乙型肝炎的污名 - 自然展望(Nature Outlook)的一部分：乙型肝炎

StephenW

消除乙型肝炎
在世界各地，患有这种疾病的人都被边缘化了。现在，患者正在寻找一种声音来抵制并要求结束歧视和孤立。

    克莱尔·安斯沃思

   
看着工厂食堂，李迪知道事情必须改变。除了房间的其他部分，还有一张桌子，感染了乙肝的同事被迫坐下。认为病毒可以通过随意接触传播的误解，例如共享食物或餐具，这意味着这些工人受到了严重的污名化。隔离只是一种惩罚。另一个人被立即解雇，这项任务落到了作为中国最大工厂之一的工厂公关经理的李身上。

但李有一个秘密：他也患有乙型肝炎，在他还是个蹒跚学步的孩子时，是从被污染的针头感染的。为了通过他的工作体检，他说服了一位朋友代替他进行血液检查。这种不诚实很快变得难以忍受。 “我感到非常痛苦，”他说。最终，李的良心战胜了高薪职业的诱惑，他辞职了。

自然展望的一部分：乙型肝炎

十五年过去了，李的情况仍然远非不寻常。而且这不是中国独有的。在全世界，对乙型肝炎感染的耻辱使数百万人丧生。人们失去了教育机会、工作、家庭甚至生命。有些人因焦虑和孤独而不堪重负，有些人死于自杀1。其他人避免寻求治疗，直到为时已晚。对于太多的人来说，患有乙型肝炎意味着死于耻辱。

乙型肝炎的污名——一个将人们区分为不同或不同的标志——是由于对病毒的无知和对其传播方式的误解的结合而加剧的。受影响的人不仅会被社会排斥，还会谴责自己。即使是受过良好教育的人也害怕告诉任何人他们患有这种疾病，这使他们无法获得护理。 “这完全没有必要，”世界肝炎联盟 (WHA) 前主席、新泽西州利文斯顿 Cooperman Barnabas 健康中心病毒性肝炎项目和亚洲健康中心的医学主任苏王说。乙型肝炎。病毒不能通过随意接触传播，例如握手（见“三个误区”）。她说，有一种负担得起的疫苗可以减少传播——包括世界许多地区的主要途径，从母婴传播——还有抑制病毒的通用抗病毒药物2，可以防止某人感染他人。然而，污名是阻止人们前来接受检测或治疗的关键因素之一。据估计，只有 10% 的感染被确诊3。

StephenW

Destigmatizing hepatitis B
Around the world, people with the disease are marginalized. Now, patients are finding a voice to push back and demand an end to discrimination and isolation.

    Claire Ainsworth

   
Looking across the factory canteen, Dee Lee knew things had to change. Set aside from the rest of the room was a table where colleagues infected with hepatitis B were forced to sit. Misconceptions that the virus could be transmitted through casual contact, such as sharing food or utensils, meant that these workers were heavily stigmatized. Segregation was just one penalty. Another was being summarily sacked, a task that fell to Lee as public-relations manager for the factory, one of the largest in China.

But Lee had a secret: he, too, had hepatitis B, contracted from a contaminated needle when he was just a toddler. To pass the medical examination for his job, he had persuaded a friend to stand in for the blood tests. The dishonesty soon became unbearable. “I felt absolutely tormented,” he says. Ultimately, Lee’s conscience won out over the lure of his well-paid career, and he resigned.

Part of Nature Outlook: Hepatitis B

Fifteen years on, Lee’s situation remains far from unusual. And it’s not unique to China. Across the world, the stigma against hepatitis B infection blights millions of lives. People lose educational opportunities, jobs, their families and even their lives. Overwhelmed by anxiety and loneliness, some die by suicide1. Others avoid seeking treatment until it is too late. For too many people, living with hepatitis B means dying from shame.

Hepatitis B stigma — a mark that singles people out as different or lesser — is fuelled by a combination of ignorance about the virus and misunderstandings about how it spreads. Affected individuals not only are shunned by society, but also condemn themselves. Even well-educated people fear telling anyone they have it, and this prevents them from accessing care. “It’s completely unnecessary,” says Su Wang, a former president of the World Hepatitis Alliance (WHA) and medical director of viral-hepatitis programmes and the Center for Asian Health at the Cooperman Barnabas Health Center in Livingston, New Jersey, who herself has hepatitis B. The virus cannot spread through casual contact, such as shaking hands (see ‘Three myths’). There’s an affordable vaccine that cuts transmission — including the main route in many parts of the world, from mother to child — and there are generic antiviral drugs that suppress the virus2, which prevents someone from infecting others, she says. Yet stigma is one of the key factors stopping people coming forwards for testing or treatment. A mere 10% of infections are estimated to have been diagnosed3.

StephenW

https://www.nature.com/articles/d41586-022-00816-x