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Hepatitis B e-antigen positive (HBeAg-positive) hepatitis B is a state in which the hepatitis B surface antigen (HBsAg), hepatitis B e-antigen (HBeAg), and hepatitis B core antibody (anti-HBc) are all positive in the human serum during the "two pairs" test for hepatitis B virus. In general, hepatitis B e-antigen positive status indicates active viral replication and a high level of infectivity, but it does not necessarily mean severe liver damage. With proper treatment, the progression to cirrhosis and liver cancer can be minimized.
Hepatitis B e-antigen positive (HBeAg-positive) hepatitis B refers to the state in which all three items in the "two pairs" test for hepatitis B virus, HBsAg, HBeAg, and anti-HBc, are positive, and hepatitis B virus DNA can generally be detected, indicating a disease course of more than 6 months. The appearance of this condition indicates that the patient has been infected with hepatitis B virus, and the virus is in a relatively active replication period. During this period, the infectivity of the individual is high, but it does not necessarily mean that there is irreversible liver damage. These hepatitis B-infected individuals should undergo regular monitoring of HBV DNA, liver function, "two pairs," and ultrasound examinations. If antiviral treatment is needed, patients should actively undergo treatment with the goal of long-term viral replication suppression, symptom relief, and reduction of liver damage, thus preventing the further progression of the disease and reducing the likelihood of complications such as liver cancer and cirrhosis.
Hepatitis B virus (HBV)
This virus has strong resistance and can withstand low temperatures, dryness, and ultraviolet light. 70% alcohol disinfection cannot deactivate the virus, but high temperatures, sodium hypochlorite, bleach, and other chemical disinfectants can destroy the envelope of the hepatitis B virus, rendering it non-infectious and can be used for disinfection against hepatitis B virus.
Sources of transmission
Hepatitis B patients and asymptomatic carriers of hepatitis B virus.
Routes of transmission
Hepatitis B virus is mainly transmitted through blood, body fluids, close contact, and sexual contact.
Blood and body fluid transmission
In addition to being transmitted through blood transfusion and blood products, hepatitis B virus can also be transmitted through small amounts of blood from injuries, injections, and other means. Body fluids containing hepatitis B virus, such as saliva, breast milk, semen, and secretions, can also cause transmission directly into the body or through contact with damaged skin or mucous membranes. It is important to note that hepatitis B virus is not transmitted through mosquito bites.
Close contact in daily life
"Close contact in daily life" refers to a special form of bloodborne transmission that may result from minor injuries due to lack of attention in daily life, which may lead to infection through shared toothbrushes, razors, etc. It does not transmit through the digestive tract or respiratory route.
Mother-to-child transmission
Also known as vertical transmission, mother-to-child transmission can occur in utero, perinatal, and postnatal periods. The probability of fetal infection in the uterus is approximately 5% to 10%, and the virus from the mother can infect the newborn through micro-injuries during childbirth. After birth, the mother may transmit the virus to the newborn through breast milk due to nipple damage.
Sexual transmission
Hepatitis B virus has been found in the semen and vaginal secretions of infected individuals. Spouses of hepatitis B virus-infected individuals are more likely to be infected compared to other family members, supporting the evidence that sexual contact can transmit the virus.
Depending on the patient's condition, chronic hepatitis B can be classified into three categories: mild, moderate, and severe. Mild patients may be asymptomatic or have recurrent symptoms such as fatigue, abdominal pain, aversion to oily foods, decreased appetite, and discomfort in the liver area. Severe patients may experience persistent or significant fatigue, decreased appetite, jaundice, a dark liver disease complexion, liver palms, spider nevi, and other symptoms of liver disease. Moderate symptoms are intermediate between mild and severe.
Liver disease complexion
When the patient's liver function is abnormal, the complexion appears dark and dull, and the skin is rough and dry, known as a liver disease complexion.
Liver palms
Redness appears in the palm area, specifically under the thumbs and little fingers, or red spots or patches appear, which turn white upon application of pressure.
Spider nevi
When the liver function is abnormal, structures similar to "moles" appear on the patient's body. They have a red dot in the center, and radiating capillaries can be observed around them, resembling a spider. Applying pressure to the central red dot causes it to disappear. They are commonly found on the chest and neck.
Hepatitis B e-antigen positive (HBeAg-positive) hepatitis B and hepatitis B e-antigen negative (HBeAg-negative) hepatitis B are mainly differentiated through the "two pairs" test for hepatitis B. In HBeAg-positive patients, HBsAg, HBeAg, and anti-HBc are all positive, while in HBeAg-negative patients, HBsAg, anti-HBe, and anti-HBc are positive.
Patients with significant symptoms, severe conditions, and jaundice should rest in bed, avoid excessive fatigue, and bed rest can increase liver blood flow, aiding in recovery.
Diet should be light and balanced, with appropriate high-protein, high-calorie, and high-vitamin foods to aid in liver repair, but excessive nutrition should be avoided to prevent fatty liver. Patients should avoid alcohol consumption.
Diet
The diet should be healthy and balanced, with an emphasis on energy and protein supplementation, while avoiding overeating and controlling sugar and fat intake. Patients should strictly abstain from alcohol to reduce the burden on the liver and liver damage.
Exercise
Moderate exercise can enhance resistance. Low-intensity exercise is recommended, with a duration that should not be too long, and patients should avoid feeling overly exhausted. Patients with severe conditions are advised to rest in bed.
Lifestyle
Maintain a healthy lifestyle.
Emotional and psychological well-being
Mental factors are also important contributors to worsening the condition. Therefore, maintaining a healthy and positive mindset is crucial. If the disease causes distress in the patient's work and life, they can communicate with the doctor or family members.
Patients should undergo regular (generally every 3-6 months) re-examination to monitor changes in the disease. A small number of patients may experience certain side effects after using antiviral drugs and should seek medical attention promptly for the doctor to adjust individualized treatment plans based on the patient's condition.
For patients with positive markers of hepatitis B virus infection, blood donation should be avoided, and according to national regulations, they should also avoid working in catering and childcare.
Daily prevention
Develop good personal hygiene habits and avoid sharing toothbrushes, razors, and other items with others. After contact with patients, handwashing should be practiced.
Protection of susceptible populations
Vaccination against hepatitis B is the most crucial measure for preventing hepatitis B. After vaccination, the body should be regularly checked for protective antibodies. If the antibodies disappear, supplementary vaccination should be administered. For high-risk individuals who have accidentally come into contact with hepatitis B virus-contaminated objects, timely administration of hepatitis B immunoglobulin is recommended.
For mothers infected with hepatitis B, hepatitis B immunoglobulin and hepatitis B vaccine should be administered to the newborn immediately after birth, followed by additional doses at 1 month and 6 months, to prevent infection.
