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• Hepatit B ile yaşama  Hepatit B enfeksiyonundan iyileşir miyim?Yeni enfekte olmuş çoğu sağlıklı yetişkin herhangi bir problem olmadan iyileşir. Ancak bebekler ve küçük çocuklar virüsten başarıyla kurtulamayabilir. • Yetişkinler – sağlıklı yetişkinlerin %90'ı virüsten kurtulup problemsiz bir şekilde iyileşir; %10'unda kronik hepatit B gelişecektir. • Küçük Çocuklar – 1 ile 5 yaş arasındaki enfekte küçük çocukların %50'sine kadarında kronik hepatit B enfeksiyonu gelişir.• Bebekler – %90'ı kronik enfekte hale gelir; sadece %10'u virüsten kurtulabilir. "Akut" ve "kronik" hepatit B enfeksiyonu arasında ne fark vardır?Hepatit B enfeksiyonu virüse maruz kaldıktan sonraki ilk 6 ayda "akut" olarak düşünülür. Bu süre hepatit B enfeksiyonundan iyileşmek için geçen ortalama süredir. 6 aydan sonra halen hepatit B virüsü için testiniz pozitifse (HBsAg+) sizde ömür boyu sürebilecek "kronik" hepatit B enfeksiyonu olduğu düşünülür. Akut hepatit B durumum varsa hastalanır mıyım?Hepatit B genellikle belirtiye neden olmadığından "sessiz bir enfeksiyon" olarak düşünülür. Çoğu kişi kendini sağlıklı hisseder ve enfekte olduğunu bilmez, yani virüsü farkında olmadan başkalarına geçirebilirler. Başkalarında ise ateş, yorgunluk, eklem veya kas ağrısı veya iştah kaybı gibi hafif belirtiler olur ve bunlar nezleyle karıştırılabilir. Daha nadir ama daha ciddi belirtiler arasında şiddetli bulantı ve kusma, sarı gözler ve cilt ("sarılık" denir) ve karında şişlik vardır - bu belirtiler hemen tıbben ilgilenilmesini gerektirir ve kişinin hastaneye yatırılması gerekebilir. "Akut" hepatit B enfeksiyonundan iyileştiğimi nasıl bilirim?Doktorunuz vücudunuzdan virüsü attığınızı ve koruyucu antikorların (HBsAb+) geliştiğini bir kan testiyle doğruladıktan sonra gelecekteki bir hepatit B enfeksiyonundan korunmuş olursunuz ve artık başkaları için bulaşıcı değilsinizdir. Kronik hepatit B tanısı konduysa ne yapmalıyım?Hepatit B virüsü için testleriniz 6 aydan uzun bir süre pozitif çıkarsa bu durum sizde kronik hepatit B enfeksiyonu olduğu anlamına gelir. Bir hepatolog (karaciğer hastalıkları uzmanı), gastroenterolog veya hepatit B'ye aşina bir aile hekiminden randevu almanız gerekir. Doktor hepatit B virüsünün vücudunuzda ne kadar aktif olduğunu ve karaciğerinizin sağlığını izlemek için kan testleri ve belki de bir karaciğer ultrasonu isteyecektir. Doktorunuz muhtemelen hepatit B durumunuzu izlemek ve tedaviden fayda görüp görmeyeceğinizi belirlemek için sizi yılda bir veya iki kez görmek isteyecektir. Kronik enfeksiyonu olan herkes doktorları tarafından tedavi gereksin veya gerekmesin düzenli tıbbi bakım için en az yılda bir (veya daha sık) görülmelidir. Virüs daha az aktif bir fazda bulunup da hasar hiç olmasa veya çok az olsa bile bu durum zamanla değişebilir ve düzenli izleme bu nedenle önemlidir. Hepatit B ile kronik enfeksiyonu olan çoğu kişi uzun ve sağlıklı bir ömür sürmeyi bekleyebilir. Size kronik hepatit B tanısı konduğunda virüs kan ve karaciğerinizde ömür boyu kalabilir. Kendinizi hasta hissetmeseniz bile virüsü başkalarına geçirebileceğinizi bilmek önemlidir. Bu nedenle evdeki tüm yakın temas halindeki kişilerin ve cinsel partnerlerin hepatit B'ye karşı aşılandığından emin olmanız çok önemlidir. Hepatit B durumumu izlemek için hangi testler yapılacaktır?Doktorlar tarafından hepatit B durumunuzu izlemek için sık kullanılan testlere hepatit B kan paneli, karaciğer fonksiyon testleri (ALT, AST), hepatit B e-Antijeni (HBeAg), hepatit B e-Antikoru (HBeAb), hepatit B DNA miktar belirleme (viral yük) ve karaciğer görüntüleme çalışması (ultrason, FibroScan [Geçici Elastografi] veya BT tarama) vardır. Kronik hepatit B için tam bir tedavi var mıdır?Şu anda kronik hepatit B için tam bir tedavi yoktur, ama burada iyi olan kronik enfekte kişilerde virüsü yavaşlatarak karaciğer hastalığının ilerlemesini yavaşlatabilecek tedaviler bulunmasıdır. Daha az hepatit B virüsü üretiliyorsa karaciğerde daha az hasar oluşur. Bazen bu ilaçlar virüsü tamamen de atabilir ama bu sık rastlanan bir durum değildir. Heyecan verici tüm yeni araştırmalarla yakın gelecekte kronik hepatit B için tam bir tedavinin bulunacağı konusunda büyük ümit vardır. Geliştirilen diğer ümit veren ilaçların listesi için Drug Watch (İlaç Haberleri) kısmımızı ziyaret edin. Kronik hepatit B tedavisi için onaylanmış ilaç var mıdır?Hepatit B için mevcut tedaviler antiviraller ve bağışıklık düzenleyiciler şeklinde iki genel kategoriye girer: Antiviral İlaçlar - Bunlar hepatit B virüsünü yavaşlatan veya durduran ilaçlardır ve bu durum karaciğerde iltihap ve hasarı azaltır. Bunlar en az 1 yıl ve genellikle daha uzun bir süre boyunca günde bir kez bir hap olarak alınır. Şu anda ABD FDA onaylı 6 antiviral mevcuttur ama sadece üç birinci basamak antiviral ilaç önerilir: tenofovir disoproksil (Viread/TDF), tenofovir alafenamid (Vemlidy/TAF) ve Entekavir (Baraclude). Birinci basamak antiviraller önerilir çünkü daha güvenli ve en etkili olanlardır. Ayrıca direnç profilleri daha eski antivirallerden daha iyidir yani yazıldıkları şekilde alındıklarında mutasyon ve direnç olasılığı daha düşüktür. Direnç oluşması virüsü tedavi ve kontrol etmeyi zorlaştırır. Bağışıklık Düzenleyici İlaçlar - Bunlar hepatit B virüsünü kontrol etmeye yardımcı olmak üzere bağışıklık sistemini güçlendiren ilaçlardır. Bu ilaçlar 6 ay ila 1 yıl boyunca enjeksiyonlar şeklinde verilir. En sık yazılanlar arasında interferon alfa-2b (Intron A) ve pegile interferon (Pegasys) vardır. Bunlar hepatit delta enfeksiyonu da olan hastalar için tek önerilen tedavilerdir. Bu ilaçlar kronik hepatit B için "tam" bir tedavi sağlar mı?
Tam bir tedavi sağlamasalar da mevcut ilaçlar virüsü yavaşlatır ve yaşamın daha ileri dönemlerinde daha ciddi karaciğer hastalığı riskini azaltır. Bu durum birkaç ay sonra virüsün karaciğer hasarı yavaşladığı ve hatta ilaçlar uzun dönem alındıklarında geri döndürüldüğü için hastaların kendilerini daha iyi hissetmesiyle sonuçlanır. Antivirallerin durdurulup başlatılması planlanmamıştır ve bu nedenle kronik HBV tedavisine başlamadan önce bilgili bir doktor tarafından kapsamlı bir değerlendirme çok önemlidir. Kronik hepatit B enfeksiyonum varsa ilaç almalı mıyım?Kronik hepatit B durumu olan herkese ilaç vermeye gerek olmadığını anlamanız önemlidir. İlaç tedavisi için iyi bir aday olup olmadığınızı doktorunuzla konuşmanız gerekir. Doktorunuz ve siz tedaviye başlamaya karar verseniz de vermeseniz de bir karaciğer uzmanı veya hepatit B konusunda bilgili bir doktor tarafından düzenli olarak görülmeniz gerekir. Hepatit B enfeksiyonum için bitkisel ilaçlar veya takviyeler almak güvenli mi?Çoğu kişi bağışıklık sistemini güçlendirmek ve karaciğerlerine yardımcı olmak için bitkisel ilaçlar veya takviyeler almakla ilgilenir. Buradaki problem bu ürünleri üreten şirketlerin düzenlenmemesi yani güvenlik veya saflık açısından kapsamlı testler yapılmamasıdır. Bu nedenle bitkisel çözüm veya vitamin takviyesinin kalitesi şişeden şişeye değişebilir. Ayrıca bazı bitkisel çözümler hepatit B veya diğer hastalıklar için reçeteli ilaçlarınızı olumsuz etkileyebilir; bazıları hatta karaciğerinize zarar bile verebilir. Bu bitkisel çözümler kronik hepatit B enfeksiyonu için tam bir tedavi sağlamaz. İnternette ve sosyal medyada ürünleri hakkında olmayacak iddialarda bulunan birçok şirket vardır. Çevrim içi iddialar ve Facebook üzerindeki hasta ifadeleri doğru değildir ve insanları pahalı bitkisel çözümler ve takviyeler satın alma konusunda kandırmak için kullanılır. Unutmayın ki doğru olamayacak kadar iyi gibiyse muhtemelen doğru değildir. Aşağıda bitkiler ve alternatif tıp hakkında güvenilir bilgi kaynakları vardır. Bu bilgi desteksiz sözleri değil bilimsel kanıtları temel alır. Bitkisel çözümler veya takviyelerinizdeki aktif bileşenlerin gerçek olup olmadığını ve karaciğeriniz için güvenli olup olmadığını kontrol edin. En önemli şey karaciğerinizin daha da fazla zarar görmesini önlemektir. Kronik hepatit B ile yaşayanlar için ne gibi sağlıklı karaciğer önerileri vardır?Kronik hepatit B enfeksiyonu yaşayan kişiler için ilaç tedavisi gerekebilir veya gerekmeyebilir. Ancak kişilerin karaciğerlerini koruyup sağlıklarını düzeltmek için yapabileceği birçok başka şey vardır. Aşağıda bugün başlanabilecek en önemli 10 sağlık tercihi listemiz bulunmaktadır!• Sağlığınızı ve karaciğerinizin sağlığını korumak için karaciğer uzmanınız veya sağlık uzmanınızla düzenli ziyaretler planlayın.• Karaciğere saldıran başka bir virüsten kendinizi korumak için Hepatit A aşısı yaptırın.• Alkol ve sigara kullanmaktan kaçının çünkü her ikisi zaten hepatit B virüsünden zarar görmüş karaciğerinize zarar verecektir.• Herhangi bir bitkisel çözüm veya vitamin takviyesi başlamadan sağlık uzmanınızla görüşün çünkü bazıları reçeteli hepatit B ilaçlarınızı olumsuz etkileyebilir ve hatta karaciğerinize zarar verebilir.• Herhangi bir reçetesiz ilaç (örn. asetaminofen, parasetamol) veya hepatit B için olmayan reçeteli ilacı almadan önce karaciğer için güvenli olduklarından emin olmak için eczacınıza danışın çünkü bunların çoğu karaciğerinizde işlenir. • Boya, tiner, yapıştırıcı, ev temizlik ürünleri, oje ve karaciğerinize zarar verebilecek diğer toksik olabilecek kimyasalların dumanlarını solumaktan kaçının. • Meyve, tam tahıl, balık, yağsız et ve bol miktarda sebzeden oluşan sağlıklı bir diyet yiyin. Özellikle “turpgiller grubundan sebzelerin” - lahana, brokoli, karnabahar - karaciğeri çevresel kimyasallara karşı koruduğu gösterilmiştir. • Karaciğer için çok zehirli olan ve çok ciddi zarar verebilecek Vibrio vulnificus adlı bir bakteri bulunabileceğinden çiğ veya az pişmiş kabuklu deniz ürünleri (örn. deniz tarağı, midye, istiridye, fistolar) yemekten kaçının.• Fındık, darı, mısır, yerfıstığı, süpürge darısı ve akdarı gibi gıdaları kullanmadan önce üzerlerini küf belirtileri açısından kontrol edin. Gıda nemli koşullarda saklanırsa ve uygun şekilde kapatılmazsa küfün problem oluşturma olasılığı daha yüksektir. Küf mevcutsa gıdaya karaciğer kanseri için bilinen bir risk faktörü olan "alfatoksinler" bulaşmış olabilir.• Stres düzeylerinizi sağlıklı gıdalar yiyerek, düzenli egzersiz yaparak ve bol miktarda istirahat ederek azaltın. Yediğiniz, içtiğiniz, soluduğunuz veya ciltten emilen her şeyin zamanla karaciğerde filtrelendiğini unutmayın. Bu nedenle karaciğeriniz ve sağlığınızı koruyun! Hepatit B durumum varsa kan bağışı yapabilir miyim? Hayır. Akut bir enfeksiyondan iyileşmiş olsanız bile kan bankası hepatit B'ye maruz kalmış herhangi bir kanı kabul etmez. Living with Hepatitis B Will I recover from a hepatitis B infection?Most healthy adults who are newly infected will recover without any problems. But babies and young children may not be able to successfully get rid of the virus. • Adults – 90% of healthy adults will get rid of the virus and recover without any problems; 10% will develop chronic hepatitis B. • Young Children – Up to 50% of young children between 1 and 5 years who are infected will develop a chronic hepatitis B infection.