Hepatitis B Foundation

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纽约市亚裔肝健支援讨论小组 acrobat document

与乙型肝炎共存

如医生说我是乙型肝炎“慢性携带者”则意味着什么?

首次感染乙型肝炎的成人通常能够在六个月以内清除病毒。如病毒在六个月后仍然在您的血液中停留,您就可能被诊断为乙型肝炎“慢性携带者”,这意味着您可能会将病毒传染给他人。您今后患上严重肝病的风险也较高。如果您是孕妇,您也有可能会将病毒传染给新生儿。但这是可以防止的。欲知详情,请查阅《孕妇和乙型肝炎》部分。

如果我没有生病的感觉,我还有可能是“慢性携带者”吗?

许多乙型肝炎慢性携带者即使体内有病毒,仍然感觉健康体壮。他们可能已长期遭受感染,但仍不知情。正因为此, 乙型肝炎被称为“无声的传染病”。如发生慢性感染,病毒长期停留在您的肝脏中并侵害您的肝脏。等到您感到自己病情严重,需要接受医生治疗时,您可能已经患上了严重的肝病。因此,请您务必在有生病的感觉之前即接受化验。

如果我是慢性携带者,我是否仍应接受疫苗注射?

遗憾的是,对于慢性携带者来说,注射乙型肝炎疫苗已经太迟。由于您已经患上乙型肝炎,这没有帮助作用。但是疫苗能够保护您的亲人。请务必保证在日常生活中与您有密切接触者包括婴儿和儿童获得疫苗注射。

如果我是“慢性携带者”,这是否意味着我不会长寿?

患有慢性乙型肝炎者仍可健康长寿。许多慢性携带者可数年甚至数十年与乙型肝炎共存,而没有任何症状。但是,每个携带者都有患上较为严重的肝病的风险。无论您是否感觉生病,乙型肝炎病毒都能够侵害您的肝脏。因此,寻求医生定期接受检查并保护好您的肝脏非常重要。有些疗法能够帮助乙型肝炎慢性携带者。您也可选择合理的生活方式保护您自己的肝脏。

慢性乙型肝炎能够导致何种严重的肝病?

慢性乙型肝炎有时能够导致“肝硬化”或“肝癌”。这些疾病由乙型肝炎病毒造成,并可能缩短寿命。如发生“肝硬化”,肝脏在受到病毒侵害后自我修补,从而造成疤痕组织。这一疤痕组织使肝脏变硬,从而无法行使正常的功能。而健康的肝脏柔软并具有弹性。肝癌较为少见,但对生命的危害更大。肝硬化和肝癌都需要专家医治。及早诊断这两种疾病非常重要。这些严重的肝病的治疗选择包括服药,有时甚至包括肝脏移植,以延长病人的寿命。

慢性乙型肝炎是否能够治愈?

对慢性携带者来说,好消息是有若干种很有希望的疗法。而十年以前病人没有这种选择。现在有药物能够减缓病毒对肝脏造成的侵害,这意味着您今后患上严重肝病的机率也较低。这些药物有时甚至能够清除病毒,尽管这种情况并不常见。有了所有这些令人振奋的研究,人们也更加希望能够为慢性携带者找到一种完全根治的疗法。

慢性乙型肝炎有何种疗法?

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﹗

为了使自己保持健康,我还能够做什么事情?

您能够做的最重要的事情之一,就是帮助保护您的肝脏。即使您并没有生病的感觉,病毒仍有可能损害您的肝脏。因此请照顾好您的肝脏。我们包括了一份您现在就能够做的事情简表。但是,您还能够做很多其它事情,因此请务必与您的医生讨论您能够以何种其它方式,保持自己的肝脏健康强壮!

1.务必寻找一名深刻了解乙型肝炎的医生。“肝脏学家”是治疗肝病的专科医生。他们通常拥有有关 乙型肝炎化验和治疗的最新信息。但是家庭医生可能也同样能够胜任。

2. 由您的肝脏学家或家庭医生定期进行体检。提出许多问题!为了避免今后的问题,您需要现有的最佳信息和医疗。

3.避免饮酒或严格限制您的酒量。医学研究表明,酒精对肝脏非常有害。避免吸烟或请戒烟,因为这对肝脏也非常有害。

4.如果您是孕妇,请告诉医生您患有慢性乙型肝炎,务必确保您的新生宝宝在产房中获得疫苗注射。这非常重要,因为您的宝宝必须在出生后的12个小时以内即接种首剂乙型肝炎疫苗,以防止慢性感染。

5.即使慢性乙型肝炎患者并无专门饮食,请努力多吃新鲜水果和蔬菜,限制脂肪和垃圾食物,并饮用大量的水。

6.在试用草药、维生素或流行的饮食方法时要非常小心。某些草药可能有帮助作用,但是某些草药或流行饮食可能会伤害您的肝脏,并在有些时候可能会干扰您的治疗。请务必与您的医生讨论您想试用何种草药或您已在试用的草药,以避免任何潜在的问题。

7.让您的亲人接受乙型肝炎化验。确保他们获得疫苗注射。

8.避免使他人与您的血液接触。不要共享剃须刀、耳环或牙刷等尖利的物品。使用避孕套并采取安全的性爱措施。不要吸食非法的街头毒品。

如果我患上慢性乙型肝炎,则未来前景如何?

