Avoid the sun, work hard to live... Post-80s people living under the shadow of hepatitis B

Those born in the 1980s are the last group of children in China to be completely exposed to the shadow of hepatitis B.

Without the concept and technology of "preventing mother-to-child transmission", without the prevalence of hepatitis B vaccine and unsafe injection, this group of people born in the 1980s were unfortunately infected with hepatitis B. Since then, their life train has entered a dark period, but with the development of medical technology, some people have been saved, while others are still struggling in the darkness.

A 2018 study in The Lancet Gastroenterology & Hepatology showed that there are about 86 million people infected with hepatitis B in mainland China, and the infection rate has dropped significantly compared with the 1990s (120 million infected people). This is due to the emergence and popularization of hepatitis B vaccines, hepatitis B immunoglobulins and antiviral drugs.

However, misunderstandings about hepatitis B are still prevalent among the public, which causes hepatitis B virus carriers to suffer discrimination and experience more hardships in life.

Because of a premarital medical examination report, Zhou Yang's wedding was ruined. His fiancée insisted on breaking up, and his future mother-in-law scolded him for being a liar and returned all the betrothal gifts and other returnable items.

Zhou Yang had expected this day, but when it actually happened, he was still a little dazed. This was the wedding of his dreams, but also a wedding that he probably shouldn't have expected because of his fiancée's miserable life.

Zhou Yang is a patient who has developed liver cirrhosis due to hepatitis B virus infection. He once felt that he didn't have much time left and didn't want to drag another person into this abyss, but he couldn't bear his mother's pleading to leave a descendant for the family, and he also longed for love and marriage, so after a blind date with his fiancée, he quickly got engaged under the deliberate concealment of the whole family.

But once you tell a lie, you need to use countless lies to cover it up: Before the marriage check-up, Zhou Yang had the words on his lips countless times, wanting to tell his fiancée: "I have hepatitis B, I have cirrhosis of the liver." But every time he thought of the consequences of being honest, he chose to swallow the words back and leave everything to fate.

Finally, after the premarital medical examination report came out, what was supposed to happen still happened! His fiancée could not accept the fact that he had hepatitis B, and even worried that she would be infected: "You are lying. If I knew you had this disease, I would never go on a blind date with you. I want to go to a big hospital to confirm it. If you infect me, my life will be ruined!"

This was not the first time Zhou Yang had heard such heart-wrenching words, but it was even more painful to hear them from his fiancée. From childhood to adulthood, the alienation of his friends, the indifference of his classmates, and the breakup with his first girlfriend all told him through their actions: You are a walking infectious body.

He had always wanted to tell them that normal communication and contact would not be contagious. But the prejudice against hepatitis B was so deep-rooted that Zhou Yang had no chance to argue. Even if he did, they would not believe him, including his fiancée.

Indeed, the rumor that eating with a hepatitis B carrier can infect people still exists today. Some relevant laws and regulations in the early years even set up unfounded occupational bans for hepatitis B carriers, which once made the rumor very popular.

Many hepatitis B virus carriers have been deprived of many options by such rumors and misunderstandings. Wang Yu, a carrier, was one of them. After dropping out of school, he wanted to work in a food factory, but was rejected during the physical examination. "How many options are there for someone like me who didn't study much? Either work in a factory or in the catering industry, but both ended in tragedy."

Wang Yu eventually entered the beauty and hairdressing industry, "which has the lowest entry barriers." She started as a cashier at the front desk, trying to avoid direct contact with customers. In her life, she also tried to live alone, not wanting to cause trouble to others.

However, in reality, the only ways of transmission of hepatitis B virus are mother-to-child transmission, blood transmission, sexual transmission, medical transmission and close contact in daily life (sharing razors, toothbrushes, etc.). It is not contagious through normal communication.

How did they get infected? This is a question that all infected people will repeatedly explore after being diagnosed.

Zhou Yang guessed that he was infected through medical transmission. He was often sick when he was a child and was a frequent visitor to the town clinic, but the small clinic had limited resources and every time he got an injection, everyone had to share the same needle.

In Zhou Yang's recollection: On the doctor's desk was an aluminum lunch box with an alcohol lamp underneath. A few needles sank to the bottom of the lunch box. After giving me the injection, he pulled out the needles and put them back into the lunch box, scalding them for disinfection. Even when the children were getting vaccinated, they were lined up in rows, with one needle for each row. When they were too busy, the needles were rinsed and taken out for use right after they were put in.

Wang Yu guessed that she was infected by her mother, who was also infected, so she and her brother were not spared. This kind of "hepatitis B family" is not uncommon in her village. So after Wang Yu got married, she was worried about whether she could give birth to a healthy child.