• Infants – 90% will become chronically infected; only 10% will be able to get rid of the virus. What is the difference between an "acute" and a "chronic" hepatitis B infection?A hepatitis B infection is considered to be “acute” during the first 6 months after being exposed to the virus. This is the average amount of time it takes to recover from a hepatitis B infection. If you still test positive for the hepatitis B virus (HBsAg+) after 6 months, you are considered to have a "chronic" hepatitis B infection, which can last a lifetime. Will I become sick if I have acute hepatitis B?Hepatitis B is considered a "silent infection” because it often does not cause any symptoms. Most people feel healthy and do not know they have been infected, which means they can unknowingly pass the virus on to others. Other people may have mild symptoms such as fever, fatigue, joint or muscle pain, or loss of appetite that are mistaken for the flu. Less common but more serious symptoms include severe nausea and vomiting, yellow eyes and skin (called “jaundice”), and a swollen stomach - these symptoms require immediate medical attention and a person may need to be hospitalized. How will I know when I have recovered from an "acute" hepatitis B infection?Once your doctor has confirmed through a blood test that you have gotten rid of the virus from your body and developed the protective antibodies (HBsAb+), you will be protected from any future hepatitis B infection and are no longer contagious to others. What should I do if I am diagnosed with chronic hepatitis B?If you test positive for the hepatitis B virus for longer than 6 months, this indicates that you have a chronic hepatitis B infection. You should make an appointment with a hepatologist (liver specialist), gastroenterologist, or family doctor who is familiar with hepatitis B. The doctor will order blood tests and possibly a liver ultrasound to evaluate how active the hepatitis B virus is in your body, and to monitor the health of your liver. Your doctor will probably want to see you at least once or twice a year to monitor your hepatitis B and determine if you would benefit from treatment. All chronically infected people should be seen by their doctor at least once a year (or more frequently) for regular medical follow-up care, whether they start treatment or not. Even if the virus is in a less active phase with little or no damage occurring, this can change with time, which is why regular monitoring is so important. Most people chronically infected with hepatitis B can expect to live long, healthy lives. Once you are diagnosed with chronic hepatitis B, the virus may stay in your blood and liver for a lifetime. It is important to know that you can pass the virus along to others, even if you don’t feel sick. This is why it’s so important that you make sure that all close household contacts and sex partners are vaccinated against hepatitis B. What tests will be used to monitor my hepatitis B?Common tests used by doctors to monitor your hepatitis B include the hepatitis B blood panel, liver function tests (ALT, AST), hepatitis B e-Antigen (HBeAg), hepatitis B e-Antibody (HBeAb), hepatitis B DNA quantification (viral load), and an imaging study of the liver (ultrasound, FibroScan [Transient Elastography] or CT scan). Is there a cure for chronic hepatitis B?Right now, there is no cure for chronic hepatitis B, but the good news is there are treatments that can help slow the progression of liver disease in chronically infected persons by slowing down the virus. If there is less hepatitis B virus being produced, then there is less damage being done to the liver. Sometimes these drugs can even get rid of the virus, although this is not common. With all of the new exciting research, there is great hope that a cure will be found for chronic hepatitis B in the near future. Visit our Drug Watch for a list of other promising drugs in development. Are there any approved drugs to treat chronic hepatitis B?Current treatments for hepatitis B fall into two general categories, antivirals and immune modulators: Antiviral Drugs - These are drugs that slow down or stop the hepatitis B virus, which reduces the inflammation and damage to the liver. These are taken as a pill once a day for at least 1 year, usually longer. There are 6 U.S. FDA approved antivirals, but only three first-line antivirals are recommended treatments: tenofovir disoproxil (Viread/TDF), tenofovir alafenamide (Vemlidy/TAF) and Entecavir (Baraclude). First-line antivirals are recommended because they are safer and most effective. They also have a better resistance profile than older antivirals, which means that when they are taken as prescribed, there is less chance of mutation and resistance. Building resistance makes it harder to treat and control the virus. Immunomodulator Drugs - These are drugs that boost the immune system to help control the hepatitis B virus. They are given as injections over 6 months to 1 year. The most commonly prescribed include interferon alfa-2b (Intron A) and pegylated interferon (Pegasys). This is the only recommended treatment for patients coinfected with hepatitis delta. Do these drugs provide a “cure” for chronic hepatitis B?
Although they do not provide a complete cure, current medications will slow down the virus and decrease the risk of more serious liver disease later in life. This results in patients feeling better within a few months because liver damage from the virus is slowed down, or even reversed in some cases, when taken long-term. Antivirals are not meant to be stopped and started, which is why a thorough evaluation by a knowledgeable doctor is so important before beginning treatment for chronic HBV. If I have a chronic hepatitis B infection, should I be on medication?It is important to understand that not every person with chronic hepatitis B needs to be on medication. You should talk to your doctor about whether you are a good candidate for drug therapy. Whether you and your doctor decide you should start treatment or not, you should be seen regularly by a liver specialist or a doctor knowledgeable about hepatitis B. Is it safe to take herbal remedies or supplements for my hepatitis B infection?Many people are interested in using herbal remedies or supplements to boost their immune systems and help their livers. The problem is that there is no regulation of companies manufacturing these products, which means there is no rigorous testing for safety or purity. So, the quality of the herbal remedy or vitamin supplement may be different from bottle to bottle. Also, some herbal remedies could interfere with your prescription drugs for hepatitis B or other conditions; some can even actually damage your liver. These herbal remedies will not cure a chronic hepatitis B infection. There are many companies that make false promises on the Internet and through social media about their products. Online claims and patient testimonials on Facebook are fake and are used to trick people into buying expensive herbal remedies and supplements. Remember, if it sounds too good to be true, then it’s probably not true. Below are reliable sources of information about herbs and alternative medicines. This information is based on scientific evidence, not false promises. Check whether the active ingredients in your herbal remedies or supplements are real and safe for your liver. The most important thing is to protect your liver from any additional injury or harm. What healthy liver tips are there for those living with chronic hepatitis B?People living with chronic hepatitis B infection may or may not need drug treatment. But there are many other things patients can do to protect their liver and improve their health. Below is our list of the top 10 healthy choices that can be started today! • Schedule regular visits with your liver specialist or health care provider to stay on top of your health and the health of your liver.• Get the Hepatitis A vaccine to protect yourself from another virus that attacks the liver.• Avoid drinking alcohol and smoking since both will hurt your liver, which is already being injured by the hepatitis B virus.• Talk to your provider before starting any herbal remedies or vitamin supplements because some could interfere with your prescribed hepatitis B drugs or even damage your liver.• Check with your pharmacist about any over-the-counter drugs (e.g. acetaminophen, paracetamol) or non-hepatitis B prescription drugs before taking them to make sure they are safe for your liver since many of these drugs are processed through your liver. • Avoid inhaling fumes from paint, paint thinners, glue, household cleaning products, nail polish removers, and other potentially toxic chemicals that could damage your liver. • Eat a healthy diet of fruit, whole grains, fish and lean meats, and lot of vegetables. “Cruciferous vegetables” in particular -- cabbage, broccoli, cauliflower -- have been shown to help protect the liver against environmental chemicals. • Avoid eating raw or undercooked shellfish (e.g. clams, mussels, oysters, scallops) because they could be contaminated with bacteria called Vibrio vulnificus, which is very toxic to the liver and could cause a lot of damage.• Check for signs of mold on nuts, maize, corn, groundnut, sorghum, and millet before using these foods. Mold is more likely to be a problem if food is stored in damp conditions and not properly sealed. If there is mold, then the food could be contaminated by “aflatoxins,” which are a known risk factor for liver cancer.• Reduce your stress levels by eating healthy foods, exercising regularly, and getting plenty of rest. Keep in mind everything you eat, drink, breathe, or absorb through the skin is eventually filtered by the liver. So, protect your liver and your health! Can I donate blood if I have hepatitis B? No. The blood bank will not accept any blood that has been exposed to hepatitis B, even if you have recovered from an acute infection.  

  https://www.hepb.org/languages/turkish/living-with-hepatitis-b/

• Genel Bilgi Hepatit B nedir?Hepatit B dünyanın en sık görülen karaciğer enfeksiyonudur. Nedeni karaciğere saldıran ve zarar veren hepatit B virüsüdür (HBV). Kan, korunmasız cinsel ilişki, paylaşılan veya tekrar kullanılan iğnelerle ve hamilelik veya doğum sırasında enfekte bir anneden yenidoğan bebeğe geçer. Çoğu enfekte yetişkin kendilerindeki hepatit B virüsünden bir problem olmadan kurtulabilir. Ancak bazı yetişkinler ve çoğu enfekte bebek ve çocuk virüsten kurtulamazlar ve kronik (ömür boyu) enfeksiyon gelişir. Burada iyi olan hepatit B enfeksiyonunu önlemek için güvenli bir aşı olması ve zaten hepatit B enfeksiyonu olanlar için yeni tedavilerin bulunmasıdır. Hepatit B'den kaç kişi etkilenmiştir?Dünya çapında 2 milyar kişi (3 kişiden 1'i) hepatit B ile enfektedir ve 257 milyon kişi kronik olarak enfektedir (yani virüsten kurtulamamaktadırlar). Her yıl hepatit B ve komplikasyonları nedeniyle tahmini 700.000 kişi ölür. Hepatit B neden dünyanın bazı kısımlarında daha sıktır?Hepatit B her yaş ve etnik kökenden kişileri enfekte edebilir ama dünyada hepatit B'nin daha sık görüldüğü yerler mevcuttur: örneğin Asya, Afrika ve Güney Amerika'nın bazı kısımları, Doğu Avrupa ve Orta Doğu'daki kişilerin enfekte olma riski çok daha yüksektir. Hepatit B bu bölgelerde doğan Amerikalılar (veya ebeveynleri buralarda doğmuş olanlar) arasında da sıktır. Hepatit B dünyanın bazı bölgelerinde o bölgelerde hepatit B ile zaten enfekte olan kişi sayısı çok olduğundan daha sıktır. Hepatit B bir "Asya hastalığı" veya bir "Afrika hastalığı" olmasa da bu bölgelerden yüzlerce milyon kişiyi etkiler - ve bu nedenle hepatit B virüsünü başkalarına geçirebilecek daha fazla kişi vardır. Bu durum enfekte olma riskinizi arttırır. Enfekte olan daha az sayıda Batılı bulunduğundan bu grubun enfeksiyon riski daha düşüktür. Hepatit B'nin sık olduğu bölgelerde kişiler genellikle yenidoğan döneminde virüsü doğum sırasında bebeğine farkında olmadan geçiren bir anneden enfekte olurlar. Küçük çocuklar da enfekte bir aile üyesine gündelik yakın temas halinde yaşıyorsa risk altındadır. Bebekler ve çocuklarda kronik hepatit B enfeksiyonu gelişme olasılığı daha yüksektir çünkü genç bağışıklık sistemleri virüsü atmakta zorlanır. Siz veya aileniz haritada daha koyu mavi bir alandan geliyorsanız hepatit B enfeksiyonu açısından daha yüksek risk altında olabilirsiniz ve test yaptırma konusunda doktorunuzla konuşmanız gerekir. Hepatit B konusunda neden endişe duymalıyım?Kronik hepatit B durumu siroz veya karaciğer kanseri gibi ciddi karaciğer hastalığına neden olabilir. Test yaptırmak önemlidir çünkü erken tanı yaşamınızı kurtarabilecek erken tedaviyi mümkün kılabilir. Ayrıca enfekte kişiler virüsü başkalarına yayabilir. Çoğu kişi enfekte olduğunu bilmediğinden hastalığı birçok başka kişiye farkında olmadan yaymaktadırlar. Kişiler test olmazsa hepatit B bir ailede ve toplum içinde birçok nesil boyunca yayılabilir. Yanlış bilinen bir bilgi bir ailede birkaç nesil enfekte olabileceğinden hepatit B'nin "kalıtsal" olabileceğidir. Ancak hepatit B genetik bir hastalık DEĞİLDİR - hepatit B'nin nedeni sıklıkla anneden çocuğa bulaşma veya evde yanlışlıkla kana maruz kalma sonucunda aile üyeleri arasında bulaşmadır. Aileler hepatit B enfeksiyonu döngüsünü test yaptırıp aşılanarak ve tedavi olarak kırabilir. Hepatit B neden bu kadar tehlikeli?Hepatit B tehlikelidir çünkü insanları onlar farkında olmadan enfekte edebilen "sessiz bir enfeksiyondur". Hepatit B ile enfekte olan çoğu kişi enfeksiyonunun farkında değildir ve farkında olmadan virüsü kan veya enfekte vücut sıvıları yoluyla