幸运的是,乙型肝炎是一种进展缓慢的疾病。问题都可能是在以后发生。这是好消息,因为如果有了更好的教育、及早化验、定期治疗和新的治疗选择,则可行的方法大为增加。许多慢性携带者现在均可期待自己健康长寿。此外,研究人员在寻求根治方法方面正在取得进展—对于全球的四亿慢性携带者来说,前途是非常光明的!

 

Living with Hepatitis B

What does it mean if my doctor tells me I'm a "chronic carrier" of hepatitis B?
Adults infected with hepatitis B for the first time are usually able to get rid of the virus after six months. If the virus remains in your blood after six months, then you can be diagnosed as a "chronic carrier" of hepatitis B. This means you can pass the virus on to others. You are also at greater risk for developing serious liver disease later in life. If you are a pregnant woman, you can also pass the virus on to your newborn baby. But this can be prevented. Please check Pregnant Women and Hepatitis B for more information.

If I don't feel sick, can I still be a "chronic carrier"?
Many chronic carriers of hepatitis B feel healthy and strong even though the virus is in their bodies. They can be infected for a long time and not even know it. That is why hepatitis B is called a "silent infection". With a chronic infection, the virus stays in your liver and continues to attack and injure your liver for a long period of time. By the time you feel sick enough to see a doctor, you could already have serious liver disease. So make sure you get tested before you feel sick.

Should I get the vaccine if I am a chronic carrier?
Unfortunately, the hepatitis B vaccine is too late for chronic carriers. It will not help you since you already have hepatitis B. But the vaccine can protect your loved ones. Make sure those who live in close contact with you, including babies and children are vaccinated.

If I am a "chronic carrier", does it mean that I won't live a long life?
People with chronic hepatitis B can live a long healthy life. Many chronic carriers can live with hepatitis B for years, even decades, without any symptoms. However every carrier lives with a greater risk of developing more serious liver disease. Chronic hepatitis B can injure your liver, whether you feel sick or not. This is why it is important to find a good doctor, get regular check-ups, and take good care of your liver. There are treatments that can help chronic hepatitis B carriers. You can also make simple lifestyle choices to protect the health of your liver as well.

What serious liver diseases can result from chronic hepatitis B?
Chronic hepatitis B can sometimes lead to "cirrhosis" or "liver cancer". These diseases occur due to liver damage from the hepatitis B virus and can be life-shortening. In "cirrhosis", the liver becomes hardened from fighting the virus. As the liver tries to repair itself from constant attacks by the virus, scar tissue is created. This scar tissue makes the liver hard which makes it unable to work normally. A healthy liver is soft and flexible. Liver cancer is less common but is more immediately life-threatening. Both cirrhosis and liver cancer require expert medical attention. Early diagnosis of both diseases is very important. Treatment options for these serious liver diseases can include medications and sometimes even a liver transplant to help extend one's life.

Is there a cure for chronic hepatitis B?

The good news is that there are promising new treatment for people living with chronic hepatitis B. Today, there are several approved drugs in the United States that can slow down liver damage caused by the virus.

The new drugs can help slow the progression of liver disease in chronically infected people by slowing down the virus. If there is less hepatitis B virus being produced, then there is less damage being done to the liver. Sometimes these drugs can even get rid of the virus. With all of the new exciting research, there is great hope that a complete cure will be found for chronic hepatitis B in the near future.

What treatments are available for 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!

What other things can I do to keep myself healthy?
One of the most important things you can do is to help protect your liver. Even if you don't feel sick, the virus can still damage your liver. So take good care of your liver. We have included a short list of simple things you can do right now. But there are many other things you can do, so be sure to talk to your doctor about other ways you can help keep your liver healthy and strong!

  1. Make sure you find a good doctor who is knowledgeable about hepatitis B. A "liver specialist" is a doctor who specializes in liver disease. They usually have the most current information about hepatitis B testing and treatments. But a family doctor may be just as good.
  2. Get regular medical check-ups with your liver specialist or family doctor. Ask a lot of questions! You need the best information and medical care possible to avoid future problems.
  3. Avoid alcohol or strictly limit the amount of alcohol you drink. Medical studies show that alcohol is very damaging to the liver. Avoid smoking or Stop smoking because this is also very harmful to the liver.
  4. If you are a pregnant woman, tell your doctor that you have chronic hepatitis B. Make sure your doctor orders the hepatitis B vaccine in advance. Make sure your newborn baby is vaccinated in the delivery room. This is very important because your baby must get the first dose of hepatitis B vaccine within the first 12 hours of life to prevent a chronic infection.
  5. Although there is no specific diet for chronic hepatitis B, try to eat lots of fresh fruits and vegetables, limit fat and junk foods, and drink plenty of water.
  6. Be very careful about trying herbs, vitamins, or fad diets. Some herbs may be helpful, but some herbs or fad diets can hurt your liver. Sometimes they can even interfere with your medical treatments. Be sure to talk to your doctor about what herbs you want to try or what you are already taking to avoid any potential problems.
  7. Have your loves ones tested for hepatitis B. Make sure they get vaccinated.
  8. Avoid spreading your blood to others. Don't share sharp objects like razors, earrings, or toothbrushes. Use condoms and follow safe sex practices. Avoid illegal street drugs.

What does my future look like if I have chronic hepatitis B?
Fortunately, hepatitis B is a slow-growing virus. If problems arise, it can be later in life. This is good news because with better education, early testing, regular medical attention, and new treatment options, there is so much more to offer. Many chronic carriers can now expect to live long and healthy lives. In addition, researchers are making progress in finding a cure -- for the 400 million chronic carriers worldwide, the future looks very bright!