Hepatitis B Foundation

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一般信息

什么是乙型肝炎?

乙型肝炎是世界上最为常见的传染性肝病。它是由乙型肝炎病毒(HBV)引起,这一病毒侵害肝脏。通常大多数成人都能够抵抗乙型肝炎病毒,并彻底康复。但是也有许多成人无法抵抗乙型肝炎病毒。令人遗憾的是,这也包括大多数受到传染的婴儿和儿童。他们被诊断为乙型肝炎病毒的“慢性携带者”—病毒可在其血液和肝脏停留很长时间。他们可能会将病毒传染给他人。好消息是已经有一种疫苗够预防乙型肝炎。同时那些“慢性携带者”也能够获得多种治疗。

有多少人受到影响?

全球有二十亿人(将近有三分之一人口)已受到乙型肝炎病毒感染。许多人清除了病毒并康复,但是有四亿人无法清除病毒,并继续充当病毒的“慢性携带者”。乙型肝炎在亚洲、东南亚、印度和部分非洲和南美洲、东欧及中东地区最为常见。 美国有一百多万慢性乙型肝炎病毒携带者。

华人为何应当关心乙型肝炎?

乙型肝炎能够传染任何年龄或种族的任何人,但是亚裔人士受到传染的风险要高得多。在全球的乙型肝炎“慢性携带者”中,有75%为亚裔。虽然乙型肝炎在中国极为常见,它也是美籍华人的一个问题。随着华人迁入美国和其它国家,病毒也与其共行。

亚裔人士中的误解之一是认为乙型肝炎可能“来自遗传”,因为有时一个家族中有数代人受到感染。但这并非“遗传病”— 乙型肝炎是由病毒引起的。华人家庭可以通过接受化验、疫苗注射和治疗,来打破乙型肝炎传染的循环。

我如何可能患上乙型肝炎?

乙型肝炎是一种通过血液传播的“传染病”。含血体液也能够传染病毒。乙型肝炎通过血液的直接接触、无防护性交、共享针头传播,也可由受到感染的母亲在分娩时传染给新生婴儿。您不可能从空气、拥抱或触摸、马桶座或门把的接触中感染乙型肝炎。乙型肝炎并非通过偶然接触传播。

何人最有可能受到乙型肝炎感染?

虽然每个人均有受到乙型肝炎感染的风险,有些人受到感染的可能性较大。由于您的工作、生活方式,或者仅仅是由于您出生在一个有乙型肝炎史的家庭中,都可能增加您受到感染的机会。以下是某些最为常见的“高风险”群体—但是请记住这一名单并不全面﹕

  • 亚裔人士,特别是那些父母移民到美国的人士。
  • 与患有乙型肝炎者结婚或与其家庭密切接触的人士,包括成人和儿童。
  • 在乙型肝炎流行的国家(亚洲、印度和部分非洲和南美洲、东欧及中东地区)居住或旅行的人士。
  • 从事无防护性交及/或拥有多个性伴侣的人士。
  • 在工作中与血液接触的健康护理人员和他人。
  • 接受肾透析或在医院内居住的人士。
  • 吸毒的瘾君子。

是否有疫苗能够防止乙型肝炎?

有。所有婴儿、儿童和成人均可接受疫苗注射。这一疫苗非常安全—您不可能由于接种疫苗而患上乙型肝炎。最好的消息是您和您的亲人只需要接受三次注射,即可获得终生保护。婴儿和18岁以下儿童通常可从本州卫生厅获得免费疫苗注射。请向您的医生查询有关乙型肝炎疫苗的事宜。

我是否应当接受疫苗注射?

在美国,医生建议所有新生儿和18岁以下儿童均应当接受疫苗注射。成人特别是亚裔人士也有患上乙型肝炎的风险。请与您的医生讨论有关接受乙型肝炎疫苗注射的事宜—请保护您自己不患上这一种严重的传染性肝病。

乙型肝炎疫苗是否安全?

