Hepatitis B Foundation

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與乙型肝炎共存

如醫生說我是乙型肝炎“慢性携帶者”則意味著什麽?

首次感染乙型肝炎的成人通常能够在六個月以內清除病毒。如病毒在六個月後仍然在您的血液中停留,您就可能被診斷爲乙型肝炎“慢性携帶者”,這意味著您可能會將病毒傳染給他人。您今後患上嚴重肝病的風險也較高。如果您是孕婦,您也有可能會將病毒傳染給新生兒。但這是可以防止的。欲知詳情,請查閱《孕婦和乙型肝炎》部分。

如果我沒有生病的感覺,我還有可能是“慢性携帶者”嗎?

許多乙型肝炎慢性携帶者即使體內有病毒,仍然感覺健康體壯。他們可能已長期遭受感染,但仍不知情。正因爲此, 乙型肝炎被稱爲“無聲的傳染病”。如發生慢性感染,病毒長期停留在您的肝臟中幷侵害您的肝臟。等到您感到自己病情嚴重,需要接受醫生治療時,您可能已經患上了嚴重的肝病。因此,請您務必在有生病的感覺之前即接受化驗。

如果我是慢性携帶者,我是否仍應接受疫苗注射?

遺憾的是,對于慢性携帶者來說,注射乙型肝炎疫苗已經太遲。由于您已經患上乙型肝炎,這沒有幫助作用。但是疫苗能够保護您的親人。請務必保證在日常生活中與您有密切接觸者包括嬰兒和兒童獲得疫苗注射。

如果我是“慢性携帶者”,這是否意味著我不會長壽?

患有慢性乙型肝炎者仍可健康長壽。許多慢性携帶者可數年甚至數十年與乙型肝炎共存,而沒有任何症狀。但是,每個携帶者都有患上較爲嚴重的肝病的風險。無論您是否感覺生病,乙型肝炎病毒都能够侵害您的肝臟。因此,尋求醫生定期接受檢查幷保護好您的肝臟非常重要。有些療法能够幫助乙型肝炎慢性携帶者。您也可選擇合理的生活方式保護您自己的肝臟。

慢性乙型肝炎能够導致何種嚴重的肝病?

慢性乙型肝炎有時能够導致“肝硬化”或“肝癌”。這些疾病由乙型肝炎病毒造成,幷可能縮短壽命。如發生“肝硬化”,肝臟在受到病毒侵害後自我修補,從而造成疤痕組織。這一疤痕組織使肝臟變硬,從而無法行使正常的功能。而健康的肝臟柔軟幷具有彈性。肝癌較爲少見,但對生命的危害更大。肝硬化和肝癌都需要專家醫治。及早診斷這兩種疾病非常重要。這些嚴重的肝病的治療選擇包括服藥,有時甚至包括肝臟移植,以延長病人的壽命。

 慢性乙型肝炎是否能够治愈?

對慢性携帶者來說,好消息是有若干種很有希望的療法。而十年以前病人沒有這種選擇。現在有藥物能够减緩病毒對肝臟造成的侵害,這意味著您今後患上嚴重肝病的機率也較低。這些藥物有時甚至能够清除病毒,儘管這種情况幷不常見。有了所有這些令人振奮的研究,人們也更加希望能够爲慢性携帶者找到一種完全根治的療法。

慢性乙型肝炎有何種療法?

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﹗

 爲了使自己保持健康,我還能够做什麽事情?

您能够做的最重要的事情之一,就是幫助保護您的肝臟。即使您幷沒有生病的感覺,病毒仍有可能損害您的肝臟。因此請照顧好您的肝臟。我們包括了一份您現在就能够做的事情簡表。但是,您還能够做很多其它事情,因此請務必與您的醫生討論您能够以何種其它方式,保持自己的肝臟健康强壯!

1.務必尋找一名深刻瞭解乙型肝炎的醫生。“肝臟學家”是治療肝病的專科醫生。他們通常擁有有關 乙型肝炎化驗和治療的最新信息。但是家庭醫生可能也同樣能够勝任。

2. 由您的肝臟學家或家庭醫生定期進行體檢。提出許多問題!爲了避免今後的問題,您需要現有的最佳信息和醫療。

3.避免飲酒或嚴格限制您的酒量。醫學研究表明,酒精對肝臟非常有害。避免吸烟或請戒烟,因爲這對肝臟也非常有害。

4.如果您是孕婦,請告訴醫生您患有慢性乙型肝炎,務必確保您的新生寶寶在産房中獲得疫苗注射。這非常重要,因爲您的寶寶必須在出生後的12個小時以內即接種首劑乙型肝炎疫苗,以防止慢性感染。

5.即使慢性乙型肝炎患者幷無專門飲食,請努力多吃新鮮水果和蔬菜,限制脂肪和垃圾食物,幷飲用大量的水。

6.在試用草藥、維生素或流行的飲食方法時要非常小心。某些草藥可能有幫助作用,但是某些草藥或流行飲食可能會傷害您的肝臟,幷在有些時候可能會干擾您的治療。請務必與您的醫生討論您想試用何種草藥或您已在試用的草藥,以避免任何潜在的問題。

7.讓您的親人接受乙型肝炎化驗。確保他們獲得疫苗注射。

8.避免使他人與您的血液接觸。不要共享剃鬚刀、耳環或牙刷等尖利的物品。使用避孕套幷采取安全的性愛措施。不要吸食非法的街頭毒品。

如果我患上慢性乙型肝炎,則未來前景如何?

幸運的是,乙型肝炎是一種進展緩慢的疾病。問題都可能是在以後發生。這是好消息,因爲如果有了更好的教育、及早化驗、定期治療和新的治療選擇,則可行的方法大爲增加。許多慢性携帶者現在均可期待自己健康長壽。此外,研究人員在尋求根治方法方面正在取得進展—對于全球的四億慢性携帶者來說,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!