başkalarına geçirebilir. Kronik enfeksiyonu olanlarda yaşamın daha ilerideki dönemlerinde artmış karaciğer yetmezliği, siroz ve/veya karaciğer kanseri gelişmesi riski vardır. Virüs, saptanmadan karaciğere birçok yıl boyunca sessiz ve sürekli olarak saldırabilir. Akut hepatit B nedir?Bir akut hepatit B enfeksiyonu altı aya kadar sürebilir (belirtiler ile veya olmadan) ve enfekte kişiler virüsü bu süre içinde başkalarına geçirebilir. Akut bir enfeksiyonun belirtileri arasında iştah kaybı, eklem ve kas ağrısı, hafif ateş ve olası mide ağrısı vardır. Çoğu kişi belirti yaşamasa da belirtiler enfeksiyondan 60-150 gün sonra ve ortalama 3 ay sonra ortaya çıkabilir. Bazı kişiler bulantı, kusma, sarılık (gözler ve ciltte sararma) veya karın şişliği gibi daha şiddetli belirtiler yaşayabilir ve bunlar bir sağlık uzmanına gitmelerine neden olabilir. Basit bir kan testi ile hepatit B virüsünün bir kişinin kanında olup olmadığı söylenebilir. Akut hepatit B tanısı konduysa doktorun iyileşip iyileşmediğinizi veya kronik hepatit B enfeksiyonu geliştirip geliştirmediğinizi belirlemek için 6 ay sonra tekrar bir kan testi yapması gerekecektir. Sağlık uzmanınız kan testinizin artık kanınızda hepatit B virüsü olmadığını gösterdiğini söylemesine kadar başkalarını olası bir enfeksiyondan korumak önemlidir. Ayrıca cinsel partnerinizi/partnerlerinizi ve aile üyelerinizi (veya evde yakın temas halinde yaşayan kişileri) hepatit B için test ettirmek önemlidir. Enfekte olmadılarsa – ve hepatit B aşısı yapılmadıysa – hepatit B aşısı dizisinin başlanması gerekir. Akut hepatit B durumu olan kişilere özel hepatit B tedavisi yazılmaz – akut hepatit B enfeksiyonunu geçirecek bir tedavi yoktur ve yetişkinken enfekte olan kişilerin çoğu kendi kendine iyileşir. Ancak bazen şiddetli belirtileri olan bir kişi, genel destek sağlanması için hastaneye yatırılabilir. İstirahat ve belirtilerin takibi bu tıbbi bakımın temel hedefleridir. Akut bir enfeksiyonla "fulminan hepatit" adlı nadir ve yaşamı tehdit edici bir durum oluşabilir ve kişide ani karaciğer yetmezliği gelişebileceğinden hemen ve acil tıbbi bakım gerektirir. Bir akut hepatit B enfeksiyonu sırasında karaciğerinizi korumak için basit önlemler alkolden kaçınmak, sigara içmeyi kesmek veya sınırlamak, sağlıklı gıdalar yemek, yağlı yemekler veya kızartmalardan kaçınmak ve karaciğeriniz için güvenli olduklarından emin olmak üzere aldığınız tüm ilaçları (reçeteli veya reçetesiz ilaçlar, vitaminler veya bitkisel ilaçlar) sağlık uzmanınıza sormaktır. Ayrıca bu sırada varsa diğer sorularınızı da sorabilirsiniz. Vitaminler ve karaciğer sağlığı takviyelerinin kullanılması iyileşmenize muhtemelen yardımcı olmaz ve karaciğere iyilikten çok kötülük yapabilir. Akut bir enfeksiyondan iyileştiğinizden emin olmak için gerekli herhangi bir ek kan testi açısından sağlık uzmanınızı tekrar görmeyi unutmayın. Kronik hepatit B nedir?Hepatit B virüsü için altı aydan uzun süre (ilk kan testi sonucundan sonra) pozitif olan kişilere kronik enfeksiyon tanısı konur. Bu durum bağışıklık sisteminin hepatit B virüsünü atamadığı ve virüsün halen kan ve karaciğerde kaldığı anlamına gelir. Kronik bir enfeksiyonu tedavi ve takip etmenin etkin yolları vardır ama tam bir tedavi yoktur. Kronik enfeksiyonunuz varsa virüs muhtemelen yaşamınızın kalan kısmı boyunca kanınızda kalacaktır. Kronik hepatit B durumu olan kişiler farkında olmadan virüsü başkalarına geçirebilir. Kronik hepatit B, siroz veya karaciğer kanseri gibi ciddi karaciğer hastalıklarına neden olabilir. Kronik enfeksiyonu olan herkeste ciddi karaciğer hastalığı gelişmeyecektir. Ancak enfekte olmayan birine göre bu risk daha yüksektir. Kronik hepatit B enfeksiyonu gelişmesi riski kişinin hepatit B virüsüyle ilk enfekte olduğu yaşla ilişkilidir:• Enfekte yenidoğanlar ve bebeklerin %90'ında kronik hepatit B enfeksiyonu gelişecektir.• Enfekte çocukların (1-5 yaş) %50'sinde kronik hepatit B enfeksiyonu gelişecektir.• Enfekte yetişkinlerin %5-10'unda kronik hepatit B enfeksiyonu gelişecektir (yani %90'ı iyileşecektir)Sizde kronik hepatit B enfeksiyonu olduğunu öğrenmek çok rahatsız edici olabilir. Birçok kişide belirti olmadığından ve hepatit B virüsüne ilk maruz kalmalarından on yıllar sonra tanı konabileceğinden kronik hepatit B enfeksiyonu tanısı konması büyük bir sürpriz olabilir. Burada iyi olan kronik hepatit B durumu olan çoğu kişinin uzun ve sağlıklı bir ömür yaşamayı bekleyebileceğidir. Enfekte hamile kadınlar virüsü doğum sırasında yenidoğan bebeklerine geçirebilir. Bu nedenle yenidoğanların doğumda kronik olarak enfekte olması riski yüksek olduğundan hem Dünya Sağlık Örgütü (DSÖ) hem de ABD Hastalık Kontrol ve Önleme Merkezleri (CDC) tüm bebeklere doğumdan sonraki 12-24 saat içinde hepatit B aşısının ilk dozunun yapılmasını önerir. Hamileyseniz ve enfekte olabileceğinizi biliyorsanız bebeğinize doğumdan sonraki 12-24 saat içinde hepatit B aşısının ilk dozunun yapılmasını sağlayabilirsiniz!Kronik hepatit B enfeksiyonu için tam bir tedavi olmasa da hepatit B virüsünü kontrol edebilecek ve karaciğere zarar vermesini önleyebilecek etkin ilaç tedavileri vardır. Ayrıca henüz araştırma evresinde olan ve belki de çok yakın gelecekte tam bir tedavi sağlayabilecek ümit verici yeni ilaçlar vardır. Ciddi karaciğer hastalığı veya karaciğer kanseri gelişme riski kronik hepatit B durumuyla yaşayanlarda enfekte olmayanlara göre daha yüksek olsa da kişilerin riski azaltmaya yardımcı olması için yapabileceği birçok basit şey bulunmaktadır.• Bir karaciğer uzmanı veya hepatit B konusunda bilgili bir sağlık uzmanına karaciğerinizin sağlığını izleyebilmesi için altı ayda bir (veya en azından yılda bir) düzenli olarak gitmeyi planlayın.• Sağlık uzmanınıza kronik hepatit B enfeksiyonunuzun tedavisinin ciddi karaciğer hastalığı veya karaciğer kanserini önlemeye yardımcı olup olmayabileceği konusunda konuşun.• Sağlık uzmanınızın sizi düzenli ziyaretler sırasında karaciğer kanseri için taradığından emin olun çünkü erken saptama daha fazla tedavi seçeneği ve daha uzun ömür anlamına gelir.• Alkol ve sigara kullanımını sınırlayın veya bunlardan kaçının çünkü ikisi de karaciğerinize yük bindirir.• Kızarmış ve yağlı yemekler karaciğerinizi zorladığından bol miktarda sebzeli sağlıklı bir diyet yiyin. "Kronik taşıyıcı" olmak ne demektir?Birisinde kronik hepatit B enfeksiyonu olduğunda doktoru kendisinden "kronik taşıyıcı" olarak bahsedebilir. Bir "kronik taşıyıcı" olmak sizde kronik hepatit B enfeksiyonu bulunduğu ve virüsü başkalarına geçirebileceğiniz ve enfeksiyonunuz için bir doktorun takibi altında olmanız gerektiği anlamına gelir. Hepatit B için tam bir tedavi var mıdır?Çoğu yetişkin akut bir enfeksiyondan ilaca gerek olmadan kendiliğinden iyileşir. Kronik hepatit B enfeksiyonu gelişen yetişkinler, çocuklar ve bebekler için şu anda tam bir tedavi yoktur. Ancak burada iyi olan kronik enfekte kişilerde virüsü yavaşlatarak karaciğer hastalığının ilerlemesini yavaşlatabilecek tedaviler bulunmasıdır. Daha az hepatit B virüsü üretiliyorsa karaciğerde daha az hasar oluşur. Heyecan verici tüm yeni araştırmalarla yakın gelecekte kronik hepatit B için tam bir tedavinin bulunacağı konusunda büyük ümit vardır. Geliştirilen diğer ümit veren ilaçların listesi için Drug Watch (İlaç Haberleri) kısmımızı ziyaret edin. Benim hepatit B durumum için ne gibi seçenekler vardır?Akut bir enfeksiyon için genel olarak herhangi bir belirtiyi tedavi etmek üzere destekleyici önlemler ve istirahat dışında bir tedavi yoktur. Kronik hepatit B için birkaç tedavi mevcuttur. Kronik hepatit B durumu olan herkesi tedavi etmeye gerek olmadığını anlamanız önemlidir. İlaca gerek olup olmadığına veya bekleyip durumunuzun izlenmesinin uygun olup olmadığına karar vermeye doktorunuz yardımcı olacaktır. Hepatit B virüsünün çoğalmasını yavaşlatan veya durduran ve böylece karaciğerde iltihap ve hasarı azaltan birkaç antiviral ilaç mevcuttur. Bu antiviraller en az 1 yıl ve genellikle daha uzun bir süre boyunca günde bir kez bir hap olarak alınır. Şu anda ABD FDA onaylı 6 antiviral mevcuttur ama sadece üç "birinci basamak" antiviral ilaç önerilir: tenofovir disoproksil (Viread/TDF), tenofovir alafenamid (Vemlidy/TAF) ve entekavir (Baraclude). Birinci basamak antiviraller önerilir çünkü daha güvenli ve en etkili olanlardır. Birinci basamak antiviral tedavilere yanıt vermeyen veya bunlara erişimi olmayan kişiler için başka seçenekler mevcuttur: telbivudine (Tyzeka, Sebivo), adefovir dipivoksil (Hepsera) ve lamivudin (Epivir-HBV, Zeffix, Heptodin). FDA bu antiviralleri kronik hepatit B için onaylamış olsa da şu anda tam bir tedavi sağlamazlar. Ancak karaciğer hasarı ve karaciğer kanseri gelişme riskini önemli ölçüde azaltabilirler. Antivirallerin durdurulup başlatılması planlanmamıştır ve bu nedenle kronik hepatit B tedavisine başlamadan önce bilgili bir doktor tarafından kapsamlı bir değerlendirme çok önemlidir. Ayrıca hepatit B virüsünü kontrol etmeye yardımcı olmak üzere bağışıklık sistemini güçlendiren bağışıklık düzenleyici ilaçlar (immünomodülatörler) vardır. Bu ilaçlar 6 ay ila 1 yıl boyunca enjeksiyonlar şeklinde verilir. En sık yazılanlar arasında interferon alfa-2b (Intron A) ve pegile interferon (Pegasys) vardır. Sizin için varsa hangisinin en iyi olduğunu belirlemek üzere siz ve doktorunuzun tedavi seçeneklerini konuşması gerekir. Bu ilaçlar çoğu kişide hepatit B virüsünü azaltır veya durdurur. Bu durum birkaç ay sonra virüsün karaciğer hasarı yavaşladığı ve hatta ilaçlar uzun dönem alındıklarında geri döndürüldüğü için hastaların kendilerini daha iyi hissetmesiyle sonuçlanır. Hepatit B için FDA onaylı ilaçlar ve diğer ümit veren ilaçların tam bir listesi için Drug Watch (İlaç Haberleri) kısmımızı ziyaret edin. General Information What is hepatitis B?Hepatitis B is the world's most common liver infection. It is caused by the hepatitis B virus (HBV), which attacks and injures the liver. It is transmitted through blood, unprotected sex, shared or re-used needles, and from an infected mother to her newborn baby during pregnancy or delivery. Most infected adults are able to get rid of the hepatitis B virus without any problems. However, some adults and most infected babies and children are unable to get rid of the virus and will develop chronic (life-long) infection. The good news is that there is a safe vaccine to prevent a hepatitis B infection and new treatments for those already infected with hepatitis B. How many people are affected by hepatitis B?Worldwide, 2 billion people (1 out of 3 people) have been infected with hepatitis B; and 257 million people are chronically infected (which means they are unable to get rid of the virus). An estimated 700,000 people die each year from hepatitis B and its complications. Why is hepatitis B more common in some parts of the world?Hepatitis B can infect any person of any age or ethnicity, but people from parts of the world where hepatitis B is common, such as Asia, parts of Africa and South America, Eastern Europe, and the Middle East, are at much higher risk for getting infected. Hepatitis B is also common among Americans who were born (or whose parents were born) in these regions. Hepatitis B is more common in certain regions of the world because there are so many more people already infected with hepatitis B in these regions. Although hepatitis B is not an "Asian disease" or an “African disease,” it affects hundreds of millions of people from these regions – so there are more people who can pass the hepatitis B virus on to others. This increases the risk that you could get infected. Since there is a smaller number of Westerners who are infected, this group has a lower risk of infection. In regions where hepatitis B is common, people are usually infected as newborns - from a mother who unknowingly passes the virus to her baby during delivery. Young children are also at risk if they live in close daily contact with an infected family member. Babies and children are more likely to develop a chronic hepatitis B infection because their young immune systems have trouble getting rid of the virus. If you, or your family, is from an area of the map that is darker blue, you might be at greater risk for hepatitis B infection and should talk to a doctor about getting tested. Why should I be concerned about hepatitis B?Chronic hepatitis B can lead to serious liver disease such as cirrhosis or liver cancer. It's