是,医学和科学研究已显示,这是现有的最为安全的疫苗之一。在全球接受疫苗注射者已超过十亿人次。疫苗是在实验室中制成的—您不可能由于接受疫苗注射而患上乙型肝炎。最常见的副作用是胳膊的注射部位发红和酸痛。请在接受系列疫苗注射之前,与您的医生讨论其它可能的副作用,及您的任何过敏体征。

我还能采取何种其它措施,保护自己不患上乙型肝炎?

由于乙型肝炎是通过血液传播的,您应当避免与他人共用尖利的物品,如剃须刀、牙刷、耳环和指甲剪。在接受针灸、刺青和身体穿刺时,请务必使用消毒针头。请戴手套或使用纸巾保护自己的手,以避免触摸血液。与性伙伴使用避孕套。使用漂白粉清洗血渍。在触摸血液之后务必用肥皂和水彻底洗手。最重要的是请务必接受疫苗注射。

我如何得知自己已受到乙型肝炎感染?

乙型肝炎是一种“无声的传染病”。大多数人在受到感染时没有任何症状。因此,他们可能在不知情的情况下患上乙型肝炎。您可要求您的医生或当地的健康诊所进行简单的验血。验血可显示您是否已受到感染。

有多少人从乙型肝炎“康复”或成为乙型肝炎病毒的“慢性携带者”?

答案取决于您是在成年后、童年还是在婴儿时期受到感染。成人通常能够“康复”,因为他们的免疫系统能够清除病毒。如果健康的成人受到感染,他们有90%的机率清除病毒,另有10%的机率成为慢性携带者。但是如婴儿和儿童受到感染则更有可能成为慢性携带者,因为其免疫系统较难清除病毒。如婴儿受到感染,他们只有10%的机率清除病毒,有90%的机率成为慢性携带者。幼儿则有40%的康复机率,另有60%的机率成为慢性携带者。但是每个人都能够通过接受疫苗注射获得保护,避免受到乙型肝炎感染。

我可以到何处获得化验?

您可要求您的医生、当地的卫生部门或肝病专家进行一次简单的验血检测乙型肝炎。这一验血可在任何医生诊所进行。如果您在纽约市地区居住,您可致电给免费电话 1-888-888-0981了解详情和医生的转诊。您可以获得英语、国语和粤语信息。

如果我患上乙型肝炎,是否有何治疗方法?

美国目前有7种以经过批准的治疗慢性乙型肝炎的药物,这几种药也在中国提供。

  • Intron A (alpha干扰素) 是一种注射药物, 一周注射数次,用六个月到一年,有时或更久,此药可能会引起象感冒﹑忧郁症和头痛一样症状的副作用,于1991年批准,可用于儿童和成人。

  • Pegasys (pegylated interferon) 聚乙二醇化干扰素) 是一种注射药物,每周注射一次,通常要连续注射六个月到半年。这种药可能会有副作用,如流感症状、抑郁症和其它心理健康问题。此药于2005年5月获得批准,并仅供成人使用。

  • Epivir-HBV 或 Zeffix (lamivudine) 是一种口服药片,一天服用一次,几乎没有副作用﹐服用至少一年或一年以上。主要问题是治疗时和治疗后可能会发生乙型肝炎病毒变异。于1998 年批准,可用于儿童和成人。

  • Hepsera (adefovir dipivoxil) 是一种口服药片,一天服用一次,副作用很少,服用至少一年或一年以上。主要问题是服用此药可能会发生肾脏问题。于2002 年9月批准,仅可用于成人。儿科临床试验正在进行中。

  • Baraclude (entecavir) 恩替卡韦) 是一种每日服用的片剂,可连续服用长达一年而几乎没有任何副作用。这种药在目前用来治疗慢性乙型肝炎的口服抗病毒药物中,被普遍认为是药效最强的一种。此药于2005年4月获得批准,并仅供成人使用。今后可能要进行儿科临床试验。

  • Tyzeka (telbivudine) 是一种每日服用的片剂,可连续服用一年而几乎没有任何副作用。研究显示该药能迅速有效地抑制乙肝病毒。于2006年10月批准用于成人。

