Routine physical examination for hepatitis B?

The answer is that current routine physical examinations - whether it is a unified screening for admission or employment, or a basic health package that ordinary people do every year, by default do not include pathogenic tests such as hepatitis B halves and hepatitis B virus DNA. Only basic liver function (that is, indicators such as transaminases and bilirubin) are routine must-check items.

The source of this matter is an explicit regulation jointly issued by the Ministry of Human Resources and Social Security and the former Ministry of Health in 2010, which clearly prohibits routine screening for hepatitis B related items in physical examinations for admission and employment. This is because it is afraid of causing discrimination in school and employment for hepatitis B virus carriers. After so many years of implementation, no matter whether it is a public physical examination center or a private institution, hepatitis B testing will not be included in the general package. Not long ago, I met a young girl who had just graduated. She was a junior Sanyang, and she was preparing to join an Internet company. She came to our center half a month in advance to inquire about the content of the entry package. She was relieved after confirming that there were no hepatitis B-related projects. She said that she almost turned down the offer because of this, and she had been anxious for a long time.

However, many clinicians have expressed different opinions in recent years. They feel that if hepatitis B screening is not included in routine projects at all, there is actually a risk of missed diagnosis. After all, there are basically no symptoms in the early stages of hepatitis B infection, and many people do not know they are infected. When abnormal liver function is detected in routine physical examinations, further investigation will often lead to liver fibrosis or even worse. I treated a 28-year-old programmer last month. His basic physical examination revealed that his transaminase levels were three times higher. After further investigation, it was discovered that he was infected with hepatitis B. He said that his whole family had no history of hepatitis B, and he had never been specifically tested. He had no idea when he was infected.

The current common practice in the industry is to find a balance between both sides: it will not be forced to be included in regular packages to avoid unnecessary information leakage and discrimination. However, if you have needs, for example, if you have relatives at home who are hepatitis B carriers, often eat out, and are not sure whether you have protective antibodies, you can tell the doctor when you place the order and actively add items. Two and a half rations of hepatitis B only cost about 100 yuan, which is similar to how you usually buy milk tea with a topping. If it is found that the antibody titer is not enough, you can go directly to the community hospital to get the vaccine, which is safer than anything else.

By the way, I also want to mention that many people think that checking liver function means checking for hepatitis B. This is completely a misunderstanding. For example, a liver function test is equivalent to checking whether the walls of your house are cracked or whether the water pipes are leaking. It can only determine whether the liver is currently damaged. ； The hepatitis B test is to see if there is a thief who has sneaked into the house and damaged the house. If the thief doesn't make a big noise, he can't be found just by looking at the wall water pipes. If you encounter an employer that requires you to be tested for hepatitis B as part of your regular employment physical examination, this is actually against the rules and you can refuse.