1. What should I do if I contracted Hepatitis B?

You are suggested to undergo a thorough check on the following items:
(i) whether your ALT level is normal?
(ii) whether you have HBsAg and/or HBeAg?
(iii) Hepatitis B viral load HBV DNA (copies/mL)(The higher the copies, the more severe is the disease.)

Vigconic Modernized TCM Centres provide free Chinese medical consultation services to customers.

2. Why is it necessary to check the amount of HBV DNA?

It is crucial to check the virus count. According to a guideline published in 2001 by the National Institute of Health (NIH) of the US, HBV DNA greater than 100,000 copies/mL of blood indicates virus positive and severe replication rate, and this must be treated. If, after a period of treatment, HBV DNA count drops to less than 10,000 copies/mL of blood, and this figure does not rise again three months after stopping the medications, then the virus is said to be suppressed, and the chances that the hepatitis progresses to Cirrhosis or Liver Cancer are reduced significantly. In other words, the drug treatment is effective.

3. Why is it necessary to check HBsAg and HBeAg?

The checks on HBsAg and HBeAg are also important, because simply the awareness of Hepatitis B is not enough for effective drug treatment. The best therapy is to identify and target specifically on the type(s) of antigens, HBsAg and/or HBeAg, found in your body.

4. Why did my doctor just check ALT and AST alone as diagnosis for Hepatitis, but not HBV DNA?

In the past, the check on HBV DNA usually is qualitative (results being either positive or negative only) instead of quantitative (providing exact figures). The qualitative tests do not have a common standard and varies from individual to individual. Also, the testing fee for a HBV DNA test is about HK$1,000, which is quite expensive.

5. After I was diagnosed to have Hepatitis B, why did my doctor just perform routine checks and advise me to have enough sleeping and avoid alcohol, but not prescribe any medications?

It is because you only have HBsAg but without HBeAg. The drugs do not work well when only HBsAg is present, because the genes of the virus mutate frequently, leading to the disappearance of HBeAg. In addition, the liver, which acts rather like a detoxifying factory, plays a major role in metabolisms like food and drug metabolism. Therefore the introduction of drugs that is not so effective to the liver will just increase its burden. In the past, the presence of only HBsAg was misinterpreted as an indication of a less severe disease.

However, according to the article titled "The Risks and Opportunities of Hepatitis" (original in Chinese), written by Dr. Joseph Sung, Head of Gastroenterology and Hepatology of CUHK and published in one of the local newspaper on 19 February 2000, the notion that the absence of Hepatitis B e-antigen (HBeAg) means a less severe Hepatitis B may not be necessarily true. Based on the latest findings, the virus simply mutates to make the antigen disappear. About one third of this kind of patients still have signs of Hepatic Cirrhosis.

The book titled "Dr Melissa Palmer's Guide to Hepatitis Liver Disease" written by another famous Hepatologist in the US Melissa Palmer also said, "In this case, the genetic mutation is characterized by the failure of the virus to make the Hepatitis B e-antigen (HBeAg). This mutation does not affect the virus's ability to replicate. Therefore, on blood tests, these people are negative for HBeAg, but positive for HBV DNA. Mutant Hepatitis B has been responsible for several cases of unsuspected transmission of disease to other, as these people are highly infectious. This strain of Hepatitis B, believed to be genetically superior and more resistant to treatment, is capable of causing severe damage.".

6. What should I do if the blood tests show HBsAg (+), HBeAg (-) and HBV DNA (+) (>100,000 copies/mL)?

You may refer to the clinical report on the Vitalliver therapy on 25 mutating Chronic Hepatitis B patients, carried out by Dr. Jiang Nan, Head of the Department of Infectious Diseases, Sichuan Province People's Hospital.

7. What should I do if the blood tests show HBsAg (+), HBeAg (+) and HBV DNA (+) (>100,000 copies/mL)?

You are recommended to use Vitalliver suppositories and, at the same time, visit your physician, who may prescribe nucleotide derivatives. The combined Chinese and Western therapies produce better effects.

8. Is Vitalliver suppository effective in treating Cirrhosis patients?

You may refer to the clinical reports by Dr. Wang Hao and Supervisor Liang Chao.

9. Are there any medications effective in treating decompensated Hepatic Cirrhosis?

In the past, due to lack of effective medicines, patients at end-stage Cirrhosis are usually advised to have enough bed rests and good diets before liver transplantation is carried out. Some patients are so desperate that they resort to some folk medicines.

At the end of the clinical report on the use of Vitalliver suppositories to treat decompensated Cirrhosis, Dr. Wang Hao said: "Since there is no effective therapies (including Chinese and Western medicines) against decompensated Cirrhosis, Vitalliver suppository could be a good try for this group of patients."