  • Viread (tenofovir) 是一种每日服用的片剂,可连续服用至少一年而只有很少副作用,于2008年8月被批准用于成人。

不是每一个慢性乙型肝炎患者都需要用药﹐了解这一点很重要。一些患者只需要由其医生定期监测 (至少一年一次)。有肝病活动症状的患者最有可能从治疗中获益。请务必和您的医生谈一谈您是否可以从治疗中获益并讨论一下治疗方案。此外﹐在临床实验和研究渠道中都有令人鼓舞的新药。

所有慢性乙型肝炎患者不论是否接受治疗都要定期看医生﹐这是至关重要的﹗

 

General Information

What is hepatitis B?
Hepatitis B is the world's most common liver infection. It is caused by the hepatitis B virus (HBV) which can attack and injure the liver. Most adults are usually able to get rid of the hepatitis B virus and "recover" without any problems. But many adults, and unfortunately most infected babies and children, will be unable to get rid of the virus. They are diagnosed as being "chronic carriers" of hepatitis B -- the virus can stay in their blood and liver for a long time. They can pass the virus on to other people. 

The good news is that there is a vaccine to prevent hepatitis B and new drugs for "chronic carriers" with active signs of disease who could benefit from treatment. 

How many people are affected?
Two billion people around the world (almost 1 out of 3 persons) have been infected with the hepatitis B virus. Many people recover and get rid of the virus, but 400 million people have been unable to get rid of the virus and remain "chronic carriers" of the virus. Hepatitis B is most common in Asia, Southeast Asia, India, parts of Africa and South America, Eastern Europe, and the Middle East. In the United States there are more than one million Americans who have chronic hepatitis B infections.

Why should Chinese people be concerned about hepatitis B?
Hepatitis B can infect any person of any age or race, but Asians are at much higher risk for getting infected. Worldwide, 75% of all "chronic carriers" of hepatitis B are of Asian descent. Although hepatitis B is very common in China, it is also a problem among Chinese-Americans. As Chinese people move to the United States, and other countries, the virus travels with them.

One of the myths among Asians is that hepatitis B can be "inherited" since several generations in one family may be infected. But this is not a "genetic disease" -- hepatitis B is caused by a virus. Chinese families can break the cycle of hepatitis B infection by getting tested, vaccinated and treated.

How can I get hepatitis B?
Hepatitis B is an "infectious disease" that is spread through blood. Bodily fluids that contain blood can also pass the virus. Hepatitis B is spread through direct blood contact, unprotected sex, shared needles, and from an infected mother to her newborn baby during delivery. You cannot get hepatitis B from the air, from hugging or touching, from toilet seats or door knobs. Hepatitis B is NOT spread through casual contact.

Who is most likely to get infected with hepatitis B?
Although everyone is at some risk for getting hepatitis B, there are some people who are more likely to get infected. Your job, lifestyle, or just being born into a family with hepatitis B can increase your chances of being infected. Here are some of the most common "high risk" groups -- but please remember that this is not a complete list:

  • People of Asian descent, especially if their parents have emigrated to the United States.
  • People who are married to or live in close household contact with someone who has hepatitis B. This includes adults and children.
  • People who live in or travel to countries where hepatitis B is very common (Asia, India, parts of Africa and South America, Eastern Europe, and the Middle East).
  • People who have unprotected sex and/or have multiple sexual partners.
  • Health care workers and others who are exposed to blood in their jobs.
  • Patients who are on kidney dialysis or live in institutions.
  • People who use illegal drugs.

Is there a vaccine to prevent hepatitis B?
Yes, all babies, children and adults can be vaccinated. The vaccine is very safe -- you cannot get hepatitis B from the vaccine. The best news is that it only takes three shots to protect yourself and your loved ones for a lifetime. Babies and children up to age 18 years can usually receive free vaccine from state health departments. Ask your doctor for the hepatitis B vaccine.

Should I get vaccinated?
In the United States, doctors recommend that all newborns and children up to age 18 years should be vaccinated. Adults are also at risk for hepatitis B, especially those of Asian descent. Talk to your doctor about getting the hepatitis B vaccine - protect yourself from a serious liver infection.

