Chronic Hepatitis B: Key Questions and Answers

Hepatitis B-related issues?

Dear Dr.
Yang,
I discovered an abnormal result in my hepatitis B screening during a health check-up.
The results are as follows: Hepatitis B surface antigen (HBsAg) - Positive; Hepatitis B surface antibody (Anti-HBs) - Negative.
The doctor informed me that I have chronic hepatitis B.
Could you please help me with the following questions:
1.
What is the difference between hepatitis B surface antigen and antibody? What do positive and negative results indicate?
2.
I learned from television that there are medications available for treatment (such as interferon).
Could you provide some information about these medications?
3.
If I wish to pursue treatment, could you provide the names of relevant hospitals, doctors, and outpatient departments, preferably in areas north of Taoyuan?
4.
Does receiving the hepatitis B vaccine prevent infection?
5.
What are the chances of a complete recovery?
I sincerely appreciate your assistance and detailed information.
Thank you very much.

Danny, 20~29 year old female. Ask Date: 2000/11/27

Dr. Yang Guojun reply Internal Medicine

Antigens refer to foreign or internal pathogens or substances that trigger the production of antibodies in an organism.
HBsAb (Hepatitis B surface antibody) is an antibody produced by the body in response to the invasion of an antigen; it is a type of immunoglobulin.
For example, the antigen can be likened to enemy troops, while the antibody represents our defensive forces.
A positive HBsAg (Hepatitis B surface antigen) indicates an infection with the Hepatitis B virus.
Currently, there are some antiviral medications available, such as Lamivudine (marketed in Taiwan under the brand name "Zeffix"), which provides a new treatment option for the numerous Hepatitis B patients and their physicians nationwide.
Although Lamivudine can help many Hepatitis B patients, there are still some issues to consider, such as the potential for hepatitis relapse after discontinuation, the need for long-term use, and the development of drug resistance.
Therefore, individuals should not self-medicate simply because they are carriers of Hepatitis B; they should consult an experienced physician to understand the benefits and the necessary trade-offs to avoid adverse consequences.
Please consult Dr.
He Yu-bin at Linkou Chang Gung Memorial Hospital or Dr.
Chen Jin-shun at St.
Paul’s Hospital.
Approximately 5,000 people die from liver cancer each year, highlighting the serious threat liver cancer poses to public health.
Research in Taiwan has found that long-term carrier infections of Hepatitis B and C viruses, smoking, alcohol consumption, aflatoxin exposure, a family history of liver cancer, and elevated serum testosterone levels are all risk factors for the development of liver cancer.

Reply Date: 2000/11/27

More Info

Chronic Hepatitis B (CHB) is a significant public health concern, and understanding its implications, treatment options, and management strategies is crucial for those affected. Here, I will address your questions and provide a comprehensive overview of chronic hepatitis B, including its diagnosis, treatment options, and preventive measures.

1. Difference Between Hepatitis B Surface Antigen (HBsAg) and Antibody (Anti-HBs):
- HBsAg: This is a protein on the surface of the hepatitis B virus (HBV). A positive HBsAg test indicates that a person is currently infected with the virus, either acutely or chronically. It is the first marker to appear in the blood after infection and can remain detectable for years in chronic cases.

- Anti-HBs: This is an antibody that the body produces in response to the hepatitis B virus. A positive Anti-HBs test indicates recovery from hepatitis B infection or successful vaccination against the virus. If Anti-HBs is negative, it means that the person has not developed immunity to the virus, either through infection or vaccination.

2. Treatment Options for Chronic Hepatitis B:
- Current treatment options for CHB include antiviral medications such as Entecavir and Tenofovir, which are nucleos(t)ide analogs that help suppress viral replication. Interferon therapy is another option, though it is less commonly used due to its side effects and the need for injections.

- The choice of treatment depends on various factors, including liver function, the level of viral replication, and the presence of liver damage. Regular monitoring of liver function tests and HBV DNA levels is essential to assess the effectiveness of treatment.

3. Finding Healthcare Providers:
- For specialized care, you may want to consult a hepatologist or a gastroenterologist with experience in managing hepatitis B. In the Taoyuan area and northward, hospitals such as Taipei Veterans General Hospital and National Taiwan University Hospital have reputable liver disease departments. It is advisable to check their websites or contact them directly for specific physician recommendations and appointment availability.

4. Vaccination Against Hepatitis B:
- Vaccination is a highly effective way to prevent hepatitis B infection. Individuals who have received the complete hepatitis B vaccination series (typically three doses) develop immunity and are unlikely to contract the virus. However, those who are already infected cannot benefit from vaccination, as it does not cure the infection.

5. Chances of Complete Recovery:
- The likelihood of achieving a complete cure from chronic hepatitis B varies. While some individuals can clear the virus spontaneously, many will remain lifelong carriers. Antiviral treatments can effectively manage the virus and prevent liver damage, but they may not eliminate the virus entirely. Regular follow-up and monitoring are crucial to manage the condition and reduce the risk of complications such as cirrhosis and liver cancer.

In summary, chronic hepatitis B is a manageable condition with appropriate medical care. Regular monitoring, adherence to treatment, and lifestyle modifications can significantly improve health outcomes. It is essential to maintain open communication with healthcare providers and stay informed about the latest treatment options and recommendations. If you have further questions or concerns, do not hesitate to reach out to a healthcare professional specializing in liver diseases.

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