First, why is my cannosanase fluctuating is relatively large?
Five years ago (June 2016), Xiaoyu asked me to diagnose chronic hepatitis B.At that time, Xiao Yu was 25 years old and found that hepatitis B was "Da Sanyang" for more than ten years. It was 5 months pregnant when we came to our hospital’s comprehensive outpatient clinic.Xiaoyu asked me: "Doctor Wang, why do my canopyanase value fluctuate more?" I carefully looked at her liver function test sheet in the past three years and found that her cann aminotransferase fluctuated between 8 ~~ 55Answer her: "Your hepatitis B is estimated to be onset, the inflammatory activity in the liver is changing, and the significant fluctuations in gifda transaminase will occur."
Xiaoyu’s virus volume has been between 7 ?~~ 8. The 8th side copy is a high virus load. The risk of transmission in the palace of hepatitis B virus in this case is still relatively high. I suggest that she starts at 28 weeks of pregnancy.Take Norofovir, you can stop the medicine after childbirth.At the same time, she also explicitly told her that the probability of obviously obviously onset of hepatitis after delivery was very high.
2. One and a half months after giving birth, the aminase of cannase rose to 268 (healthy women generally <19)
About one and a half months after the birth, symptoms such as fatigue, oily, and urine yellow appeared. Blood -drawn detection of liver -to -liver foundation found that cannaninase rose to 268, total bilirubin 38 (reference value <20).I asked her: "Are you breastfeeding now?" Xiao Yu replied helplessly: "My mother -in -law knows that I am hepatitis B and Sanyang, and the baby sleeps with her as soon as it is born. Usually, my mother -in -law hugs the baby.Feed! Well, what do you know, in the countryside … "
I suggest that Xiaoyu improves the relevant examination, and the results show that: normal thyroid function, negative antibody detection, HBVDNA quantitative 7 back -side copy, HBEAG 1748 S /CO, HBSAG accurate accuracy 78150 IU /ml.Xiaoyu’s antiviral treatment plan is a general interferon combined with Entica for 28 days, and then general interferon single drug treatment.(The economic reasons are limited, no long -acting interferon is selected)
After three months of treatment of Xiaoyu interferon, the liver function is basically normal, HBVDNA quantitative 3 backup copy, HBEAG866 S /CO, HBSAG accurate fixed amount 4191 IU /ml.I said to Xiaoyu: "The effect of interferon treatment is very good, the virus volume and hepatitis B -related antigen decrease significantly. It is recommended to continue interferon therapy." Xiaoyu said: "I use interferon to insomnia, and the hair loss is obviously obviously, People have lost a lot of weight, do I want to stop interferon? "I patiently persuaded:" It is best to persist, I really don’t want to interferon. I suggest you start taking Enfatcavir or Nonofir. In this case, you are in this situation.If the drug is stopped, hepatitis will definitely recur, wouldn’t it be abandoned before! "
Xiaoyu didn’t want to continue to inject interferon, nor was she willing to take oral antiviral drugs, worried about long -term medication or even taking medicine for a long time.Because there are still many patients waiting, I no longer persuade it, and tell her to review it on time after stopping the medicine.
Third, after four months of discontinuous interferon, the virus rebounded to 8th side, and the spleen was enlarged
In four months, Xiaoyu stopped the interferon and found that the viral volume rebounded to 8 times.I said to Xiao Yu seriously: "You are only 26 years old this year, and the spleen starts to swell. In this case, the regulatory antiviral treatment will be delayed.The antiviral treatment can quickly inhibit virus replication, continue to control liver inflammation, can live healthy and longevity, what is the relationship between long -term medication and even medication for lifetime? Not to mention, young patients with hepatitis BYu Xian was determined this time and replied: "Okay, I listen to you, I insist on taking medicine every day from today!"
Fourth, take Norofovir for two years and three months, hepatitis B clinical cure!Why is the effect so good?
Xiaoyu started taking Norofova to treat hepatitis B. After half a month, it came to review it. The result was prompting that the quantitative HBVDNA quantitative dropped to 5. The citizer was increased to 265.I told her: As the amount of virus fell rapidly, it dropped by 1,000 times in half a month. The ability to remove hepatitis B virus was further activated. Liver inflammation worsened for a short time. There is no need to worry and no liver protection.
After a month, Xiao Yu came to review again. The result was prompt: HBVDNA quantitatively dropped to three regions of copying, and citrobinase dropped to about 150.I suggest that she can review every three months in the future.When Xiaoyu took the medicine until two years and three months, he found that the hepatitis B surface antigen <0.05 IU/ml, the results of the review after one month are still the same, hepatitis B is cured clinically!IntersectionI suggest that Xiaoyu consolidate the treatment for one year, and can stop the drug to observe.
Whether it is taking Ensicavir or Norofovir, patients with chronic hepatitis B can reach the probability of clinical hepatitis B clinical cure for ten years. Why is the treatment effect of Xiaoyu so good?The virus drops rapidly after taking the medicine, and the virus rebounds quickly after stopping the medicine. This is an important reason for inducing obvious immune removal of Xiaoyu, and this activation is at least two times. The interferon treatment is also one of the reasons for the auxiliary.On the basis of removing the immune response of hepatitis B virus, the powerful Norofovir continued to inhibit the replication of hepatitis B virus, and finally obtained a good effect of removing hepatitis B surface antigen for two years and three months.
5. The onset of hepatitis B after childbirth may give birth to the hope of clinical cure for hepatitis B
Hepatitis B pregnant women with high virus load (≥2.0e+05 IU/ML) take Donofir in the second trimester (24 ~~ 28 weeks). This is an important means to block the transmission of hepatitis B virus.Joint immunomyrum (hepatitis B immunoglobulin+hepatitis B vaccine), the success rate of maternal and infant blocking was almost 100%.However, a considerable number of hepatitis B maternal has obvious hepatitis activity after the drug was suspended. Whether this situation is related to the use of Norofovir. At present, the liver disease community is controversial.In fact, when pregnant women in the past did not take medicine, the incidence of hepatitis after childbirth was also very high.
Hepatitis after childbirth is obviously onset. As long as the antiviral drugs are used reasonably, the hope of breeding hepatitis B clinical cure may not be a case.Some readers will ask: In the short period of time, the virus volume has prompted the rapid decline in the amount of virus. Will the virus volume rebound rapidly after stopping the drug, will it induce severe hepatitis?I answered: There is such a possibility, but treatment is very safe under the guidance of professional liver disease doctors.
Readers will ask: Is this repeated liver of hepatitis obviously active, will there be obvious liver fibrosis?I answered: The short -term hepatitis worse, as long as it is treated in time, there will be no obvious liver fibrosis.Xiaoyu’s spleen entertaining recovered after taking Norofovir for half a year.
The purpose of writing this article is to emphasize the importance of activating the immune response of hepatitis B virus. This is the internal cause of hepatitis B patients to obtain clinical cure. Of course, the continuous and effective antiviral treatment is also the key to the key.For specific treatment plans, please discuss with your local attending physician, and follow the suggestions of local attending physicians.Thank you for reading.
Wang Chunxi, Director of the Comprehensive Outpatient Department of Shangrao Second People’s Hospital, Shangrao City, Jiangxi Province