For the HBsAg positive patients with normal aminotransferase, we are called HBV carriers. One of the HBV DNA positive we referred to as chro
For the HBsAg positive patients with normal aminotransferase, we are called HBV carriers. One of the HBV DNA positive we referred to as chronic HBV carriers, HBV DNA negative we referred to as inactive HBsAg carriers. Carriers are relatively stable, once the abnormal liver function of chronic hepatitis is a disease activity? The answer is not necessarily.
A "big Sanyang" young patients, occasionally a liver function test, ALT 60 U/L, the family is very nervous, thought active hepatitis. By questioning the patients on the day before the afternoon to check liver function, once played basketball for several hours. Not to prescribe medicine, commanded every half a liver patient. The results of two consecutive patients with normal liver function test. It turned out that excessive strenuous exercise led to a transient fluctuation of transaminase.
Another "small Sanyang" middle aged patients, HBV DNA negative, but in January two liver function test alanine aminotransferase were more than 60 U/L. What is the reason?. Careful inquiry, the patient usually eat greasy food, do not love sports, check the abdominal wall fat thick; after CT and B ultrasound examination, the original patients with fatty liver.
So for patients with mildly elevated alanine aminotransferase, 2 weeks after the review of normal, may be the cause of the accident, such as colds, strenuous exercise, menstrual period, drunk, etc.. If not normal. Fatty liver and other diseases, such as thyroid disease, should also be excluded,
But pay attention to a point, "small Sanyang" patients, the hepatitis B virus (HBV DNA) higher than 10 of the 5 party, no matter how much can transaminase, HBeAg negative chronic hepatitis B. Why, in general, the immune function under the action of "big 3 this world" to "small three", HBV DNA will soon turn. Now HBV DNA does not fall or rise, because the virus mutates. The big three patients are adolescents, there is tolerance. "Small Sanyang" patients are middle-aged, immune tolerance as not, not peace, the more the more severe disease virus.
Why should the hepatitis B virus mutation? Because it is outside the "enemy", the adult immune cells mature, to remove the virus; hepatitis B virus to be cleared, we must not let the immune cells make only superficial changes, to recognize, to continue to do.