important to get tested because early diagnosis can lead to early treatment which can save your life. Also, people who are infected can spread the virus to others. Since most people don't know they are infected, they are unknowingly spreading it to many other people. If people are not tested, hepatitis B can pass through several generations in one family and throughout the community. One common myth is that hepatitis B can be "inherited" since several generations in one family may be infected. But hepatitis B is NOT a genetic disease -- hepatitis B is caused by a virus, which is often transmitted among family members due to mother-to-child transmission or accidental household exposure to blood. Families can break the cycle of hepatitis B infection by getting tested, vaccinated and treated. Why is hepatitis B so dangerous?Hepatitis B is dangerous because it is a “silent infection” that can infect people without them knowing it. Most people who are infected with hepatitis B are unaware of their infection and can unknowingly pass the virus to others through their blood and infected bodily fluids. For those who become chronically infected, there is an increased risk of developing liver failure, cirrhosis and/or liver cancer later in life. The virus can quietly and continuously attack the liver over many years without being detected. What is acute hepatitis B?An acute hepatitis B infection may last up to six months (with or without symptoms) and infected persons are able to pass the virus to others during this time. Symptoms of an acute infection may include loss of appetite, joint and muscle pain, low-grade fever, and possible stomach pain. Although most people do not experience symptoms, they can appear 60-150 days after infection, with the average being 3 months. Some people may experience more severe symptoms such as nausea, vomiting, jaundice (yellowing of the eyes and skin), or a bloated stomach that may cause them to see a health care provider. A simple blood test can tell a person if the hepatitis B virus is in their blood. If you have been diagnosed with acute hepatitis B, the doctor will need to test your blood again in 6 months to figure out if you have recovered, or if you have developed a chronic hepatitis B infection. Until your health care provider confirms that your blood test shows that there is no more hepatitis B virus in your blood, it is important to protect others from a possible infection. It is also important to have your sexual partner(s) and family members (or those you live in close household contact with) tested for hepatitis B. If they have not been infected – and have not received the hepatitis B vaccine – then they should start the hepatitis B vaccine series. People who have acute hepatitis B are not prescribed specific hepatitis B treatment – there is no treatment that will get rid of an acute hepatitis B infection, and most people infected as adults recover on their own. Sometimes, a person with severe symptoms may be hospitalized for general support. Rest and managing symptoms are the primary goals of this medical care. A rare, life-threatening condition called “fulminant hepatitis” can occur with a new acute infection and requires immediate, urgent medical attention since a person can go into sudden liver failure. Simple tips for taking care of your liver during an acute hepatitis B infection are to avoid alcohol, stop or limit smoking, eat healthy foods, avoid greasy or fatty foods, and talk to your health care provider about any medications you are taking (prescriptions, over-the-counter medications, vitamins or herbal supplements) to make sure they are safe for your liver. This is a good time to ask any other questions you may have. The use of vitamins and liver health supplements will likely not assist your recovery and may actually cause more harm than good to the liver. Be sure to follow-up with your health care provider for any additional blood tests that are needed to confirm your recovery from an acute infection. What is chronic hepatitis B?People who test positive for the hepatitis B virus for more than six months (after their first blood test result) are diagnosed as having a chronic infection. This means their immune system was not able to get rid of the hepatitis B virus and it still remains in their blood and liver. There are effective ways to treat and manage a chronic infection, but there is no cure. If you are chronically infected, the virus will likely remain in your blood for the rest of your life.People who have chronic hepatitis B can unknowingly pass the virus on to others. Chronic hepatitis B can also lead to serious liver diseases, such as cirrhosis or liver cancer. Not every person who is chronically infected will develop serious liver disease. However, they have a greater chance than someone who is not infected. The risk of developing a chronic hepatitis B infection is related to the age at which one first becomes infected with the hepatitis B virus:• 90% of infected newborns and babies will develop a chronic hepatitis B infection• Up to 50% of infected children (1-5 years) will develop a chronic hepatitis B infection• 5-10% of infected adults will develop a chronic hepatitis B infection (that is, 90% will recover) Learning that you have a chronic hepatitis B infection can be very upsetting. Because most people do not have symptoms and can be diagnosed decades after their initial exposure to the hepatitis B virus, it can be a shock and a surprise to be diagnosed with a chronic hepatitis B infection. The good news is that most people with chronic hepatitis B should expect to live a long and healthy life. Infected pregnant women can pass the virus to their newborns during childbirth. Therefore, since the risk of newborns becoming chronically infected at birth is high, both the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC) recommend that all infants receive the first dose of the hepatitis B vaccine within 12-24 hours after birth. If you are pregnant and you know that you are infected, you can make sure that your baby gets the first dose of the hepatitis B vaccine within 12-24 hours after delivery! While there is no cure for chronic hepatitis B infection, there are effective drug therapies that can control the hepatitis B virus and stop it from damaging the liver. There are also promising new drugs in the research phase that could provide a cure in the very near future. Although the risk of developing a serious liver disease or liver cancer is higher for those living with chronic hepatitis B than those who are not infected, there are still many simple things a person can do to help reduce their risk. • Schedule regular visits every six months (or at least every year) with a liver specialist or a health care provider who is knowledgeable about hepatitis B so they can monitor the health of your liver.• Talk to your health care provider about whether treatment for your chronic hepatitis B infection would be helpful in preventing serious liver disease or liver cancer.• Make sure that your health care provider screens you for liver cancer during your regular visits since early detection equals more treatment options and a longer life.• Avoid or limit alcohol and smoking since both cause a lot of stress to your liver.• Eat a healthy diet with lots of vegetables since fried, greasy foods are hard on your liver. What does it mean to be a “chronic carrier”?When someone has a chronic hepatitis B infection, their doctor may refer to them as being a “chronic carrier.” Being a “chronic carrier” means that you have a chronic hepatitis B infection, can pass the virus on to others, and you should be managed by a doctor for your infection. Is there a cure for hepatitis B?Most adults will recover from an acute infection on their own without the need for medication. For adults, children and infants who develop a chronic hepatitis B infection, there is currently no cure. But the good news is there are treatments that can help slow the progression of liver disease in chronically infected persons by slowing down the virus. If there is less hepatitis B virus being produced, then there is less damage being done to the liver. With all of the new exciting research, there is great hope that a cure will be found for chronic hepatitis B in the near future. Visit our Drug Watch for a list of other promising drugs in development. What options are there to treat my hepatitis B?For an acute infection, there is generally no treatment other than rest and supportive measures to manage any symptoms. For chronic hepatitis B, there are several treatments available. It is important to understand that not everyone with chronic hepatitis B needs treatment. Your doctor will help you decide if you need medication or if you can wait and monitor your condition. There are several antiviral medications that slow down or stop the hepatitis B virus from replicating, which reduces the inflammation and damage to the liver. These antivirals are taken as a pill once a day for at least 1 year, usually longer. There are 6 U.S. FDA approved antivirals, but only three “first-line” antivirals are recommended: tenofovir disoproxil (Viread/TDF), tenofovir alafenamide (Vemlidy/TAF) and entecavir (Baraclude). First-line antivirals are recommended because they are safer and most effective. For people who do not respond to, or have access to, the first-line antiviral treatments, other options are available: telbivudine (Tyzeka, Sebivo), adefovir dipivoxil (Hepsera), and lamivudine (Epivir-HBV, Zeffix, Heptodin). Although the FDA has approved these antivirals for chronic hepatitis B, they do not provide a complete cure. They can, however, greatly decrease the risk of developing liver damage and liver cancer. Antivirals are not meant to be stopped and started, which is why a thorough evaluation by a knowledgeable doctor is so important before beginning treatment for chronic hepatitis B. There are also immunomodulator drugs that boost the immune system to help control the hepatitis B virus. They are given as injections over 6 months to 1 year. The most commonly prescribed include interferon alfa-2b (Intron A) and pegylated interferon (Pegasys). You and your doctor will need to discuss the treatment options before deciding which one, if any, is best for you. For many people, these medications will decrease or stop the hepatitis B virus. This results in patients feeling better within a few months because liver damage from the virus is slowed down, or even reversed in some cases, when taken long-term. For a complete list of FDA approved drugs and other promising drugs in development for hepatitis B, visit our Drug Watch.

  https://www.hepb.org/languages/turkish/general-information/

•     與 B 型肝炎共存  我會從 B 型肝炎感染痊癒嗎？大多數剛受感染的健康成年人會毫無困難地痊癒。但嬰兒和幼兒可能無法成功地擺脫這種病毒。 • 成年人——90% 的健康成年人會擺脫這種病毒，並且毫無困難地痊癒；10% 會演變為慢性 B 型肝炎。 • 幼兒——多達 50% 的 1-5 歲受感染幼兒會演變為慢性 B 型肝炎感染。• 嬰兒——90% 會演變為慢性感染；只有 10% 能擺脫這種病毒。 「急性」和「慢性」B 型肝炎感染有什麼區別？接觸病毒後最初 6 個月期間的 B 型肝炎感染被認為是「急性」感染。這是從 B 型肝炎感染痊癒的平均時間。 6 個月後，如果您 B 型肝炎病毒檢驗結果仍然呈陽性 (HBsAg+)，則您被認為患有「慢性」B 型肝炎感染，可以持續一生。 如果我患有急性 B 型肝炎，我會生病嗎？B 型肝炎被認為是一種「無聲的感染」，因為通常不會引起任何症狀。大多數人感到健康而且不知道自己已受感染，這表示他們會在不知情的情況下將病毒傳給他人。其他人可能有輕微症狀，比如誤以為由流感導致的發燒、疲勞、關節或肌肉疼痛，或者食慾減退。 不常見但更嚴重的症狀包括嚴重噁心和嘔吐，眼睛和皮膚發黃（稱為「黃疸」）和胃脹——這些症狀需要立即就醫，患者可能需要住院。 我如何知道我已經從「急性」B 型肝炎感染痊癒？一旦您的醫生透過驗血已確認您的體內已擺脫這種病毒，並產生保護性抗體 (HBsAb+)，您就會免於任何未來的 B 型肝炎感染，並且對其他人不再有傳染性。 如果我被診斷出患有慢性 B 型肝炎，我應該怎麼辦？如果您的 B 型肝炎病毒檢驗結果呈陽性超過 6 個月，這表明您患有慢性 B 型肝炎感染。您應該與肝病專家、胃腸科醫師或熟悉 B 型肝炎的家庭醫生預約。醫生會為您驗血，可能還會為您做肝臟超音波檢查，以評估 B 型肝炎病毒在您體內的活躍程度，並觀察您的肝臟健康情況。您的醫生很可能希望每年至少見到您一次或兩次，以監測您的 B 型肝炎，並確定您是否會從治療中改善。 所有慢性感染者無論是否開始治療，都應該至少每年看一次（或更頻繁地）醫生，進行定期的醫療追蹤。即使病毒處於較不活躍的階段，肝臟極少或沒有發生任何損傷，但這會隨時間發生改變，這也正是定期追蹤如此重要的原因。 大多數慢性 B 型肝炎感染者都有望活得健康長久。一旦您被診斷為慢性 B 型肝炎，病毒可能在您的血液和肝臟中終生停留。重要的是要知道，您可能將病毒傳給他人，即使您並不覺得不舒服。所以確保所有親密的家人和性伴侶都接種 B 型肝炎疫苗是很重的。 哪些檢查會用來監測我的 B 型肝炎？醫生用來監測 B 型肝炎的常見檢查包括 B 型肝炎血檢、肝功能檢驗 (ALT、AST)、B 型肝炎病毒 e 抗原 (HBeAg)、B 型肝炎 e 抗體 (HBeAb)、B 型肝炎 DNA 定量（病毒載量）和肝臟造影研究（超音波、FibroScan [暫態彈性造影] 或 CT 掃描）。 慢性 B 型肝炎有治癒的方法嗎？慢性 B 型肝炎目前還沒有治癒的方法，但好消息是，有一些治療方法可以藉由減緩病毒擴散的速度來幫助減緩慢性感染者肝病的進展。如果產生的 B 型肝炎病毒較少，那麼對肝臟的損傷就比較小。有時這些藥物甚至可以擺脫這種病毒，儘管並不常見。 隨著令人振奮的新研究，相信找到慢性 B 型肝炎的治癒方法指日可待。請參閱我們的 Drug Watch，瞭解目前正在研發中的其他具有潛力的藥物。 有任何已批准的藥物來治療慢性 B 型肝炎嗎？目前針對 B 型肝炎的治療分為兩種一般類別：抗病毒藥物和免疫調節劑： 抗病毒藥物——這些藥物可以減緩或阻止 B 型肝炎病毒，進而減少肝臟發炎和造成的損害。這些藥物為丸劑，每天服用一次，療程至少 1 年，通常更久 目前有六種經美國食品和藥物管理局 (FDA) 批准的抗病毒藥物，但是只有三種一線抗病毒藥物是獲得推薦的治療方法：惠立妥（tenofovir disoproxil，商品名 Viread/TDF）、韋立得（tenofovir alafenamide，商品名 Vemlidy/TAF）和貝樂克（entecavir，商品名 Baraclude）。推薦使用一線抗病毒藥物，因為他們更安全也最有效。他們的抗藥性比舊的抗病毒藥物更好，這表示按處方服用時，發生突變和抗藥性的可能性更小。抗藥性增加使得治療和控制病毒更加困難。 免疫調節藥——這些藥物可以增強免疫系統，以幫助控制 B 型肝炎病毒。他們在 6 個月到 1 年的時間裡以注射方式給藥。最常見的處方藥物包括干擾素 alfa-2b (Intron A) 和聚 B 二醇干擾素 (Pegasys)。這是針對同時感染肝炎三角區的患者唯一的推薦治療方法。 這些藥物能為慢性 B 型肝炎提供「治癒的方法」嗎？
