Hepatitis B Foundation

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一般信息

什麽是乙型肝炎?

乙型肝炎是世界上最爲常見的傳染性肝病。它是由乙型肝炎病毒(HBV)引起,這一病毒侵害肝臟。通常大多數成人都能够抵抗乙型肝炎病毒,幷徹底康復。但是也有許多成人無法抵抗乙型肝炎病毒。令人遺憾的是,這也包括大多數受到傳染的嬰兒和兒童。他們被診斷爲乙型肝炎病毒的“慢性携帶者”—病毒可在其血液和肝臟停留很長時間。他們可能會將病毒傳染給他人。好消息是已經有一種疫苗够預防乙型肝炎。同時那些“慢性携帶者”也能够獲得多種治療。

有多少人受到影響?

全球有二十億人(將近有三分之一人口)已受到乙型肝炎病毒感染。許多人清除了病毒幷康復,但是有四億人無法清除病毒,幷繼續充當病毒的“慢性携帶者”。乙型肝炎在亞洲、東南亞、印度和部分非洲和南美洲、東歐及中東地區最爲常見。 美國有一百多萬慢性乙型肝炎病毒携帶者。

華人爲何應當關心乙型肝炎?

乙型肝炎能够傳染任何年齡或種族的任何人,但是亞裔人士受到傳染的風險要高得多。在全球的乙型肝炎“慢性携帶者”中,有75%爲亞裔。雖然乙型肝炎在中國極爲常見,它也是美籍華人的一個問題。隨著華人遷入美國和其它國家,病毒也與其共行。

亞裔人士中的誤解之一是認爲乙型肝炎可能“來自遺傳”,因爲有時一個家族中有數代人受到感染。但這幷非“遺傳病”— 乙型肝炎是由病毒引起的。華人家庭可以通過接受化驗、疫苗注射和治療,來打破乙型肝炎傳染的循環。

我如何可能患上乙型肝炎?

乙型肝炎是一種通過血液傳播的“傳染病”。含血體液也能够傳染病毒。乙型肝炎通過血液的直接接觸、無防護性交、共享針頭傳播,也可由受到感染的母親在分娩時傳染給新生嬰兒。您不可能從空氣、擁抱或觸摸、馬桶座或門把的接觸中感染乙型肝炎。乙型肝炎幷非通過偶然接觸傳播。

何人最有可能受到乙型肝炎感染?

雖然每個人均有受到乙型肝炎感染的風險,有些人受到感染的可能性較大。由于您的工作、生活方式,或者僅僅是由于您出生在一個有乙型肝炎史的家庭中,都可能增加您受到感染的機會。以下是某些最爲常見的“高風險”群體—但是請記住這一名單幷不全面﹕

  • 亞裔人士,特別是那些父母移民到美國的人士。
  • 與患有乙型肝炎者結婚或與其家庭密切接觸的人士,包括成人和兒童。
  • 在乙型肝炎流行的國家(亞洲、印度和部分非洲和南美洲、東歐及中東地區)居住或旅行的人士。
  • 從事無防護性交及/或擁有多個性伴侶的人士。
  • 在工作中與血液接觸的健康護理人員和他人。
  • 接受腎透析或在醫院內居住的人士。
  • 吸毒的癮君子。

是否有疫苗能够防止乙型肝炎?

有。所有嬰兒、兒童和成人均可接受疫苗注射。這一疫苗非常安全—您不可能由于接種疫苗而患上乙型肝炎。最好的消息是您和您的親人只需要接受三次注射,即可獲得終生保護。嬰兒和18歲以下兒童通常可從本州衛生廳獲得免費疫苗注射。請向您的醫生查詢有關乙型肝炎疫苗的事宜。

我是否應當接受疫苗注射?

在美國,醫生建議所有新生兒和18歲以下兒童均應當接受疫苗注射。成人特別是亞裔人士也有患上乙型肝炎的風險。請與您的醫生討論有關接受乙型肝炎疫苗注射的事宜—請保護您自己不患上這一種嚴重的傳染性肝病。

乙型肝炎疫苗是否安全?

是,醫學和科學研究已顯示,這是現有的最爲安全的疫苗之一。在全球接受疫苗注射者已超過十億人次。疫苗是在實驗室中製成的—您不可能由于接受疫苗注射而患上乙型肝炎。最常見的副作用是胳膊的注射部位發紅和酸痛。請在接受系列疫苗注射之前,與您的醫生討論其它可能的副作用,及您的任何過敏體征。

我還能采取何種其它措施,保護自己不患上乙型肝炎?

由于乙型肝炎是通過血液傳播的,您應當避免與他人共用尖利的物品,如剃鬚刀、牙刷、耳環和指甲剪。在接受針灸、刺青和身體穿刺時,請務必使用消毒針頭。請戴手套或使用紙巾保護自己的手,以避免觸摸血液。與性夥伴使用避孕套。使用漂白粉清洗血漬。在觸摸血液之後務必用肥皂和水徹底洗手。最重要的是請務必接受疫苗注射。

我如何得知自己已受到乙型肝炎感染?

乙型肝炎是一種“無聲的傳染病”。大多數人在受到感染時沒有任何症狀。因此,他們可能在不知情的情况下患上乙型肝炎。您可要求您的醫生或當地的健康診所進行簡單的驗血。驗血可顯示您是否已受到感染。

有多少人從乙型肝炎“康復”或成爲乙型肝炎病毒的“慢性携帶者”?

答案取决于您是在成年後、童年還是在嬰兒時期受到感染。成人通常能够“康復”,因爲他們的免疫系統能够清除病毒。如果健康的成人受到感染,他們有90%的機率清除病毒,另有10%的機率成爲慢性携帶者。但是如嬰兒和兒童受到感染則更有可能成爲慢性携帶者,因爲其免疫系統較難清除病毒。如嬰兒受到感染,他們只有10%的機率清除病毒,有90%的機率成爲慢性携帶者。幼兒則有40%的康復機率,另有60%的機率成爲慢性携帶者。但是每個人都能够通過接受疫苗注射獲得保護,避免受到乙型肝炎感染。

我可以到何處獲得化驗?

您可要求您的醫生、當地的衛生部門或肝病專家進行一次簡單的驗血檢測乙型肝炎。這一驗血可在任何醫生診所進行。如果您在紐約市地區居住,您可致電給免費電話 1-888-888-0981瞭解詳情和醫生的轉診。您可以獲得英語、國語和粵語信息。

如果我患上乙型肝炎,是否有何治療方法?

對患有慢性乙型肝炎的病人來說,美國有幾種經過批准的藥物。這幾種藥也在中國提供:

  • 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1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-HBVZeffix (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2008年8月批准用于成人。

不是每一個慢性乙型肝炎患者都需要用藥﹐瞭解這一點很重要。一些患者只需要由其醫生定期監測 (至少一年一次)。有肝病活動症狀的患者最有可能從治療中獲益。請務必和您的醫生談一談您是否可以從治療中獲益幷討論一下治療方案。此外﹐在臨床實驗和研究渠道中都有令人鼓舞的新藥。

所有慢性乙型肝炎患者不論是否接受治療都要定期看醫生﹐這是至關重要的﹗

 

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!