Is the hepatitis B vaccine safe?
Yes, medical and scientific studies have shown it to be one of the safest vaccines ever made. More than one billion doses have been given throughout the world. The vaccine is made in a laboratory -- you cannot get hepatitis B from the vaccine. The most common side effects are redness and soreness in the arm where the shot is given. Talk to your doctor about other possible side effects and whether you have any allergies before starting the vaccine series.

What else can I do to protect myself from hepatitis B?
Since hepatitis B is spread through blood, you should avoid sharing sharp objects such as razors, toothbrushes, earrings, and nail clippers. Make sure that sterile needles are used for acupuncture, tattoos and body piercing. Avoid touching blood by using gloves or paper towels to protect your hands. Use bleach to clean up blood spills. Use condoms with sexual partners. Avoid using illegal drugs. Always wash your hands thoroughly with soap and water after touching any blood. Most importantly, make sure you get vaccinated.

How will I know if I have been infected with hepatitis B?
Hepatitis B is a "silent infection. Most people don't have any symptoms when they are infected. So they can have hepatitis B without even knowing it. Your doctor or local health clinic can order a simple blood test. The blood test can show whether you have been infected or not.

How many people "recover" from or become "chronic carriers" of hepatitis B?
The answer depends on whether you are infected as an adult, a child, or a baby. Adults usually "recover" because their immune systems can get rid of the virus. If a healthy adult is infected, they have a 90% chance of getting rid of the virus and a 10% chance of becoming chronically infected. Babies and children, however, are more likely to develop a chronic infection. Their immune systems have more difficulty getting rid of the virus. If a baby is infected, there is only a 10% chance of getting rid of the virus and a 90% chance of developing a chronic infection. Young children have a 40% chance of recovering and a 60% chance of developing a chronic infection. But everyone can be protected against hepatitis B infections through vaccination.

Where can I go to be tested?
You can ask your family doctor, the local health department, or a liver specialist to order the simple hepatitis B blood test. This blood test can be done in any doctor's office.

You can also call the GlaxoSmithKline HBV Info and Assistance line, toll-free at 1-888-888-0981.  Information about HBV and physician referrals across the country are available in English, Mandarin, Cantonese, Korean, and Vietnamese.

Are there any treatments if I have chronic hepatitis B?
Currently, there are seven approved drugs in the United States for people who have chronic hepatitis B infections. These drugs are also available in China:

  • Interferon Alpha (Intron A) is given by injection several times a week for six months to a year, or sometimes longer. The drug can cause side effects such as flu-like symptoms, depression, and headaches. Approved 1991 and available for both children and adults.
  • Pegylated Interferon (Pegasys) is given by injection once a week usually for six months to a year. The drug can cause side effects such as flu-like symptoms and depression. Approved May 2005 and available only for adults.
  • Lamivudine (Epivir-HBV, Zeffix, or Heptodin) is a pill that is taken once a day, with few side effects, for at least one year or longer. Approved 1998 and available for both children and adults.
  • Adefovir Dipivoxil (Hepsera) is a pill taken once a day, with few side effects, for at least one year or longer. Approved September 2002 for adults. Pediatric clinical trials are in progress.
  • Entecavir (Baraclude) is a pill taken once a day, with few side effects, for at least one year or longer. Approved April 2005 for adults. Pediatric clinical trials are in progress.
  • Telbivudine (Tyzeka, Sebivo) is a pill taken once a day, with few side effects, for at least one year or longer. Approved October 2006 for adults.
  • Tenofovir (Viread) is a pill taken once a day, with few side effects, for at least one year or longer. Approved August 2008 for adults.

It is important to know, not every chronic hepatitis B patient needs to be on medication. Some patients only need to be monitored by their doctor on a regular basis (at least once a year, or more). Other patients with active signs of liver disease may benefit the most from treatment. Be sure to talk to your doctor about whether you could benefit from treatment and discuss the treatment options. In addition, there are promising new drugs in clinical trials and in the research pipeline. 

However, it is vital that all people with chronic hepatitis B visit their doctor on a regular basis, whether they receive treatment or not!