Tragedy of patients with liver cirrhosis who stopped taking medicine

  Recently, one of my patients was out of control and passed away in just 1 week. I have not let go of this incident for several weeks. This has not happened before. His illness should not have been like this, but his own stubbornness led to his misfortune. Let me talk to everyone below, I hope friends with similar situations can take it as a warning.
   Patient Zhou Mou, 40 years old, gymnastics coach. He was diagnosed with cirrhosis five years ago, but his general condition is very good. He has no liver palm and face of liver disease, which is the early stage of liver cirrhosis. At that time, he was given antiviral treatment according to his condition, and he went to the hospital for examination every 3 months. But it feels that he has not come to the outpatient clinic for nearly a year.
   Three weeks ago, the patient came to the hospital suddenly, saying that he had hepatitis and yellow skin and sclera. When asked about the medical history, the patient told me that the antiviral drugs had been discontinued for 1 year.
   Results The patient’s condition progressed very quickly. Although he was fully rescued, he died due to ineffective treatment within 10 days after admission. Finally, the family members were asked. The patient stopped using antiviral drugs on their own. The family asked him to ask the doctor that he insisted that he was in good condition and had no problems. After stopping the drugs, he did not monitor in time.
  Current anti-hepatitis B virus drugs can only inhibit viral replication, but cannot kill the virus, and require long-term medication. If the drug is stopped in a hurry, the condition will be significantly worse, especially for patients with basic liver disease.
   The purpose of hepatitis B antiviral therapy is to suppress the virus, improve liver function, minimize or delay the occurrence of liver cirrhosis and liver cancer, thereby improving the quality of life and prolonging survival. At present, the mechanism of action of oral antiviral drugs is to inhibit viral replication, not to kill the virus.
   In this sense, to control viral replication, such drugs need to be taken for a long time and need to be monitored regularly during the medication. For highly resistant varieties such as lamivudine and telbivudine, it needs to be reviewed once every 3 months, and for entecavir and tenofovir which are low resistance once every 5 to 6 months, so that the virus can be closely monitored Duplication, changes in condition, etc. The course of oral antiviral drugs is generally longer, at least 3 years, and some patients stop taking the drugs themselves after 3 years. Even more patients with normal liver function and hepatitis B virus-negative monitoring stopped treatment during treatment, leading to relapse of the disease. Individual patients could not control the disease and eventually died, bringing painful lessons.
   Antiviral therapy has strong specialty characteristics, and patients need standardized treatment and monitoring under the guidance of specialists to achieve satisfactory results.
   This kind of medicine does not have to be taken for life, but it must be stopped under strict monitoring. It is best to have a specialist to participate. For example, the virus is easy to rebound within the first 6 months after the drug is stopped, and it is tested every 1 to 2 months. It was found that the virus changed from negative to positive and needed immediate retreatment. If the virus has not rebounded after monitoring for more than 1 year, the probability of rebounding is very small, so it is safer to stop the drug.
   If the liver function is very poor before taking the drug or if there is a basis for cirrhosis, it is necessary to be cautious when stopping the drug, because such patients have poor liver compensatory ability. Once the virus rebounds, it can easily lead to liver failure and even life-threatening. This patient had liver cirrhosis a few years ago. The liver’s potential compensatory function was poor. After stopping the drug, he did not seek medical treatment in time, which eventually led to the result of death.
   This example alone warns all hepatitis B patients with antiviral treatment that they must be cautious when using nucleoside analogs for antiviral treatment, and it is best to use medication under the guidance of a specialist.