Question Title: Need your help

Forum: The Hepatitis Forum
Topic: Hepatitis B

Hi Doctor,

First of all, I was so glad to have found this Forum page.

I have a few questions to consult you.

In 1992, my girlfriend went for a medical checkup and found out that she has contacted Hepatitis B. At first she was sad about it but has learned to accept the facts after all these years.
However till now, she is still not very clear about how serious is her condition.

Below are her latest biochemistry test results on her blood sample done on 09 June 98.

GENERAL CHEMISTRY
=

TUMOUR MARKER STUDIES
=

VIRAL STUDIES
=

Q1. Can you help me to analyse her condition base on the above test result ? Will her condition get worse ? Will she transmit the virus to others ?

Q2. Can her condition gets better/improve as times goes by ?
Will the result of the viral studies change as time goes by ?

Q3. Is there any medical treatment that you can recommend in order for her to get better ?

Q4. If I have taken the Hepatitis B vaccination, can we get married ( have sexual relationship )? What are the chances of the Hepatitis virus being transmitted in the above scenario ?

Q5. If we have children, will the child get the virus ? What are the chances of the child getting the virus ?

I know I have posted quite an amount of questions for you to answer. However all these are questions which I have doubts in and I have a hard time looking for a correct answer. I would very much appreciate your help if you could help me to answer those questions.

Thanks.

Dear Bob:

I appreciate your questions and your concerns. I’ll try to make some general comments about hepatitis B that hopefully will be helpful to you and your girlfriend.

Individuals who are reactive to the hepatitis B surface antigen have a chronic hepatitis B infection. However, chronic hepatitis B comes in at least two flavors. In one form the hepatitis B virus is replicating or making new viral particles. We feel these patients have active hepatitis B infections and they should be considered for treatment.

However, some patients have negative blood tests for replicating virus. The two tests we usually do for replicating virus are the hepatitis B e antigen and the hepatitis B DNA. It sounds like your wife should probably have the test for hepatitis B DNA. I understand her test for the hepatitis B e antigen is negative or non-reactive. If someone has negative tests for viral replication (Hbe Ag, HBV DNA) and there SGOT and SGPT are normal, we feel they are not replicating. We sometimes call these individuals “hepatitis B carriers”. As a general rule, we do not feel these individuals develop advanced liver disease and they do not respond to or need any treatment. They can, however, give the infections to others and they can potentially develop liver cancer so we screen them on at least a yearly basis.

If you have been vaccinated and you have protective levels of antibody (I would have your antibody levels checked), you should be at no risk of obtaining hepatitis B from your girlfriend and it should be safe for the two of you to have sex. Their is some chance she can give the hepatitis B to her offspring but there are combinations of medications that we can give the baby at the time of birth that are more than 90% successful in preventing a hepatitis B infection in the child.

Let me make a final suggestion to you. An individual who is potentially infected with hepatitis B is not necessarily straightforward. I might make it a point to have your girlfriend see some one who has experience with these situations and you might consider seeing a liver specialist. Again, someone with a non-reactive hepatitis B e antigen and a negative HBV DNA should not develop advanced liver disease. There are unusual circumstances in which someone’s inactive hepatitis B can become active, but a specialist can keep an eye out for those.

I hope this information is helpful to you. Good luck to you and with your appointment. As always, we encourage you to post additional information and questions through MEDHELP. The direct number to our liver clinic at Henry Ford is: (313) 916-8865. At Henry Ford, we have an active group of liver specialists with experience with hepatitis B.

This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.

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