hepatitis B, and introduces some basic knowledge (more familiar readers, just take a glance). After two and a half cases of hepatitis B are found to be abnormal, further examination is required, instead of escaping or seeking medical treatment and expecting a cure, which is unrealistic at present.
I am a clinician who loves popular science, seeing a doctor, consulting, answering questions, solving doubts, popularizing medical knowledge, and experiencing the power of warm words in the rush of clinical work!
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