雖然他們無法徹底治癒這種病，但目前的藥物會減緩病毒擴散的速度，並降低日後患上更嚴重肝病的風險。患者在幾個月以內會有所改善，這是因為病毒對肝臟的損傷減緩，或者在某些情況下，甚至在長期服用後出現逆轉。抗病毒藥物不能隨意停止和開始，這就是在開始治療慢性 B 型肝炎病毒之前需要由專業醫生進行徹底評估的原因。 如果我患有慢性 B 型肝炎感染，我應該服用藥物嗎？重要的是要瞭解，並非每個慢性 B 型肝炎患者都需要服藥。您應該與您的醫生討論您是否適合藥物療法。無論您和您的醫生決定您是否應該開始治療，您都應該定期去肝臟專科醫生或精通 B 型肝炎治療的醫生處就診。 若患有 B 型肝炎感染，服用草藥或補充劑安全嗎？許多人都有興趣使用草藥或補充劑來增強他們的免疫系統和幫助他們的肝臟。問題在於，生產這些產品的公司並沒有被監管，這表示沒有嚴格的安全或純度檢測。因此，各類草藥或維他命補充劑的產品品質可能不同。另外，有些草藥可能會干擾治療 B 型肝炎或其他病症的處方藥；有些甚至會傷害您的肝臟。這些草藥不會治癒慢性 B 型肝炎。 有許多公司在網路上或者透過社交媒體對他們的產品做誇大不實的廣告。網路上臉書上的宣傳和患者感言可能是假的，用來欺騙人們購買昂貴的草藥和補充劑。記住，如果好得令人難以置信，那麼很可能不是真的。 以下是關於藥草和替代藥物的可靠資訊來源。這些資訊基於科學證據，不是以訛傳訛。檢查您的草藥或補充劑中的有效成分是否是真的，而且對您的肝臟是安全的。最重要的是要保護您的肝臟免受任何額外的損害。 對於那些慢性 B 型肝炎患者，有哪些健康的提示？慢性 B 型肝炎感染患者可能或可能不需要藥物治療。但是，患者可以做很多其他的事情來保護他們的肝臟和增進他們的健康。以下是我們今天可以開始的十大健康選擇的清單！ 安排定期到您的肝臟專科醫生或醫護人員處就診，以掌握您的健康和肝臟的健康情況。 接種 A 型肝炎疫苗，以保護自己遠離對肝臟有害的其他病毒。 避免飲酒和抽菸，因為兩者都會傷害肝臟。 在開始服用任何草藥或維他命補充劑之前，先與您的醫生討論，因為有些藥物可能會干擾您的 B 型肝炎處方藥物，甚至會損害您的肝臟。 向您的藥劑師諮詢任何非處方藥（如：對 B 醯氨基酚、撲熱息痛）或非 B 型肝炎處方藥，之後再服用這些藥物，以確保他們對您的肝臟是安全的，因為很多這些藥物都是經過肝臟處理的。  避免吸入油漆、油漆稀釋劑、膠水、家用清潔產品、去光水以及其他可能損害肝臟的有毒化學物質的氣味。  健康飲食，食用水果、全穀類、魚類和瘦肉以及大量蔬菜。尤其是「十字花科蔬菜」，如包心菜、青花菜、花椰菜等，已被證明有助於保護肝臟對抗環境中的化學物質。  避免食用生的或未煮熟的貝類（如蛤蚌、貽貝、牡蠣、扇貝），因為他們可能會被一種叫做創傷弧菌的細菌污染，這種細菌對肝臟非常有害，可能造成嚴重損傷。 檢查堅果、玉蜀黍、玉米、花生、高粱和小米有無發霉跡象。如果食物儲存在潮濕的環境中，沒有妥善密封，那麼黴菌則更有可能是個問題。如果有黴菌，那麼這些食物可能會被「黃麴黴毒素」污染，這是肝癌的已知風險因素。 藉著吃健康的食物、規律運動和獲得充分的休息來減輕壓力。  記住您吃的、喝的、呼吸的或透過皮膚吸收的每樣東西最終都要由肝臟來過濾。所以，請保護您的肝臟和您的健康！ 如果我有 B 型肝炎，我可以捐血嗎？ 不能。即使您已經從急性感染痊癒，血庫也不會接受任何已接觸過 B 型肝炎的血液。   Living with Hepatitis B  Will I recover from a hepatitis B infection?Most healthy adults who are newly infected will recover without any problems. But babies and young children may not be able to successfully get rid of the virus. Adults – 90% of healthy adults will get rid of the virus and recover without any problems; 10% will develop chronic hepatitis B.  Young Children – Up to 50% of young children between 1 and 5 years who are infected will develop a chronic hepatitis B infection. Infants – 90% will become chronically infected; only 10% will be able to get rid of the virus.    What is the difference between an "acute" and a "chronic" hepatitis B infection?A hepatitis B infection is considered to be “acute” during the first 6 months after being exposed to the virus. This is the average amount of time it takes to recover from a hepatitis B infection. If you still test positive for the hepatitis B virus (HBsAg+) after 6 months, you are considered to have a "chronic" hepatitis B infection, which can last a lifetime. Will I become sick if I have acute hepatitis B?Hepatitis B is considered a "silent infection” because it often does not cause any symptoms. Most people feel healthy and do not know they have been infected, which means they can unknowingly pass the virus on to others. Other people may have mild symptoms such as fever, fatigue, joint or muscle pain, or loss of appetite that are mistaken for the flu. Less common but more serious symptoms include severe nausea and vomiting, yellow eyes and skin (called “jaundice”), and a swollen stomach - these symptoms require immediate medical attention and a person may need to be hospitalized. How will I know when I have recovered from an "acute" hepatitis B infection?Once your doctor has confirmed through a blood test that you have gotten rid of the virus from your body and developed the protective antibodies (HBsAb+), you will be protected from any future hepatitis B infection and are no longer contagious to others.What should I do if I am diagnosed with chronic hepatitis B?If you test positive for the hepatitis B virus for longer than 6 months, this indicates that you have a chronic hepatitis B infection. You should make an appointment with a hepatologist (liver specialist), gastroenterologist, or family doctor who is familiar with hepatitis B. The doctor will order blood tests and possibly a liver ultrasound to evaluate how active the hepatitis B virus is in your body, and to monitor the health of your liver. Your doctor will probably want to see you at least once or twice a year to monitor your hepatitis B and determine if you would benefit from treatment.All chronically infected people should be seen by their doctor at least once a year (or more frequently) for regular medical follow-up care, whether they start treatment or not. Even if the virus is in a less active phase with little or no damage occurring, this can change with time, which is why regular monitoring is so important. Most people chronically infected with hepatitis B can expect to live long, healthy lives. Once you are diagnosed with chronic hepatitis B, the virus may stay in your blood and liver for a lifetime. It is important to know that you can pass the virus along to others, even if you don’t feel sick. This is why it’s so important that you make sure that all close household contacts and sex partners are vaccinated against hepatitis B. What tests will be used to monitor my hepatitis B?Common tests used by doctors to monitor your hepatitis B include the hepatitis B blood panel, liver function tests (ALT, AST), hepatitis B e-Antigen (HBeAg), hepatitis B e-Antibody (HBeAb), hepatitis B DNA quantification (viral load), and an imaging study of the liver (ultrasound, FibroScan [Transient Elastography] or CT scan). Is there a cure for chronic hepatitis B?Right now, there is no cure for chronic hepatitis B, but the good news is there are treatments that can help slow the progression of liver disease in chronically infected persons by slowing down the virus. If there is less hepatitis B virus being produced, then there is less damage being done to the liver. Sometimes these drugs can even get rid of the virus, although this is not common. With all of the new exciting research, there is great hope that a cure will be found for chronic hepatitis B in the near future. Visit our Drug Watch for a list of other promising drugs in development. Are there any approved drugs to treat chronic hepatitis B?Current treatments for hepatitis B fall into two general categories, antivirals and immune modulators: Antiviral Drugs - These are drugs that slow down or stop the hepatitis B virus, which reduces the inflammation and damage to the liver. These are taken as a pill once a day for at least 1 year, usually longer. There are 6 U.S. FDA approved antivirals, but only three first-line antivirals are recommended treatments: tenofovir disoproxil (Viread/TDF), tenofovir alafenamide (Vemlidy/TAF) and Entecavir (Baraclude). First-line antivirals are recommended because they are safer and most effective. They also have a better resistance profile than older antivirals, which means that when they are taken as prescribed, there is less chance of mutation and resistance. Building resistance makes it harder to treat and control the virus. Immunomodulator Drugs - These are drugs that boost the immune system to help control the hepatitis B virus. They are given as injections over 6 months to 1 year. The most commonly prescribed include interferon alfa-2b (Intron A) and pegylated interferon (Pegasys). This is the only recommended treatment for patients coinfected with hepatitis delta. Do these drugs provide a “cure” for chronic hepatitis B?
Although they do not provide a complete cure, current medications will slow down the virus and decrease the risk of more serious liver disease later in life. This results in patients feeling better within a few months because liver damage from the virus is slowed down, or even reversed in some cases, when taken long-term. Antivirals are not meant to be stopped and started, which is why a thorough evaluation by a knowledgeable doctor is so important before beginning treatment for chronic HBV. If I have a chronic hepatitis B infection, should I be on medication?It is important to understand that not every person with chronic hepatitis B needs to be on medication. You should talk to your doctor about whether you are a good candidate for drug therapy. Whether you and your doctor decide you should start treatment or not, you should be seen regularly by a liver specialist or a doctor knowledgeable about hepatitis B. Is it safe to take herbal remedies or supplements for my hepatitis B infection?Many people are interested in using herbal remedies or supplements to boost their immune systems and help their livers. The problem is that there is no regulation of companies manufacturing these produces, which means there is no rigorous testing for safety or purity. So, the quality of the herbal remedy or vitamin supplement may be different from bottle to bottle. Also, some herbal remedies could interfere with your prescription drugs for hepatitis B or other conditions; some can even actually damage your liver. These herbal remedies will not cure a chronic hepatitis B infection. There are many companies that make false promises on the Internet and through social media about their products. Online claims and patient testimonials on Facebook are fake and are used to trick people into buying expensive herbal remedies and supplements. Remember, if it sounds too good to be true, then it’s probably not true. Below are reliable sources of information about herbs and alternative medicines. This information is based on scientific evidence, not false promises. Check whether the active ingredients in your herbal remedies or supplements are real and safe for your liver. The most important thing is to protect your liver from any additional injury or harm. What healthy liver tips are there for those living with chronic hepatitis B?People living with chronic hepatitis B infection may or may not need drug treatment. But there are many other things patients can do to protect their liver and improve their health. Below is our list of the top 10 healthy choices that can be started today! Schedule regular visits with your liver specialist or health care provider to stay on top of your health and the health of your liver. Get the Hepatitis A vaccine to protect yourself from another virus that attacks the liver. Avoid drinking alcohol and smoking since both will hurt your liver, which is already being injured by the hepatitis B virus. Talk to your provider before starting any herbal remedies or vitamin supplements because some could interfere with your prescribed hepatitis B drugs or even damage your liver. Check with your pharmacist about any over-the-counter drugs (e.g. acetaminophen, paracetamol) or non-hepatitis B prescription drugs before taking them to make sure they are safe for your liver since many of these drugs are processed through your liver.  Avoid inhaling fumes from paint, paint thinners, glue, household cleaning products, nail polish removers, and other potentially toxic chemicals that could damage your liver.  Eat a healthy diet of fruit, whole grains, fish and lean meats, and lot of vegetables. “Cruciferous vegetables” in particular -- cabbage, broccoli, cauliflower -- have been shown to help protect the liver against environmental chemicals.  Avoid eating raw or undercooked shellfish (e.g. clams, mussels, oysters, scallops) because they could be contaminated with bacteria called Vibrio vulnificus, which is very toxic to the liver and could cause a lot of damage. Check for signs of mold on nuts, maize, corn, groundnut, sorghum, and millet before using these foods. Mold is more likely to be a problem if food is stored in damp conditions and not properly sealed. If there is mold, then the food could be contaminated by “aflatoxins,” which are a known risk factor for liver cancer. Reduce your stress levels by eating healthy foods, exercising regularly, and getting plenty of rest. Keep in mind everything you eat, drink, breathe, or absorb through the skin is eventually filtered by the liver. So, protect your liver and your health! Can I donate blood if I have hepatitis B? No. The blood bank will not accept any blood that has been exposed to hepatitis B, even if you have recovered from an acute infection.  