Like Zhou Yang, Wang Yu also had a rough relationship experience. Her first love disappeared after learning that she was a carrier of hepatitis B virus, which hurt her greatly. However, she did not regret her honesty. "This may affect the health of him (first love) and the next generation. If it were now, I would still tell him the truth."

Because Wang Yu had a fellow patient who concealed her illness and passed the virus to her husband, and her child was not spared. Eventually, her marriage broke down, and her in-laws hated her and called her "an evil spirit who harmed three generations of her family."

Fortunately, Wang Yu met a husband who did not despise her a few years later. After consulting a doctor, her husband got the hepatitis B vaccine and has not been infected since then.

However, the anxiety caused by the risk of mother-to-child transmission still surrounds Wang Yu and every "expectant mother with hepatitis B". They are all deeply worried: What if the child is also infected, how can I explain to my in-laws? It will also ruin the child's life.

After consulting the doctor, Wang Yu had a pregnancy checkup every two weeks after she became pregnant. Her mood changed with the rise and fall of the hepatitis B virus count. Later, the doctor prescribed antiviral drugs, and the virus count dropped to the third power, and has remained at this value since then.

"Several times" is the quantitative value of hepatitis B virus, which is a technical method for DNA detection of hepatitis B virus and a common means of judging hepatitis B virus replication. Generally speaking, a value greater than 10 to the power of 3 is considered positive, 3-5 to the power is considered low replication, 5-7 to the power is medium, and greater than 7 to the power is high. The higher the replication, the stronger the infectiousness.

Until the birth, after strict operation by doctors and midwives, the child was injected with hepatitis B vaccine and immunoglobulin within 10 hours after birth. Later, Wang Yu's child tested negative for hepatitis B virus. Wang Yu burst into tears. Her child finally did not have to go through her old path again and could enjoy a life without inferiority and discrimination.

The success rate of mother-to-child blocking is mainly related to the timeliness of neonatal vaccination and the viral load of pregnant women. The blocking rate of vaccine + immunoglobulin is about 95%.

After experiencing a gloomy life for more than 30 years, Wang Yu has finally found her own happiness, a loving husband and healthy children. So she has to work hard to fight the virus, go to the hospital for regular checkups, and lead a regular life. She wants to live a healthy and long life.

Zhou Yang's situation is completely different from Wang Yu's. He has already developed liver cirrhosis. He has also heard and witnessed the painful experiences of fellow villagers who died of hepatitis B, liver cirrhosis, and liver cancer. Now there is a sword of Damocles hanging over his head. In addition to the financial burden of seeing a doctor for his family over the years and the current situation of discrimination against hepatitis B, he often thinks: "Why not give myself a quick death."

But he often imagined that if he had been born a few years later, he would have been vaccinated against hepatitis B and would not have been infected. But now, it is too late. In 1992, hepatitis B vaccination was included in the immunization program, which means that newborns are required to receive hepatitis B vaccination, although it is not mandatory and is at their own expense, which will give him more possibilities in life.

He also thought that if he had discovered that he was infected with the hepatitis B virus earlier, he could have been examined and treated immediately, and the disease might not have progressed to such a serious level. However, the liver is such a "silent" organ that has no nerves and cannot feel pain, which made Zhou Yang and many infected people miss the best time to control the disease.

Hepatitis B is not a disease that will attack rapidly. It takes at least 10 to 20 years from being a carrier to developing hepatitis. In many cases, the infected person will not know that they are infected without a blood test. In most cases, the hepatitis B virus will not cause a particularly serious impact on the liver, but due to individual differences, after some people are infected or at a certain moment, the human immune system will be activated and begin to frantically attack the liver cells infected by the virus, which will induce an acute attack of hepatitis B or enter the chronic hepatitis B stage.

When liver cells are attacked by the immune system or eroded by viruses and lose their normal functions, cirrhosis is likely to develop. If this type of stimulation continues, complications such as upper gastrointestinal bleeding, hepatic encephalopathy, secondary infection, hypersplenism, ascites, and cancer will appear in the late stages.

But there are no ifs in life, and everything will never start over again. Zhou Yang now hopes that with the advancement of medical technology, people infected with hepatitis B virus can be cured, and the public can have a better understanding of hepatitis B, with less discrimination and more tolerance.

"We also want to walk in the sunshine with dignity, live a normal life, go to school, work, get married, have children..."

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(Zhou Yang and Wang Yu are pseudonyms in this article)

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Source: Youlai Healthy Life