By Zhang Kun

　　YOU would not complain if you were turned down in a job application for health reasons, such as tuberculosis - but you would not like it if it were for HBV.

　　"Between 30 and 50 per cent of people with da san yang can return to normal after treatment with an anti-viral medicine, but 'xiao san yang' can never be cured, even in a lifetime," said Wu Xianghui, a doctor at Huashan Hospital, who has been engaged in hepatitis research for more than 40 years.

　　It seems unfair to let individuals take full responsibility and suffer from discrimination because of hepatitis B, which affects nearly 10 per cent of the nation's population.

　　From the medical point of view, the virus causing the disease is not contagious when it remains inactive in the human body, according to Wu. The possibility of virus carriers becoming patients with hepatitis B is as low as 1 per cent.

　　"Except in the food and restaurant industries, pharmaceutical factories and child-care professions, people with HBV should not be rejected for this reason," Wu said. This was because such people do not pose any danger to public security.

　　Wu drew a sketch to illustrate the cause of xiao san yang formation. "When the virus enters the human body, the immune system reacts and covers it with something like a peanut shell to stop the virus from replicating so that the person won't have the disease."

　　The virus, like a nut in a shell, won't grow.

　　Elaborating, he gave a second analogy. The virus attacks the human body like a bomb. The body is not killed but the shrapnel remains inside. "The small pieces can't explode," Wu said.

　　But Wu didn't deny that the virus can break out of the shell and turn active. "If your immune ability decreases, and you get other diseases such as pneumonia, enteritis, or cholecystitis, the virus may take advantage and start to replicate itself," he said.

　　A key problem is that people can never tell whether or when this will happen. There is no agreed solution to this problem in medical circles which leads to ambiguity and discrimination in dealing with such cases, said Fang Minsheng, a medical moralist from the Traditional Chinese Medicine University of Shanghai.

　　In da san yang cases, the virus is actively replicating itself. Can it be proved that it is not contagious and doesn't risk public security in a medical sense?

　　In such a situation, it is natural for job recruiters to choose the "healthy" applicant, all other things being equal.

　　"People always prefer the healthy person if they are equally qualified," said Wu.

　　"There should be a regulation defining the diseases which disqualify people from particular jobs, instead of allowing employers to make the decision," said Fang.

　　China, together with other East Asian countries, has the largest population with HBV. In Western countries, only 1 to 2 per cent of the population have the problem. In Shanghai, the rate of infection is lower than the national average with 7 to 8 per centshavingsthe disease.

　　Rampant infection

　　Standards of hygiene, population density, and even the bodily constitutions of Asians, all result in HBV being more widespread.

　　HBV shares many causes of infection with HIV, such as blood and body fluids, but close contact with HBV sufferers can lead to infection.

　　Many people with the virus never knew how,swheresor when they were infected with it.

　　"If you have a decayed tooth, tonsillitis, or other injury in your mouth and alimentary canal, HBV can getsintosyour blood through them," Wu said. When the virus is active in the human body, it can appear in the carrier's saliva so they should dine separately from others.

　　Many hospitals nationwide claim to be capable of curing da san yang and even xiao san yang, and say in commercial advertisements that they can turn these indices negative "within three months".

　　But after spending their lifesavings and taking large doses of medicine, the health of many people is seriously damaged without achieving the claimed effect. "They are mostly false ads," Wu said. It is important for HBV carriers to bear in mind that they are not patients with hepatitis. Also they should pay high attention to healthcare, nourishment and exercise.

　　"They should take regular medical examinations every three months or half a year and refrain from any alcohol."

　　Blocking the spread

　　To stop the spread of HBV through donated blood, the city now tests blood donors strictly. "In Shanghai, HBV can certainly be eliminated from blood donations," Wu said. But the situation still remains serious in the rest of the country as the standard of local blood donations is far below Shanghai's requirements. "Many places can't do it so well as Shanghai."

　　The fear of contracting diseases from blood transfusions, especially hepatitis B and HIV, makes many people unwilling to accept donated blood unless in emergency situations.

　　The only solution to stop the spreading of HBV is vaccination, Wu and Fang agreed. Vaccinations, done by three injections over six months, can work effectively against the virus for five to 10 years.

　　New-born children in Shanghai have been required to be vaccinated and only 1 to 2 per cent of the local population below the age of 15 are HBV positive. The HBV population in Shanghai is mainly in the 18-45 age group.

　　People should be vaccinated in reputable hospitals. Foreigners should be vaccinated against HBV before entering China.

　　"It is meaningless to keep HBV a secret from people because it may risk their health," Fang said.

　　A story was published recently about a person with HIV getting married. "If their right to be married is protected, shouldn't their other rights also be protected?" asked Fang. "Isn't it harmful to the rights of the other party in this HIV marriage, if he/she were not informed about the health condition of the spouse?"

　　It would be wrong to stop testing all matters involving HBV, Fang said.

　　Wu agreed and said that if doctors found out that people with HBV were borrowing blood from others for medical examinations, they should "correct the wrongdoing". But he added that, except for very strict examinations, people were not required to attach their photos to the examination form or show their photo ID when taking the examination.

　　China used to have 20 per cent of the population suffering from HBV, twice the current rate. The drop showed the success of China's disease prevention methods. "It could have turned out to be much worse without the preventive methods. The SARS crisis last spring showed that China's public hygiene system is still weak. The state should have paid attention to the HBV problem much earlier," Wu said.