Hepatitis B Foundation

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乙型肝炎和華人社區

華人的風險爲何高于西方人?

因爲亞裔人已感染乙型肝炎的數目遠遠高于西方人。儘管乙型肝炎幷非一種“亞洲病”,但其影響了上億亞裔人士。由于亞裔社區在一開始就有大批受到感染者,可能將乙型肝炎病毒傳染給他人者也較多。這增加了您可能受到感染的風險。由于受到感染的西方人數目較少,這一群體受到傳染的風險也較低。

乙型肝炎在華人中的傳播方式有何不同?

亞裔人士和西方人均有可能通過血液接觸、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。工作和生活方式選擇對兩個群體均可能造成同等的風險。但是,乙型肝炎在在華人中的傳播方式不同。亞裔人士更多在新生兒時期即受到感染—由母親在分娩時無意中傳染病毒。幼兒如在日常生活中與受到感染的家人密切接觸也可能遭受風險。嬰兒和兒童較有可能轉變成爲乙型肝炎慢性携帶者,因爲他們未成熟的免疫系統很難清除病毒。西方人則更多地在青少年時期由于從事無防護性交而受到傳染。而成人的免疫系統通常能够清除病毒幷“康復”。

成爲乙型肝炎的“慢性携帶者”意味著什麽?

無法清除乙型肝炎病毒者被診斷爲“慢性携帶者。”病毒可在其血液和肝臟中生存很長時間。他們可在無意中將病毒傳染給他人。慢性乙型肝炎亦有可能轉變爲嚴重的肝病,如肝硬化或肝癌。儘管幷非每個慢性携帶者均將發展成爲嚴重的肝病,但與未受感染者相比,他們發展成爲嚴重肝病的機率較大。

華人爲何應對慢性乙型肝炎感染的憂慮?

慢性乙型肝炎可導致肝硬化或肝癌,因而接受化驗很重要,因爲及早診斷可導致及早治療,從而拯救您的生命。另外,慢性携帶者可能會將病毒傳播給他人。由于大多數慢性携帶者不知道自己已受到感染,他們可在無意中將其傳染給他人。如沒有進行化驗幷采取措施,則乙型肝炎可在一個家族和整個社區中傳染給數代人。

我如何能够停止乙型肝炎的傳播?

好消息是您可打破在您的家庭和華人社區中的傳染循環。接受乙型肝炎化驗。務必確保家中的每個人都接受乙型肝炎疫苗注射。同時自己也接受疫苗注射。尋求完善的醫療護理。如果您已患上慢性乙型肝炎,則與您的家庭醫生或肝病專家討論治療方案。

如果我患上慢性乙型肝炎,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﹗

 

Hepatitis B and the
Chinese Community

Why are the Chinese at greater risk than Westerners?
Because there are more Asian people already infected with hepatitis B than Westerners. Although hepatitis B is not an "Asian disease", it affects hundreds of millions of Asians. Since the Asian community starts with such a large number of infected people, there are more people who can pass the hepatitis B virus on to others. This increases the risk that you could get infected. Since there is a smaller number of Westerners who are infected, this group has a lower risk of infection. For more information, please click Dr. Tso Talks About Hepatitis B And The Chinese Community.

How is hepatitis B spread differently among the Chinese?
Asians and Westerners can both get hepatitis B through contact with blood, unprotected sex, shared needles, and from an infected mother to newborn baby during delivery. Jobs and lifestyle choices can create an equal risk for both groups. However, hepatitis B is often spread differently among Asians. Asians are most commonly infected as newborns - from a mother who unknowingly passes the virus on during delivery. Young children are also at risk if they live in close daily contact with an infected family member. Babies and children are more likely to develop a chronic hepatitis B infection because their young immune systems have trouble getting rid of the virus. Westerners are most commonly infected as young adults through unprotected sex. As adults, their immune systems can usually get rid of the virus and they "recover" from an infection.

What does it mean to be a "chronic carrier" of hepatitis B?
People who are unable to get rid of the hepatitis B virus are diagnosed as being a "chronic carrier". The virus can stay in their blood and liver for a long time. They can unknowingly pass the virus on to other people. Chronic hepatitis B can also lead to serious liver diseases, such as cirrhosis or liver cancer. Not every chronic carrier will develop serious liver disease. However, they have a greater chance than someone who is not infected.

Why should Chinese people be worried about chronic hepatitis B infections?Because chronic hepatitis B can lead to cirrhosis or liver cancer. It's important to get tested because early diagnosis can lead to early treatment which can save your life. Also, chronic carriers can spread the virus to others. Since most chronic carriers don't know they are infected, they are unknowingly spreading it to many other people. If people are not tested, hepatitis B can pass through several generations in one family and throughout the community.

How can I stop the spread of hepatitis B?
The good news is that you can break the cycle of infection in your family and in the Chinese community. Get tested for hepatitis B. Make sure everyone in your family is vaccinated against hepatitis B. Get the vaccine yourself. Look for good medical care. Discuss treatment options with your family doctor or a liver specialist if you already have chronic hepatitis B.

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 in 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, depression and other mental health problems. Approved May 2005 and available only for adults.
  • Lamivudine Epivir-HBV, Zeffix, or Heptodin) is a pill that is taken once a day, with almost no side effects, for at least one year or longer. A primary concern is the possible development of hepatitis B virus mutants during and after treatment. Approved in 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. The primary concern is that kidney problems can occur while taking the drug. Approved September 2002 and available only for adults. Pediatric clinical trials are being planned.
  • Entecavir (Baraclude) is a pill taken once a day, with almost no side effects for up to one year. It is considered to be the most potent oral antiviral drug for chronic hepatitis B to date. Approved April 2005 and available only for adults. Pediatric clinical trials may be planned for the future.
  • Telbivudine (Tyzeka) is a pill taken once a day, with almost no side effects. Approved October 2006 and available only for adults. Pediatric clinical trials may be planned for the future.
  • 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!