  https://www.hepb.org/languages/chinese-traditional/living/

• 一般資訊  什麼是 B 型肝炎？B 型肝炎是世界上最常見的肝臟感染。是由會攻擊和傷害肝臟的 B 型肝炎病毒引起的。經由血液、沒有保護的性行為、共用或重複使用的針頭傳染，以及在懷孕或分娩期間由受感染的母親傳染給新生兒。大多數受感染的成年人都能毫無困難地擺脫 B 型肝炎病毒。然而，某些成年人和大多數受感染的嬰兒和兒童卻無法擺脫這種病毒，因而演變為慢性（終生）感染。 好消息是有安全的疫苗可以預防 B 型肝炎感染，並且也有針對已感染人士的新治療方法。 有多少人受 B 型肝炎影響？全世界有 20 億人（每 3 人中就有 1 人）感染 B 型肝炎；2.57 億人為慢性感染（也就是說他們無法擺脫這種病毒）。據估計，每年有 70 萬人死於 B 型肝炎及其併發症。 為什麼 B 型肝炎在世界的某些地區比較常見？B 型肝炎可以感染任何年齡或種族的任何人，但是來自世界上 B 型肝炎較為常見的地區（如亞洲、非洲和南美洲部分地區、東歐以及中東）的人，受感染的風險要高得多。B 型肝炎在出生（或其父母出生）於這些地區的美國人中也很常見。 B 型肝炎在世界上某些地區較為常見，是因為在這些地區已經有更多的人感染了 B 型肝炎。雖然 B 型肝炎並非「亞洲病」或「非洲病」，但卻影響著來自這些地區的數億人——因此，會有更多的人將 B 型肝炎病毒傳給他人。這增加了您受感染的風險。因為比較少西方人受感染，所以這個群體的感染風險較低。 在 B 型肝炎常見的地區，人們通常在新生兒時期就受到感染——在分娩過程中由母親在不知情的情況下將病毒傳給嬰兒。在生活上與受感染的家庭成員日常接觸密切的幼兒也面臨風險。嬰兒和兒童比較容易演變為慢性 B 型肝炎感染，因為他們未成熟的免疫系統難以擺脫這種病毒。 如果您或您的家人來自地圖上的深藍色區域，您感染 B 型肝炎的風險可能更大，應該和醫生談談接受檢查的事宜。 我為什麼應該關心 B 型肝炎？慢性 B 型肝炎可以導致嚴重的肝病，如肝硬化或肝癌。接受檢查十分重要，因為早期診斷可以早期治療，進而挽救您的生命。另外，感染者可能將病毒傳給他人。大多數人根本不知道自己受感染，所以他們會在不知情的情況下傳給許多其他人。如果人們不接受檢查，B 型肝炎可能傳給一個家庭好幾代人及整個社區。 一個常見誤解是 B 型肝炎會「遺傳」，因為一個家庭中幾代人都可能感染。但 B 型肝炎並不是遺傳疾病—— B 型肝炎是由病毒引起的，通常因母嬰傳染或者不小心接觸血液而在家人之間傳染。家人之間可以透過接受檢查、接種疫苗和治療，不受 B 型肝炎感染。 B 型肝炎為什麼如此危險？B 型肝炎很危險，因為這是一種「無聲的感染」，可以讓人在不知情之下受到感染。大多數 B 型肝炎感染者根本不知道自己被感染，會在不知情的情況下經由血液和體液將病毒傳給他人。那些慢性感染者日後有更高的風險會演變為肝功能衰竭、肝硬化和/或肝癌。這種病毒可以悄無聲息、持續不斷地長年攻擊肝臟而不被察覺。 什麼是急性 B 型肝炎？急性 B 型肝炎感染可能持續達 6 個月（不論是否有症狀），感染者在這段期間會將病毒傳給他人。 急性感染的症狀可能包括食慾減退、關節和肌肉疼痛、低燒及可能出現胃痛。雖然大多數人都不沒有任何症狀，但症狀可能會在感染後的 60-150 天，平均3 個月後出現。有些人可能出現更嚴重的症狀，如噁心、嘔吐、黃疸（眼睛和皮膚發黃）或者胃脹，這些可能導致他們去就醫。 只需要簡單驗血即可辨別一個人的血液中是否有 B 型肝炎病毒。如果您已被診斷為急性 B 型肝炎，醫生需要在 6 個月後再次為您驗血，以確定您是否已經痊癒，還是已經演變為慢性 B 型肝炎。在醫護人員替您驗血確認您的血液中不再有 B 型肝炎病毒之前，保護其他人避免被感染是十分重要的。讓您的性伴侶和家人（或與您密切接觸的家屬）接受 B 型肝炎檢查也是十分重要的。如果他們尚未受感染，而且尚未接受 B 型肝炎疫苗接種，那麼他們就應該開始接種 B 型肝炎系列疫苗。 急性 B 型肝炎患者沒有特定的治療方法——目前沒有任何治療方法可以完全擺脫急性 B 型肝炎，大多數在成年期受到感染的人都能自行痊癒。有時候，症狀嚴重者可能要住院接受治療。休息和控制症狀是治療的主要目標。新的急性感染會伴隨一種叫做「猛暴型肝炎」的罕見致命疾病，需要立即進行緊急治療，因為患者可能會突然肝衰竭。 在感染急性 B 型肝炎期間照顧肝臟的簡單方法就是要避免飲酒、戒菸、食用健康食物、避免油膩或高脂肪的食物，以及告知醫護人員您正在服用的所有藥物（處方藥、非處方藥、維他命或草藥補充劑），以確保他們對您的肝臟無害。這時如果您有任何疑問要儘量提出來。使用維他命和肝臟健康補充劑可能沒法助您痊癒，實際上對肝臟的影響可能弊大於利。 請務必接受醫護人員複診，必要時再次驗血以確認您已經從急性感染痊癒。 什麼是慢性 B 型肝炎？B 型肝炎病毒檢驗結果呈陽性超過 6 個月（初次驗血結果以後）就會被診斷為患慢性感染。這表示他們的免疫系統無法擺脫 B 型肝炎病毒，而且這種病毒仍然存在於他們的血液和肝臟中。目前已經有有效的方法可以治療和控制慢性感染，但是沒有辦法治癒。如果您是慢性感染者，病毒很可能在您的一生中都留在您的血液裡。 慢性 B 型肝炎患者會在不知情的情況下將病毒傳給他人。慢性 B 型肝炎也可以導致嚴重的肝病，如肝硬化或肝癌。但並非每個慢性感染者都會演變為嚴重的肝病。然而，他們的可能性比未感染者更大。 演變為慢性 B 型肝炎感染的風險與首次感染 B 型肝炎病毒的年齡有關： 90% 受感染的新生兒和嬰兒會演變為慢性 B 型肝炎感染 高達 50% 受感染的兒童（1-5 歲）會演變為慢性 B 型肝炎感染 5%-10% 受感染的成年人會演變為慢性 B 型肝炎感染（即 90% 會痊癒） 獲悉自己患有慢性 B 型肝炎感染會非常令人沮喪。因為大多數人沒有症狀，他們在最初接觸 B 型肝炎病毒後數十年被診斷出來，所以會令人感到震驚和意外。好消息是，大多數慢性 B 型肝炎患者會活得健康長壽。 受感染的孕婦會在分娩期間將病毒傳給新生兒。新生兒在出生時慢性感染的風險很高，世界衛生組織（世衛組織）和美國疾病控制和預防中心 (CDC) 建議，所有嬰兒在出生後 12-24 小時內接受首劑 B 型肝炎疫苗接種。如果您已懷孕並且您知道自己受感染，您應該確保您的寶寶在分娩後的 12-24 小時內接受首劑 B 型肝炎疫苗接種！ 儘管慢性 B 型肝炎感染沒有治癒的方法，但有藥物可以控制 B 型肝炎病毒，並可阻止他們繼續損害肝臟。也有處於實驗階段的新藥，可以在不久的將來提供治癒方法。儘管慢性 B 型肝炎患者演變為嚴重肝病或肝癌的風險較高，但還有許多簡單的事情可以幫助他們降低風險。 安排每 6 個月（或至少每年）一次定期到肝臟專科醫生或精通 B 型肝炎治療的醫護人員處就診，以便他們能監測您的肝臟健康。 與您的醫護人員討論您的慢性 B 型肝炎感染治療是否有助於預防嚴重的肝病或肝癌。 確保您的醫護人員在您定期就診期間為您進行肝癌篩查，因為早期發現就等於更多治療選擇和生命更有保障。 戒酒和戒菸，因為菸酒都會對您的肝臟造成嚴重傷害。 健康飲食，吃大量蔬菜，因為油炸、油膩的食物會增加肝臟的負坦。   成為「慢性帶原者」意味著什麼？當某人有慢性 B 型肝炎感染時，他們的醫生可能會稱他們為「慢性帶原者」。身為「慢性帶原者」表示您有慢性 B 型肝炎感染，可以將病毒傳給他人，應該由醫生來幫您控制感染。 B 型肝炎有治癒的方法嗎？大多數成年人無需藥物治療，急性感染即可自行痊癒。對於演變為慢性 B 型肝炎感染的成年人、兒童和嬰兒，目前還沒有治癒的方法。但好消息是，有一些治療方法可以減緩病毒擴散的速度，進而減緩慢性感染者肝病的進展。如果產生的 B 型肝炎病毒較少，那麼對肝臟的損傷就比較小。 隨著令人振奮的新研究，相信找到慢性 B 型肝炎的治癒方法指日可待。請參閱我們的 Drug Watch，瞭解目前正在研發中的其他具有潛力的藥物。 B 型肝炎有哪些治療選擇？除了休息和輔助醫療來控制症狀之外，急性感染通常沒有其他任何治療方法。 慢性 B 型肝炎有幾種治療方法。重要的是要瞭解，並非每個慢性 B 型肝炎患者都需要治療。您的醫生會幫助您決定是要進行藥物治療，還是可以靜待觀察您的病情。 有幾種抗病毒藥物可以減緩或阻止 B 型肝炎病毒的複製，進而減少肝臟發炎和造成的損害。這些抗病毒藥丸每天服用一次，至少需要服用 1 年，通常更久。目前有六種經美國食品和藥物管理局 (FDA) 批准的抗病毒藥物，但是只有三種「一線」抗病毒藥物獲得推薦：惠立妥（tenofovir disoproxil，商品名 Viread/TDF）、韋立得（tenofovir alafenamide，商品名 Vemlidy/TAF）和貝樂克（entecavir，商品名 Baraclude）。推薦使用一線抗病毒藥物，因為他們更安全也最有效。對一線抗病毒治療無反應或無法獲取一線抗病毒治療的患者可以使用其他選擇：喜必福（telbivudine，商品名 Tyzeka、Sebivo）、干適能（adefovir dipivoxil，商品名 Hepsera）和干安能（lamivudine，商品名 Epivir-HBV、Zeffix、Heptodin）。 儘管 FDA 已經批准這些用於慢性 B 型肝炎的抗病毒藥物，但他們無法徹底治癒這種病。不過他們可以大幅降低肝臟損傷和肝癌的風險。抗病毒藥物不能隨意停止和開始服用，這就是為什麽在開始治療慢性 B 型肝炎之前，需要由專業醫生進行徹底評估的原因。 也有免疫調節藥物可以增強免疫系統，以助於控制 B 型肝炎病毒。他們在 6 個月到 1 年的時間裡以注射方式給藥。最常見的處方藥物包括干擾素 alfa-2b (Intron A) 和聚 B 二醇干擾素 (Pegasys)。 您和您的醫生需要討論哪種治療選擇最適合您。對許多人來說，這些藥物會減少或阻止 B 型肝炎病毒。患者在幾個月以內會有所改善，這是因為病毒對肝臟的損傷減緩，或者在某些情況下，甚至在長期服用後出現逆轉。 請參閱我們的 Drug Watch，取得 FDA 批准的藥物和目前正在研發中的其他具有潛力的藥物的完整名單。   General Information What is hepatitis B?Hepatitis B is the world's most common liver infection. It is caused by the hepatitis B virus (HBV), which attacks and injures the liver. It is transmitted through blood, unprotected sex, shared or re-used needles, and from an infected mother to her newborn baby during pregnancy or delivery. Most infected adults are able to get rid of the hepatitis B virus without any problems. However, some adults and most infected babies and children are unable to get rid of the virus and will develop chronic (life-long) infection. The good news is that there is a safe vaccine to prevent a hepatitis B infection and new treatments for those already infected with hepatitis B. How many people are affected by hepatitis B?Worldwide, 2 billion people (1 out of 3 people) have been infected with hepatitis B; and 257 million people are chronically infected (which means they are unable to get rid of the virus). An estimated 700,000 people die each year from hepatitis B and its complications. Why is hepatitis B more common in some parts of the world?Hepatitis B can infect any person of any age or ethnicity, but people from parts of the world where hepatitis B is common, such as Asia, parts of Africa and South America, Eastern Europe, and the Middle East, are at much higher risk for getting infected. Hepatitis B is also common among Americans who were born (or whose parents were born) in these regions. Hepatitis B is more common in certain regions of the world because there are so many more people already infected with hepatitis B in these regions. Although hepatitis B is not an "Asian disease" or an “African disease,” it affects hundreds of millions of people from these regions – so there are more people who can pass the hepatitis B virus on to others. This increases the risk that you could get infected. Since there is a smaller number of Westerners who are infected, this group has a lower risk of infection. In regions where hepatitis B is common, people are usually infected as newborns - from a mother who unknowingly passes the virus to her baby during delivery. Young children are also at risk if they live in close daily contact with an infected family member. Babies and children are more likely to develop a chronic hepatitis B infection because their young immune systems have trouble getting rid of the virus. If you, or your family, is from an area of the map that is darker blue, you might be at greater risk for hepatitis B infection and should talk to a doctor about getting tested. Why should I be concerned about hepatitis B?Chronic hepatitis B can lead to serious liver disease such as cirrhosis or liver cancer. It's important to get tested because early diagnosis can lead to early treatment which can save your life. Also, people who are infected can spread the virus to others. Since most people don't know they are infected, they are unknowingly spreading it to many other people. If people are not tested, hepatitis B can pass through several generations in one family and throughout the community. One common myth is that hepatitis B can be "inherited" since several generations in one family may be infected. But hepatitis B is NOT a genetic disease -- hepatitis B is caused by a virus, which is often transmitted among family members due to mother-to-child transmission or accidental household exposure to blood. Families can break the cycle of hepatitis B infection by getting tested, vaccinated and treated. Why is hepatitis B so dangerous?Hepatitis B is dangerous because it is a “silent infection” that can infect people without them knowing it. Most people who are infected with hepatitis B are unaware of their infection and can unknowingly pass the virus to others through their blood and infected bodily fluids. For those who become chronically infected, there is an increased risk of developing liver failure, cirrhosis and/or liver cancer later in life. The virus can quietly and continuously attack the liver over many years without being detected. What is acute hepatitis B?An acute hepatitis B infection may last up to six months (with or without symptoms) and infected persons are able to pass the virus to others during this time. Symptoms of an acute infection may include loss of appetite, joint and muscle pain, low-grade fever, and possible stomach pain. Although most people do not experience symptoms, they can appear 60-150 days after infection, with the average being 3 months. Some people may experience more severe symptoms such as nausea, vomiting, jaundice (yellowing of the eyes and skin), or a bloated stomach that may cause them to see a health care provider. A simple blood test can tell a person if the hepatitis B virus is in their blood. If you have been diagnosed with acute hepatitis B, the doctor will need to test your blood again in 6 months to figure out if you have recovered, or if you have developed a chronic hepatitis B infection. Until your health care provider confirms that your blood test shows that there is no more hepatitis B virus in your blood, it is important to protect others from a possible infection. It is also important to have your sexual partner(s) and family members (or those you live in close household contact with) tested for hepatitis B. If they have not been infected – and have not received the hepatitis B vaccine – then they should start the hepatitis B vaccine series. People who have acute hepatitis B are not prescribed specific hepatitis B treatment – there is no treatment that will get rid of an acute hepatitis B infection, and most people infected as adults recover on their own. Sometimes, a person with severe symptoms may be hospitalized for general support. Rest and managing symptoms are the primary goals of this medical care. A rare, life-threatening condition called “fulminant hepatitis” can occur with a new acute infection and requires immediate, urgent medical attention since a person can go into sudden liver failure. Simple tips for taking care of your liver during an acute hepatitis B infection are to avoid alcohol, stop or limit smoking, eat healthy foods, avoid greasy or fatty foods, and talk to your health care provider about any medications you are taking (prescriptions, over-the-counter medications, vitamins or herbal supplements) to make sure they are safe for your liver. This is a good time to ask any other questions you may have. The use of vitamins and liver health supplements will likely not assist your recovery and may actually cause more harm than good to the liver. Be sure to follow-up with your health care provider for any additional blood tests that are needed to confirm your recovery from an acute infection. What is chronic hepatitis B?People who test positive for the hepatitis B virus for more than six months (after their first blood test result) are diagnosed as having a chronic infection. This means their immune system was not able to get rid of the hepatitis B virus and it still remains in their blood and liver. There are effective ways to treat and manage a chronic infection, but there is no cure. If you are chronically infected, the virus will likely remain in your blood for the rest of your life. People who have chronic hepatitis B can unknowingly pass the virus on to others. Chronic hepatitis B can also lead to serious liver diseases, such as cirrhosis or liver cancer. Not every person who is chronically infected will develop serious liver disease. However, they have a greater chance than someone who is not infected.The risk of developing a chronic hepatitis B infection is related to the age at which one first becomes infected with the hepatitis B virus: 90% of infected newborns and babies will develop a chronic hepatitis B infection Up to 50% of infected children (1-5 years) will develop a chronic hepatitis B infection 5-10% of infected adults will develop a chronic hepatitis B infection (that is, 90% will recover) Learning that you have a chronic hepatitis B infection can be very upsetting. Because most people do not have symptoms and can be diagnosed decades after their initial exposure to the hepatitis B virus, it can be a shock and a surprise to be diagnosed with a chronic hepatitis B infection. The good news is that most people with chronic hepatitis B should expect to live a long and healthy life. Infected pregnant women can pass the virus to their newborns during childbirth. Therefore, since the risk of newborns becoming chronically infected at birth is high, both the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC) recommend that all infants receive the first dose of the hepatitis B vaccine within 12-24 hours after birth. If you are pregnant and you know that you are infected, you can make sure that your baby gets the first dose of the hepatitis B vaccine within 12-24 hours after delivery! While there is no cure for chronic hepatitis B infection, there are effective drug therapies that can control the hepatitis B virus and stop it from damaging the liver. There are also promising new drugs in the research phase that could provide