Healthy checkup liver function index normal may be an illusion? In response to 728 World Hepatitis Day! 2020 "All People Return to Liver" lights up Taiwan, China for a lifetime

[TB News Network] In 2020, during the global COVID-19 pandemic, many patients with chronic diseases canceled their follow-up visits on their own to avoid going to hospitals, but for patients with chronic hepatitis, stopping medication on their own will increase the risk of viral relapse, making it easy to embark on the "trilogy of liver disease"—hepatitis, cirrhosis, liver cancer—a course that ultimately leads to irreversible consequences.

The World Hepatitis Alliance (WHA) called on countries to carry out "Find the Missing Millions" on 2020 World Hepatitis Day to raise disease awareness among patients who have not yet been diagnosed or have not sought medical care. Kao Chia-hung, chairman of the Taiwan Liver Disease Medical Promotion Association, shared public health data: the number of people infected with hepatitis B virus in Taiwan, China is estimated at about 2.2 million, among whom patients with chronic hepatitis B who have not been properly treated are estimated at 300,000 to 400,000 in Taiwan, China, mostly in the group aged 35 and above. Among them are many hepatitis B virus carriers who have not yet developed the disease and show no symptoms. Under the illusion of a normal liver function index, the liver of these carriers may gradually be attacked by the virus and develop chronic inflammation, and in the future may continue to worsen, turning into liver fibrosis and cirrhosis. Therefore, the Taiwan Liver Disease Medical Promotion Association has actively promoted the "All People Return to Liver Plan" for many years, encouraging the public to undergo chronic hepatitis virus screening and providing reliable judgment indicators such as testing for hepatitis B viral load and related antigens, hoping to help reduce the liver disease situation in Taiwan, China.

Hidden crisis in health checkup reports: normal numbers do not mean a healthy liver. Basic health checkups all include blood tests for the liver function indexes ALT and AST. In most cases, doctors judge liver health according to whether the indexes are high or low. But Lin Han-chieh, chairman of the Taiwan Association for the Study of the Liver, pointed out that a "normal" liver function index does not mean that one is not infected with a chronic hepatitis virus, nor does it mean that there is no liver fibrosis or cirrhosis. Because Taiwan, China has implemented universal hepatitis B vaccination for newborns since 1986, the chronic hepatitis B infection rate among newborns has dropped from 10% to less than 1% in recent years. However, among the group aged 35 and above, there are still many hepatitis B virus carriers, with an incidence rate as high as 15%. Chairman Lin Han-chieh suggested that people aged 30 and above should not only pay attention to liver health through ALT/AST indexes, but should also use auxiliary methods such as hepatitis B viral load testing and liver ultrasound to more comprehensively care for the liver, this silent organ.

Hepatitis B drugs suppress viral replication; once medication is stopped, the relapse rate is high. Since there is currently no drug that can eradicate the hepatitis B virus, current treatment mainly focuses on suppressing viral replication. Su Tung-hung, attending physician in the Department of Internal Medicine at National Taiwan University Hospital, shared that during the treatment of chronic hepatitis B, doctors will regularly test patients' viral load to ensure treatment effectiveness and track whether drug resistance appears; more than 90% of cases can be well controlled. However, most patients in Taiwan, China will face the consideration of stopping medication after three years of treatment. Research by National Taiwan University Hospital in recent years found that the relapse rates caused by current drugs for chronic hepatitis B differ, but on average, patients who stop medication for one year have a probability of viral relapse as high as 60% to 70%. About 5% of patients will experience severe relapse, such as a sharp rise in liver function indexes and the appearance of jaundice, and a small number of patients will experience life-threatening symptoms such as liver failure, but there will also be fortunate patients. If there are any questions about the above, you can visit the official website "Hepatitis Savior Network" at http://www.loveliver.com.tw/ to break the vicious cycle of hepatitis together and regain quality of life.