Recently, I have published a number of articles related to liver disease, talking about liver cancer, liver cirrhosis, and liver fibrosis. I also told you about the complete examination of liver disease (see the previous article). Many netizens sent private messages to ask. Some related questions and time issues will be shared with you here, and will not be answered one by one.

The problem of mother-to-child transmission of hepatitis B virus, will mothers pass hepatitis B antibodies to their children? Will the antibodies go away?

Everyone knows that hepatitis B virus is passed from mother to child. If the mother has hepatitis B surface antibody, will the antibody also be passed on to the child? Babies are born with hepatitis B vaccine, but it may still fail after many years. Does it mean that the antibodies produced by the vaccine are not durable? And can the antibodies handed down from the mother last for a long time?

The hepatitis B surface antibody in the mother’s body will be passed to the fetus through the blood, but it will disappear about half a year after birth. Generally speaking, there are two sources of surface antibodies for hepatitis B in the human body. One is the antibody produced after natural infection with hepatitis B virus. This antibody exists for a long time, up to 10 years. Antibodies produced after receiving the hepatitis B vaccine may disappear over time.

No matter which way the surface antibodies are produced, they may disappear. At this time, one additional dose of vaccine can be injected or three complete doses of vaccine can be re-injected. One month after the injection, it can be tested again whether the antibodies have been produced.

Both hepatitis B surface antigen and surface antibody are positive, what does it mean?

I recently participated in the company’s physical examination. The blood test report showed that both HBsAg and HBsAb were positive. I can’t understand the blood test report. Is there hepatitis B?

HBsAg and HBsAb are both positive (+) reaction, it may be recently infected with hepatitis B. After a period of time, one of the cases is that it may become HBsAg(+) HBsAb(-), which means that the patient becomes a hepatitis B virus carrier and needs to be followed up regularly; the other is that most people will be It becomes HBsAg(-) HBsAb(+), which means that the patient already has hepatitis B surface antibody and will not be infected by hepatitis B virus again.

If the HBsAg and HBsAb are both positive for a period of time, it is possible that the patient’s HBsAg and HBsAb are from different types of hepatitis B virus. Usually, he was a hepatitis B carrier when he was a child, and he was infected with a different type of hepatitis B virus when he grew up. Therefore, such patients are still carriers of hepatitis B virus, and long-term follow-up examinations are recommended.

In addition, the clinical significance of the five hepatitis B items can be referred to the following figure:

6 cm of liver cancer with capsule, is it easy to metastasize after surgery? Can I take some health products such as Ganoderma lucidum to prevent it?

My uncle is a hepatitis B carrier. A month ago, he was found to have a liver cancer of about 6 cm. The doctor said that the tumor has a capsule and can be treated by surgery. I would like to ask if there may be cancer cell metastasis after surgical resection? Is there any way to prevent recurrence or transfer elsewhere? I heard that Ganoderma lucidum has an inhibitory effect on cancer cells, can it be eaten?

Past studies have shown that encapsulated tumors are less likely to recur after surgical resection or spread to other places. Currently, there is no absolutely effective method or drug to prevent the recurrence or metastasis of liver cancer.

However, if liver cancer is related to hepatitis C virus, and the values ​​of aspartate aminotransferase and alanine aminotransferase are abnormally elevated, interferon therapy can be considered after liver cancer is properly treated and controlled, which may reduce the recurrence rate of liver cancer. However, in hepatitis B virus-related liver cancer, if the amount of hepatitis B virus is still high, whether the current anti-hepatitis B virus drugs will reduce the recurrence rate of liver cancer, more research is needed.

As for the consumption of Ganoderma lucidum and other health products, there is currently insufficient research evidence to show that it has a preventive or inhibitory effect on cancer cells.

How to effectively prevent recurrence of hepatitis C patients who find tumors and receive embolization?

An elderly patient with hepatitis C who was found to have two liver cancers less than 2 cm in size 6 years ago received interventional embolization. However, in the past year, the recurrence rate of liver cancer has been getting faster and faster. On average, he needs to receive treatment once every 3-4 months. Some time ago, he went to the hospital for examination due to the epidemic, and it was found that the liver cancer even increased to about 5cm. How can we slow down the recurrence rate of liver cancer? There are other ways to treat liver cancer that can effectively prevent liver cancer from recurring.

