Chronic viral hepatitis is a major global public health problem, caused mainly by the infection of hepatitis B (HBV) and C (HCV), with severe consequences for human health, such as cirrhosis and liver cancer.
I. Overview of diseases and epidemiology
Hepatitis B is estimated to be some 257 million infected globally, and hepatitis B infection was once widespread in my country, and despite years of efforts to prevent and control it, such as vaccination against hepatitis B, infection rates have declined significantly, but there are still a large number of chronic hepatitis B patients. The global number of chronic hepatitis C infections is about 71 million, with a high number of new infections every year. These viruses are transmitted mainly through blood, vertical mother-to-child transmission and sexual contact. In some developing countries, the risk of transmission of the virus remains high due to limited health care and insufficient public health awareness. In some areas, for example, unsafe injecting behaviour, unregulated blood product management, etc. can be the means of transmission of the virus.
II. METHODOLOGY AND Physiology
If HBV and HCV are infected with the human body, they enter the liver and reproduce it. The persistence of the virus has triggered a complex immune response to the body. On the one hand, the immune system seeks to remove the virus, and the activated immunocellular cells release a large number of inflammatory factors that cause damage to hepatic cells; on the other hand, the virus itself may directly interfere with the normal metabolic and function of hepatic cells. Chronic and repeated inflammation has led to gradual degenerative, degenerative and fibrosis of liver tissues. As the fibrosis process progresses, normal liver structures are destroyed, resulting in cirrhosis of the liver, which may eventually develop into liver cancer. During this process, metabolism, detoxification, synthesis, etc. in the liver are gradually impaired, and there are a range of complications such as salivation, abdominal water and liver cerebral disease.
Clinical performance and diagnosis
Chronic viral hepatitis patients may have only minor symptoms at an early stage, such as lack of strength, lack of appetite, arrhythmia on the right upper abdominal, etc., which can easily be ignored. As the condition progresses, the symptoms increase, with typical signs such as yellow spleen, large liver spleen, spider moles and liver palms. Laboratory examinations are essential for diagnosis, and the detection of five hepatitis B of the serum (HBsAg, HBAg, anti-HBs, anti-HB, anti-HBc) can determine whether or not hepatitis B virus is infected and how the virus is replicated; the hepatitis C virus is mainly diagnosed by testing anti-HCV and HCV RNA. Indicators of hepatic function, such as e.g., e.g., e.g., e.g., e.g., e.g., e.g., e.g., e.g., e.g., e.g., e.g., e.g., e.g., e.g., e.g., e.g., e.g., e.g., e.g., e., e.g., e.g., e.g., e., e.g., e., e.g., e., e., e.g., e.g., e., e., e., e., e., e., e., e., e., e., e., e., e., e., e., e., e., e., g., e., e., e., e., e., e., e., g., e.g., e., e., e., e. In addition, photographic examinations such as liver ultrasound, CT, MRI, etc. help to assess liver morphology, structural changes and detect complications such as cirrhosis and liver cancer. The liver biopsy, although innovative, provides the most accurate basis for case-based diagnosis and treatment programming by directly observing the pathological changes in the liver tissue.
IV. Therapeutic approach and progress
In the case of chronic hepatitis B, the current treatment objective is to maximize the long-term inhibition of HBV replication, to reduce hepatocytosis and hepatitis fibrosis, and to reduce the occurrence of liver failure, cirrhosis, liver cancer and other complications, thereby improving the quality of life and extending the duration of life. Antiviral drugs consist mainly of interferon and nucleotide (acid) analogues. Interferences have both immuno-regulating and antiviral effects, but have more side effects, such as heat, powerlessness, bone marrow inhibition, and limited use. Nucleic acid (acid) analogues such as Nteikawe, Tinoforvet, among others, can effectively inhibit the replicability of the virus and have relatively few side effects, which are currently used as first-line drugs in clinical practice. However, these drugs require long-term or even life-long use, are at risk of resistance and are difficult to completely eliminate. The treatment of chronic hepatitis C has made major breakthroughs in recent years. The availability of direct antiviral drugs (DAAs) has significantly increased the curable rate of hepatitis C to over 95 per cent. DAAs are responsible for different components of Hepatitis C (hepatitis C) replicability, with high efficiency, low toxicity and short treatment, which significantly improves the treatment prospects of hepatitis C patients. However, because of their high cost, replication in some areas with limited resources remains a challenge.
V. Disease prevention and public health strategies
The key to preventing chronic viral hepatitis is cutting off transmission. Hepatitis B vaccination is the most effective means of preventing hepatitis B and, since its promotion, has significantly reduced the incidence of hepatitis B worldwide. With regard to hepatitis C, there is currently no vaccine available, so it is particularly important to strengthen the management of blood products, promote safe injection and raise public awareness of the means of transmission of hepatitis C. At the public health level, the supervision of health-care institutions should be strengthened to ensure strict application of sterilization and quarantine measures; a wide range of health education activities should be carried out to raise the level of awareness and prevention of viral hepatitis; and people with chronic viral hepatitis should be regulated, followed up on a regular basis, with timely detection and treatment of complications and reduced risk of transmission and social burden of the disease.
Chronic viral hepatitis is a global health problem that requires long-term attention and response. It is hoped that by strengthening preventive measures, increasing the level of diagnosis, optimizing treatment programmes and integrating public health resources, further reductions in morbidity and mortality rates and in the impact of disease on individuals and society will be achieved in the future.