a cure in the very near future. Although the risk of developing a serious liver disease or liver cancer is higher for those living with chronic hepatitis B than those who are not infected, there are still many simple things a person can do to help reduce their risk. Schedule regular visits every six months (or at least every year) with a liver specialist or a health care provider who is knowledgeable about hepatitis B so they can monitor the health of your liver. Talk to your health care provider about whether treatment for your chronic hepatitis B infection would be helpful in preventing serious liver disease or liver cancer. Make sure that your health care provider screens you for liver cancer during your regular visits since early detection equals more treatment options and a longer life. Avoid or limit alcohol and smoking since both cause a lot of stress to your liver. Eat a healthy diet with lots of vegetables since fried, greasy foods are hard on your liver. What does it mean to be a “chronic carrier”?When someone has a chronic hepatitis B infection, their doctor may refer to them as being a “chronic carrier.” Being a “chronic carrier” means that you have a chronic hepatitis B infection, can pass the virus on to others, and you should be managed by a doctor for your infection. Is there a cure for hepatitis B?Most adults will recover from an acute infection on their own without the need for medication. For adults, children and infants who develop a chronic hepatitis B infection, there is currently no cure. But the good news is there are treatments that can help slow the progression of liver disease in chronically infected persons by slowing down the virus. If there is less hepatitis B virus being produced, then there is less damage being done to the liver. With all of the new exciting research, there is great hope that a cure will be found for chronic hepatitis B in the near future. Visit our Drug Watch for a list of other promising drugs in development. What options are there to treat my hepatitis B?For an acute infection, there is generally no treatment other than rest and supportive measures to manage any symptoms. For chronic hepatitis B, there are several treatments available. It is important to understand that not everyone with chronic hepatitis B needs treatment. Your doctor will help you decide if you need medication or if you can wait and monitor your condition. There are several antiviral medications that slow down or stop the hepatitis B virus from replicating, which reduces the inflammation and damage to the liver. These antivirals are taken as a pill once a day for at least 1 year, usually longer. There are 6 U.S. FDA approved antivirals, but only three “first-line” antivirals are recommended: tenofovir disoproxil (Viread/TDF), tenofovir alafenamide (Vemlidy/TAF) and entecavir (Baraclude). First-line antivirals are recommended because they are safer and most effective. For people who do not respond to, or have access to, the first-line antiviral treatments, other options are available: telbivudine (Tyzeka, Sebivo), adefovir dipivoxil (Hepsera), and lamivudine (Epivir-HBV, Zeffix, Heptodin). Although the FDA has approved these antivirals for chronic hepatitis B, they do not provide a complete cure. They can, however, greatly decrease the risk of developing liver damage and liver cancer. Antivirals are not meant to be stopped and started, which is why a thorough evaluation by a knowledgeable doctor is so important before beginning treatment for chronic hepatitis B. There are also immunomodulator drugs that boost the immune system to help control the hepatitis B virus. They are given as injections over 6 months to 1 year. The most commonly prescribed include interferon alfa-2b (Intron A) and pegylated interferon (Pegasys). You and your doctor will need to discuss the treatment options before deciding which one, if any, is best for you. For many people, these medications will decrease or stop the hepatitis B virus. This results in patients feeling better within a few months because liver damage from the virus is slowed down, or even reversed in some cases, when taken long-term. For a complete list of FDA approved drugs and other promising drugs in development for hepatitis B, visit our Drug Watch.  

  https://www.hepb.org/languages/chinese-traditional/general-information/
• Cómo vivir con la hepatitis B

  ¿Me recuperaré de una infección por hepatitis B? La mayoría de los adultos sanos que se infectan por primera vez se recuperarán sin problemas. Sin embargo, es posible que los bebés y niños pequeños no puedan eliminar de manera exitosa el virus. Adultos: 90% de los adultos sanos eliminarán el virus y se recuperarán sin problemas; 10% desarrollará hepatitis B crónica. Niños pequeños: hasta un 50% de los niños pequeños infectados, entre 1 y 5 años, desarrollarán una infección crónica por hepatitis B. Bebés: 90% desarrollará infección crónica; solo un 10% podrá eliminar el virus.  ¿Cuál es la diferencia entre una infección "aguda" y "crónica" por hepatitis B? Una infección por hepatitis B se considera "aguda" durante los primeros 6 meses después de la exposición al virus. Esta es la cantidad de tiempo promedio que toma recuperarse de una infección por hepatitis B. Si sus pruebas aún resultan positivas para el virus de la hepatitis B (HBsAg+) después de 6 meses, se considera que tiene una infección "crónica" por hepatitis B, la cual puede durar toda la vida.  ¿Me enfermaré si tengo hepatitis B aguda? La hepatitis B se considera una "infección silenciosa" porque a menudo no produce ningún síntoma.La mayoría de las personas se sienten saludables y no saben que están infectadas, lo que significa que pueden transmitirles el virus a otras personas sin saberlo. Otras personas pueden tener síntomas leves, como fiebre, fatiga, dolor muscular o articular o pérdida del apetito, que se pueden confundir con la gripe. Los síntomas menos frecuentes pero más graves incluyen náuseas y vómitos intensos, coloración amarillenta de los ojos y de la piel (llamada "ictericia") e hinchazón del estómago. Estos síntomas requieren atención médica inmediata y es posible que sea necesario hospitalizar a la persona. ¿Cómo sabré cuándo me he recuperado de una infección "aguda" por hepatitis B? Una vez que su médico haya confirmado a través de las pruebas de sangre que usted ha eliminado el virus de su cuerpo y ha desarrollado anticuerpos protectores (HBsAb+), estará protegido de cualquier infección futura por hepatitis B y ya no será contagioso para los demás. ¿Qué debería hacer si se me diagnostica hepatitis B crónica? Si sus pruebas resultan positivas para el virus de la hepatitis B durante más de 6 meses, esto indica que tiene una infección crónica por hepatitis B. Debería solicitar una cita con un hepatólogo (especialista en hígado), un gastroenterólogo o un médico de familia que esté familiarizado con la hepatitis B. El médico le ordenará unas pruebas de sangre y posiblemente un ultrasonido hepático para evaluar cuán activo está el virus de la hepatitis B en su cuerpo y supervisar la salud de su hígado. Probablemente su médico desee verlo al menos una o dos veces al año para supervisar su hepatitis B y determinar si se beneficiaría de un tratamiento. Todas las personas con infección crónica deberían consultar con su médico al menos una vez al año (o con más frecuencia) para recibir una atención de seguimiento médico regular, inicien o no un tratamiento. Incluso si el virus está en una fase de menor actividad, produciendo poco o ningún daño, esto puede cambiar con el tiempo, por lo que es muy importante la supervisión regular. La mayoría de las personas con infección crónica por hepatitis B pueden esperar vivir vidas prolongadas y saludables. Una vez que se le diagnostique hepatitis B crónica, el virus puede permanecer en su sangre e hígado para toda la vida. Es importante que sepa que puede transmitirles el virus a otras personas, incluso si no se siente enfermo. Por eso es muy importante que se asegure de que todos los contactos cercanos en el hogar y de parejas sexuales se vacunen contra la hepatitis B. ¿Qué pruebas se utilizarán para supervisar mi hepatitis B? Las pruebas frecuentes que usan los médicos para supervisar la hepatitis B incluyen la serie de pruebas de sangre de hepatitis B, pruebas de función hepática (alanina aminotransferasa [ALT], aspartato aminotransferasa [AST]), antígeno e de la hepatitis B (HBeAg), anticuerpo e de la hepatitis B (HBeAb), cuantificación del ADN de la hepatitis B (carga viral) y un estudio por imagen del hígado (ultrasonido, FibroScan [elastografía transitoria] o tomografía axial computarizada [TAC]). ¿Existe una cura para la hepatitis B crónica? Actualmente no existe una cura para la hepatitis B crónica, pero la buena noticia es que existen tratamientos que pueden ayudar a desacelerar la progresión de la enfermedad hepática en las personas con infección crónica al desacelerar el virus. Si se produce menos virus de hepatitis B, entonces se le ocasiona menos daño al hígado. A veces esos medicamentos pueden incluso eliminar el virus, aunque no es lo común.  Con toda la nueva y fascinante investigación, existe mucha esperanza de que se encontrará una cura para la hepatitis B crónica en el futuro cercano. Visite nuestro Drug Watch (Observatorio de medicamentos) para ver una lista de otros medicamentos prometedores en desarrollo. ¿Existe algún medicamento aprobado para tratar la hepatitis B crónica? Los tratamientos actuales para la hepatitis B se clasifican en dos categorías generales, antivirales e inmunomoduladores: Medicamentos antivirales: son medicamentos que desaceleran o detienen el virus de la hepatitis B, lo cual disminuye la inflamación y el daño al hígado. Se toman como una píldora, una vez al día y al menos durante 1 año, aunque generalmente por más tiempo. Existen 6 antivirales aprobados por la FDA, pero solo se recomiendan tres tratamientos antivirales de primera línea: tenofovir disoproxilo (Viread/TDF), tenofovir alafenamida (Vemlidy/TAF) y entecavir (Baraclude). Se recomiendan los antivirales de primera línea porque son más seguros y los más eficaces. También tienen un mejor perfil de resistencia que los antivirales antiguos, lo que significa que cuando se toman como se recetan, existe menos probabilidad de mutación y resistencia. La resistencia hace que sea más difícil tratar y controlar el virus. Medicamentos inmunomoduladores: estos son medicamentos que estimulan el sistema inmunológico para ayudar a controlar el virus de la hepatitis B. Se administran como inyecciones durante 6 meses a 1 año. Los que se recetan con más frecuencia incluyen interferón alfa-2b (Intron A) y el interferón pegilado (Pegasys). Este es el único tratamiento recomendado para pacientes coinfectados con hepatitis delta. ¿Estos medicamentos ofrecen una "cura" para la hepatitis B crónica? Aunque no proporcionan una cura completa, los medicamentos actuales desacelerarán el virus y disminuirán el riesgo de enfermedad hepática más grave más adelante en la vida. Esto logra que los pacientes se sientan mejor en unos pocos meses porque el daño hepático del virus se habrá desacelerado, o incluso revertido en algunos casos, cuando los medicamentos se toman a largo plazo. Los antivirales no se deben detener y comenzar, por eso es tan importante una evaluación a fondo por parte de un médico experto antes de comenzar el tratamiento para el VHB crónica. Si tengo una infección crónica por hepatitis B, ¿debería tomar medicamentos? Es importante entender que no todas las personas con hepatitis B crónica necesitan tomar medicamentos. Debería hablar con su médico sobre si usted es un buen candidato para recibir terapia con medicamentos. Ya sea que usted y su médico decidan o no iniciar un tratamiento, debería ver con regularidad a un especialista en hígado o un médico experto en hepatitis B. ¿Es seguro tomar remedios o suplementos naturales para la infección por hepatitis B? Muchas personas se interesan en usar remedios o suplementos naturales para estimular su sistema inmunológico y ayudar al hígado. El problema es que no existe regulación de las compañías que fabrican esos productos y esto significa que no existen pruebas rigurosas de seguridad ni pureza. La calidad de los remedios naturales o de los suplementos vitamínicos puede ser diferente de una botella a otra. Así mismo, algunos remedios naturales pudieran interferir con sus medicamentos recetados para la hepatitis B u otras enfermedades; algunos pueden de hecho dañar su hígado. Esos remedios naturales no curarán una infección crónica por hepatitis B. Hay muchas compañías que hacen falsas promesas en Internet y a través de los medios de comunicación social sobre sus productos. Las exposiciones en línea y los testimonios de pacientes en Facebook son falsos y los usan para engañar a las personas para que compren remedios y suplementos naturales costosos. Recuerde: si parece demasiado bueno para ser cierto, probablemente no lo es. A continuación se presentan fuentes confiables de información sobre medicamentos naturales y alternativos. Esta información se basa en evidencia científica, no en falsas promesas. Revise si los ingredientes activos de sus remedios o suplementos naturales son reales y seguros para su hígado. Lo más importante es proteger su hígado de cualquier daño o lesión adicional. ¿Qué consejos existen sobre cómo mantener un hígado saludablepara las personas que viven con hepatitis B crónica? Las personas que viven con infección crónica por hepatitis B pueden necesitar o no tratamiento con medicamentos. Pero hay muchas otras medidas que los pacientes pueden tomar para proteger su hígado y mejorar su salud. ¡A continuación se encuentra nuestra lista de las 10 mejores elecciones saludables que se pueden comenzar hoy! Programe consultas regulares con su especialista en hígado o proveedor de atención médica para cuidar su salud y la de su hígado. Vacúnese contra la hepatitis A para protegerse de otro virus que ataca el hígado. Evite beber alcohol y fumar ya que ambos dañarán su hígado, que ya está lesionado por el virus de la hepatitis B. Converse con su proveedor antes de iniciar cualquier remedio natural o suplemento vitamínico porque algunos pueden interferir con sus medicamentos recetados para la hepatitis B o incluso dañar su hígado. Revise con su farmacéutico cualquier medicamento sin receta (p. ej., acetaminofén, paracetamol) o los medicamentos con receta que no son para la hepatitis B antes de tomarlos, para asegurarse de que sean seguros para su hígado, debido a que muchos de estos medicamentos se procesan a través de su hígado.  