The recurrence of liver cancer does make people feel both nervous and worried. However, there is still no effective method to inhibit the recurrence of liver cancer.

In addition to the interventional therapy that the patient receives, the methods for treating liver cancer include surgical resection, liver transplantation, photon knife (a type of radiation therapy), chemotherapy, targeted therapy, etc. How to choose the treatment method depends on the doctor according to the patient. The tumor size, growth location, and liver function status were evaluated.

According to the patient’s self-report, there are multiple tumors, which are not suitable for surgical resection. If the tumor invades the hepatic portal vein or the number of tumors is large, the therapeutic effect will be limited and recurrence is easy. If vascular embolization intervention is still feasible, repeated interventional therapy will be an effective method at present. If vascular embolization is no longer suitable, chemotherapy or targeted therapy may be considered as the next treatment.

Although the recurrence rate of liver cancer is quite high, if you can choose a suitable treatment method and actively treat it, there is still a chance to be cured. Therefore, you must receive effective treatment as soon as possible, and follow up regularly without delay.

Young hepatitis B carriers with high transaminases, what should I do? How to treat?

The patient is a 20-year-old hepatitis B virus carrier. At the end of May last year, he tested positive for e-antigen, and the values ​​of aspartate aminotransferase and alanine aminotransferase were 5 times the upper limit of the normal value. At that time, he wanted to change his diet and living habits, and then see if he accepted it Treatment; during the re-examination at the end of last year, the value of transaminase was higher, up to 7 times the upper limit of the normal value. The recent examination has not changed much. How to treat such a situation?

The patient is only 20 years old, and the abnormal increase of transaminase to more than 5 times the upper limit of the normal value was found for the first time, which is in line with the acute attack of hepatitis B. In fact, it can be observed for a few months before considering treatment. Some people will gradually develop inflammation due to their own immunity. slow down or disappear.

Of course, other causes of abnormal elevation of transaminase in the blood of hepatitis B carriers should also be excluded, such as acute infection of other hepatitis viruses, taking drugs, alcohol or obesity, fatty liver caused by hyperlipidemia, etc.

If it is determined to be an acute attack of chronic hepatitis B, you can consider receiving antiviral drug treatment, such as oral antiviral drugs or injection of interferon, etc., to weaken the virus activity and avoid repeated attacks of liver inflammation and cause damage.

The transaminase value of hepatitis B patients is not high, but the bilirubin is always high. Will this cause problems?

It has been more than a year since the patient was diagnosed with hepatitis B. His total bilirubin value has always been above 30 μmol/L, even close to 35 μmol/L, but alanine aminotransferase and aspartate aminotransferase are both below 40. The attending doctor said to continue to observe, But the patient is still worried, and always feels that his palms look yellow. Although the doctor said that ingesting food with pigments can also cause skin coloration, the patient is still worried that there may be other liver diseases? Can I try TCM treatment?

The patient’s total bilirubin is indeed a little high, but I don’t know if the patient has checked the direct bilirubin?

Because there are quite a few factors that may cause a slight increase in the total bilirubin value of people, such as: hemolytic anemia or bile duct obstruction, a tumor in the liver compressing the bile duct, etc., will increase bilirubin, but the level of transaminase Values ​​are normal.

In addition, there is a congenital abnormal bilirubin metabolism, bilirubin will be higher than normal, this situation is usually not pathological.

As for the yellowish appearance of the hands, this is a more subjective issue. However, consuming too many foods containing pigments, such as citrus, papaya, carrots, etc., does easily lead to skin coloration, especially in the palm of the hand. It is recommended that patients first understand the reasons for the high total bilirubin value, and do not seek medical treatment in a hurry.

I heard that red yeast rice in health food can lower blood lipids. Is this a food, not a drug, and may cause damage to the liver?

In fact, red yeast rice may damage the liver. If patients with hyperlipidemia take red yeast yeast and blood lipid-lowering drugs statins at the same time, the possibility of liver damage may increase.