Hepatitis B: Key Insights for Family Health Management

Q: Hepatitis B: Key Insights for Family Health Management

Hello： HBsAg (+) *243.300 indicates a carrier of Hepatitis B, who requires regular monitoring every six months, including blood tests and abdominal ultrasounds. <br>Hepatitis B is a high-risk factor for liver cirrhosis and liver cancer. <br>If taking dietary supplements and tradi

Regarding Hepatitis B?

Hello Doctor: Recently, my mother (70 years old) underwent a health check-up, and the ultrasound revealed signs of liver degeneration.
She has also had a clinic health examination and an upper gastrointestinal endoscopy, which showed the presence of Helicobacter pylori and a slight gastric ulcer.
She is currently undergoing treatment for the Helicobacter pylori infection.
The blood test results showed HBsAg (+) at 243.300 COL and Anti-HCV (-) at 0.03 COL, while her liver function tests are normal.
The doctor mentioned that my mother has hepatitis B and needs to have an ultrasound every six months.
Given her age, she has been measuring her blood pressure at home, which averages around 130, occasionally reaching 140.
I would like to know what I should pay attention to regarding her health.
She has a habit of taking dietary supplements and traditional Chinese medicine; should she stop these? Additionally, while undergoing treatment for the gastric ulcer, I have reminded her to maintain a balanced diet.
I am concerned about the impact of fruits on her stomach and blood pressure, so she is currently only eating cherry tomatoes in moderation.
What fruits would be suitable for her diet? Five years ago, my health report showed HBsAg (-) at 0.441 COL and Anti-HBs (+) >1000.
My brother had his check-up last year, which showed HBsAg (-) and Anti-HBs (-).
Should my brother and I consider getting booster doses of the hepatitis B vaccine?

Mr. Chen, 30~39 year old female. Ask Date: 2022/01/18

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello: HBsAg (+) *243.300 indicates a carrier of Hepatitis B, who requires regular monitoring every six months, including blood tests and abdominal ultrasounds.
Hepatitis B is a high-risk factor for liver cirrhosis and liver cancer.
If taking dietary supplements and traditional Chinese medicine, liver and kidney function should be monitored, and it is advisable to take medications only when necessary.
Medications are primarily metabolized by the liver and kidneys; excessive intake can increase the burden on these organs.
Patients with gastric ulcers should be monitored, and Helicobacter pylori should be eradicated.
For blood pressure management, dietary control is recommended, avoiding overly greasy and salty foods.
Regarding fruits for patients with gastric ulcers, those that are easy to digest, not too hard, and not too acidic or sweet are generally acceptable, as they do not provoke gastric acid, but should be consumed in moderation.
For HBsAg (-) *0.441 COL and Anti-HBS (+) >1000, there is no need for vaccination as antibodies are present.
For HBsAg (-) and Anti-HBS (-), vaccination may be considered.
Wishing you health and safety! Sincerely, Dr.
Lin Ming-Hui, Attending Physician, Gastroenterology Department, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2022/01/18

More Info

Understanding Hepatitis B: Key Insights for Family Health Management
Hepatitis B (HBV) is a significant public health concern worldwide, particularly in regions where the virus is endemic. From a public health perspective, understanding the transmission, epidemiology, prevalence, treatment, and preventive measures of Hepatitis B is crucial for effective management and intervention strategies.

Transmission and Epidemiology of Hepatitis B
Hepatitis B is primarily transmitted through contact with infectious body fluids, such as blood, semen, and vaginal secretions. Common routes of transmission include unprotected sexual contact, sharing needles, and from mother to child during childbirth. The World Health Organization (WHO) estimates that approximately 296 million people were living with chronic Hepatitis B infection in 2019, with a significant prevalence in Asia and sub-Saharan Africa.

The prevalence of Hepatitis B varies by region, with high endemicity in countries like China, Nigeria, and India. In the United States, the prevalence is lower, but certain populations, including immigrants from endemic regions and individuals with high-risk behaviors, remain at increased risk.

Clinical Management and Treatment
Chronic Hepatitis B can lead to serious liver complications, including cirrhosis and hepatocellular carcinoma (liver cancer). The management of chronic Hepatitis B involves regular monitoring of liver function and viral load, as well as assessing the degree of liver fibrosis. Antiviral treatments, such as tenofovir and entecavir, are effective in suppressing viral replication and reducing the risk of liver damage.

In your mother's case, with an HBsAg positive result and normal liver function tests, it is essential to continue regular monitoring every six months, as recommended by her healthcare provider. This includes ultrasound examinations to assess liver health and any potential complications.

Lifestyle Considerations and Dietary Recommendations
Given your mother's age and existing health conditions, including hypertension and gastric issues, it is vital to adopt a holistic approach to her health management. While she is undergoing treatment for Helicobacter pylori and gastric ulcers, it is advisable to maintain a balanced diet that is gentle on her stomach. Fruits that are easy to digest and not overly acidic or sweet, such as bananas, melons, and cooked apples, can be beneficial. It is essential to avoid excessive consumption of tomatoes, as they can be acidic and may exacerbate gastric discomfort.

Regarding her hypertension, a low-sodium diet rich in fruits, vegetables, whole grains, and lean proteins can help manage blood pressure levels. Regular monitoring of her blood pressure is crucial, and lifestyle modifications, including physical activity and stress management, should be encouraged.

Vaccination and Family Health Management
For family members, vaccination against Hepatitis B is a critical preventive measure. Since you and your brother have different serological profiles, it is advisable for your brother, who is HBsAg negative and anti-HBs negative, to receive the Hepatitis B vaccine to ensure protection against the virus. You, on the other hand, have developed immunity, as indicated by your positive anti-HBs result.

In the context of family health management, it is essential to educate all family members about Hepatitis B transmission and prevention strategies. This includes safe practices regarding blood and bodily fluid exposure, as well as the importance of regular health check-ups for early detection and management of any liver-related issues.

Conclusion
In summary, managing Hepatitis B within a family context requires a comprehensive understanding of the disease, regular monitoring, appropriate treatment, and preventive measures, including vaccination. By adopting a proactive approach to health management, you can help ensure the well-being of your mother and other family members. Always consult with healthcare professionals for personalized advice and treatment options tailored to individual health needs.

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