Evite inhalar gases de pinturas, diluyente de pintura, pegamento, productos de limpieza para el hogar, removedores de esmalte de uñas y otros químicos posiblemente tóxicos que pudieran dañar su hígado. Siga una dieta saludable de frutas, granos enteros, pescado y carnes magras, y muchos vegetales. Los "vegetales crucíferos”, en particular el repollo, el brócoli y la coliflor, han demostrado que ayudan a proteger el hígado contra los químicos ambientales.  Evite comer mariscos crudos o poco cocidos (p. ej., almejas, mejillones, ostras, vieiras) porque pudieran estar contaminados con una bacteria llamada Vibrio vulnificus, muy tóxica para el hígado y que pudiera ocasionar mucho daño. Busque signos de moho en las nueces, el maíz o elote, el cacahuate o maní, el sorgo y el mijo antes de usar esos alimentos. Es más probable que el moho sea un problema si la comida se almacena en condiciones de humedad y de sellado inapropiado. Si hay moho, la comida pudiera estar contaminada por "aflatoxinas", que son un factor de riesgo conocido para el cáncer de hígado. Reduzca sus niveles de estrés al comer alimentos saludables, hacer ejercicios regularmente y descansando lo suficiente.  Tenga presente que todo lo que coma, beba, respire o absorba a través de la piel finalmente lo filtra el hígado. Por esto, ¡proteja su hígado y su salud! ¿Puedo donar sangre si tengo hepatitis B? No. El banco de sangre no aceptará sangre que haya estado expuesta a hepatitis B, incluso si ya se recuperó de una infección aguda. Living with Hepatitis B  Will I recover from a hepatitis B infection? Most healthy adults who are newly infected will recover without any problems. But babies and young children may not be able to successfully get rid of the virus. Adults – 90% of healthy adults will get rid of the virus and recover without any problems; 10% will develop chronic hepatitis B. Young Children – Up to 50% of young children between 1 and 5 years who are infected will develop a chronic hepatitis B infection. Infants – 90% will become chronically infected; only 10% will be able to get rid of the virus. What is the difference between an "acute" and a "chronic" hepatitis B infection? A hepatitis B infection is considered to be “acute” during the first 6 months after being exposed to the virus. This is the average amount of time it takes to recover from a hepatitis B infection. If you still test positive for the hepatitis B virus (HBsAg+) after 6 months, you are considered to have a "chronic" hepatitis B infection, which can last a lifetime.  Will I become sick if I have acute hepatitis B? Hepatitis B is considered a "silent infection” because it often does not cause any symptoms. Most people feel healthy and do not know they have been infected, which means they can unknowingly pass the virus on to others. Other people may have mild symptoms such as fever, fatigue, joint or muscle pain, or loss of appetite that are mistaken for the flu. Less common but more serious symptoms include severe nausea and vomiting, yellow eyes and skin (called “jaundice”), and a swollen stomach - these symptoms require immediate medical attention and a person may need to be hospitalized. How will I know when I have recovered from an "acute" hepatitis B infection? Once your doctor has confirmed through a blood test that you have gotten rid of the virus from your body and developed the protective antibodies (HBsAb+), you will be protected from any future hepatitis B infection and are no longer contagious to others. What should I do if I am diagnosed with chronic hepatitis B? If you test positive for the hepatitis B virus for longer than 6 months, this indicates that you have a chronic hepatitis B infection. You should make an appointment with a hepatologist (liver specialist), gastroenterologist, or family doctor who is familiar with hepatitis B. The doctor will order blood tests and possibly a liver ultrasound to evaluate how active the hepatitis B virus is in your body, and to monitor the health of your liver. Your doctor will probably want to see you at least once or twice a year to monitor your hepatitis B and determine if you would benefit from treatment. All chronically infected people should be seen by their doctor at least once a year (or more frequently) for regular medical follow-up care, whether they start treatment or not. Even if the virus is in a less active phase with little or no damage occurring, this can change with time, which is why regular monitoring is so important. Most people chronically infected with hepatitis B can expect to live long, healthy lives. Once you are diagnosed with chronic hepatitis B, the virus may stay in your blood and liver for a lifetime. It is important to know that you can pass the virus along to others, even if you don’t feel sick. This is why it’s so important that you make sure that all close household contacts and sex partners are vaccinated against hepatitis B. What tests will be used to monitor my hepatitis B? Common tests used by doctors to monitor your hepatitis B include the hepatitis B blood panel, liver function tests (ALT, AST), hepatitis B e-Antigen (HBeAg), hepatitis B e-Antibody (HBeAb), hepatitis B DNA quantification (viral load), and an imaging study of the liver (ultrasound, FibroScan [Transient Elastography] or CT scan). Is there a cure for chronic hepatitis B? Right now, there is no cure for chronic hepatitis B, but the good news is there are treatments that can help slow the progression of liver disease in chronically infected persons by slowing down the virus. If there is less hepatitis B virus being produced, then there is less damage being done to the liver. Sometimes these drugs can even get rid of the virus, although this is not common.  With all of the new exciting research, there is great hope that a cure will be found for chronic hepatitis B in the near future. Visit our Drug Watch for a list of other promising drugs in development. Are there any approved drugs to treat chronic hepatitis B? Current treatments for hepatitis B fall into two general categories, antivirals and immune modulators: Antiviral Drugs - These are drugs that slow down or stop the hepatitis B virus, which reduces the inflammation and damage to the liver. These are taken as a pill once a day for at least 1 year, usually longer. There are 6 U.S. FDA approved antivirals, but only three first-line antivirals are recommended treatments: tenofovir disoproxil (Viread/TDF), tenofovir alafenamide (Vemlidy/TAF) and Entecavir (Baraclude). First-line antivirals are recommended because they are safer and most effective. They also have a better resistance profile than older antivirals, which means that when they are taken as prescribed, there is less chance of mutation and resistance. Building resistance makes it harder to treat and control the virus. Immunomodulator Drugs - These are drugs that boost the immune system to help control the hepatitis B virus. They are given as injections over 6 months to 1 year. The most commonly prescribed include interferon alfa-2b (Intron A) and pegylated interferon (Pegasys). This is the only recommended treatment for patients coinfected with hepatitis delta. Do these drugs provide a “cure” for chronic hepatitis B? Although they do not provide a complete cure, current medications will slow down the virus and decrease the risk of more serious liver disease later in life. This results in patients feeling better within a few months because liver damage from the virus is slowed down, or even reversed in some cases, when taken long-term. Antivirals are not meant to be stopped and started, which is why a thorough evaluation by a knowledgeable doctor is so important before beginning treatment for chronic HBV. If I have a chronic hepatitis B infection, should I be on medication? It is important to understand that not every person with chronic hepatitis B needs to be on medication. You should talk to your doctor about whether you are a good candidate for drug therapy. Whether you and your doctor decide you should start treatment or not, you should be seen regularly by a liver specialist or a doctor knowledgeable about hepatitis B. Is it safe to take herbal remedies or supplements for my hepatitis B infection? Many people are interested in using herbal remedies or supplements to boost their immune systems and help their livers. The problem is that there is no regulation of companies manufacturing these produces, which means there is no rigorous testing for safety or purity. So, the quality of the herbal remedy or vitamin supplement may be different from bottle to bottle. Also, some herbal remedies could interfere with your prescription drugs for hepatitis B or other conditions; some can even actually damage your liver. These herbal remedies will not cure a chronic hepatitis B infection. There are many companies that make false promises on the Internet and through social media about their products. Online claims and patient testimonials on Facebook are fake and are used to trick people into buying expensive herbal remedies and supplements. Remember, if it sounds too good to be true, then it’s probably not true. Below are reliable sources of information about herbs and alternative medicines. This information is based on scientific evidence, not false promises. Check whether the active ingredients in your herbal remedies or supplements are real and safe for your liver. The most important thing is to protect your liver from any additional injury or harm. What healthy liver tipsare there for those living with chronic hepatitis B? People living with chronic hepatitis B infection may or may not need drug treatment. But there are many other things patients can do to protect their liver and improve their health. Below is our list of the top 10 healthy choices that can be started today! Schedule regular visits with your liver specialist or health care provider to stay on top of your health and the health of your liver. Get the Hepatitis A vaccine to protect yourself from another virus that attacks the liver. Avoid drinking alcohol and smoking since both will hurt your liver, which is already being injured by the hepatitis B virus. Talk to your provider before starting any herbal remedies or vitamin supplements because some could interfere with your prescribed hepatitis B drugs or even damage your liver. Check with your pharmacist about any over-the-counter drugs (e.g. acetaminophen, paracetamol) or non-hepatitis B prescription drugs before taking them to make sure they are safe for your liver since many of these drugs are processed through your liver.  Avoid inhaling fumes from paint, paint thinners, glue, household cleaning products, nail polish removers, and other potentially toxic chemicals that could damage your liver. Eat a healthy diet of fruit, whole grains, fish and lean meats, and lot of vegetables. “Cruciferous vegetables” in particular -- cabbage, broccoli, cauliflower -- have been shown to help protect the liver against environmental chemicals.  Avoid eating raw or undercooked shellfish (e.g. clams, mussels, oysters, scallops) because they could be contaminated with bacteria called Vibrio vulnificus, which is very toxic to the liver and could cause a lot of damage. Check for signs of mold on nuts, maize, corn, groundnut, sorghum, and millet before using these foods. Mold is more likely to be a problem if food is stored in damp conditions and not properly sealed. If there is mold, then the food could be contaminated by “aflatoxins,” which are a known risk factor for liver cancer. Reduce your stress levels by eating healthy foods, exercising regularly, and getting plenty of rest.  Keep in mind everything you eat, drink, breathe, or absorb through the skin is eventually filtered by the liver. So, protect your liver and your health! Can I donate blood if I have hepatitis B? No. The blood bank will not accept any blood that has been exposed to hepatitis B, even if you have recovered from an acute infection.

  https://www.hepb.org/languages/spanish/living-with-hepatitis-b/