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Xeljanz and Hep B Reactivation
well, my mri came back as the cyst is unchanged and I will have a ct scan in 6 months just to keep an eye on things along with my bloodwork.
had an appt with my rheumatologist today and the labs I had done last week for Hep B Core ab Igm is negative which is good BUT my Hep B Core AB , Total is Reactive A and should be nonreactive so that's not good.
My last sets of tests done in Sept and another in Feb were fine. Negative, negative.
Rheumy sent me to the hospital to get a Hep B DNA viral load test drawn...now the wait.
what is done in this case?
I have cirrhosis and had Hep B which stated I was not infected and fought off the virus. I don't know when I had it or how I got it. I cannot think of anything except I used to work in a clinical laboratory and a hospital (surgery sec) in the 1970's. that's all that comes to mind for a reason to get it. Sorry I don't much about hepatitis but learning more every day.
Thank you if anyone can give me some advice.
I am now OFF of the xeljanz. On it, I did see my liver values going a tad higher. I was only taking 5 mgs a day of the xeljanz not the normal 10. well the xeljanz didn't last long.... I am also on 5 mg prednisone.
had an appt with my rheumatologist today and the labs I had done last week for Hep B Core ab Igm is negative which is good BUT my Hep B Core AB , Total is Reactive A and should be nonreactive so that's not good.
My last sets of tests done in Sept and another in Feb were fine. Negative, negative.
Rheumy sent me to the hospital to get a Hep B DNA viral load test drawn...now the wait.
what is done in this case?
I have cirrhosis and had Hep B which stated I was not infected and fought off the virus. I don't know when I had it or how I got it. I cannot think of anything except I used to work in a clinical laboratory and a hospital (surgery sec) in the 1970's. that's all that comes to mind for a reason to get it. Sorry I don't much about hepatitis but learning more every day.
Thank you if anyone can give me some advice.
I am now OFF of the xeljanz. On it, I did see my liver values going a tad higher. I was only taking 5 mgs a day of the xeljanz not the normal 10. well the xeljanz didn't last long.... I am also on 5 mg prednisone.
COMMUNITY LEADER
Hepatitis B Blood Tests
Be sure to carefully discuss your blood test results with your health care provider. Understanding your hepatitis B blood test results can be confusing, so you want to be clear about your diagnosis - do you have a new infection, have you recovered from a past infection, or do you have a chronic infection?
You may want to take a copy of this information with you to your appointment to use as a reference guide. In addition, it is helpful if you request a written copy of your blood tests so that you fully understand which test is positive or negative.
To understand your tests,you will need to understand two basic medical terms:
* Antigen -a foreign substance in the body, such as the hepatitis B virus.
* Antibody -a protein that your immune system makes in response to a foreign substance. Antibodies can be produced in response to a vaccine or a natural infection. Antibodies usually protect you from future infection.
Common Hepatitis B Blood Tests
* HBsAg (hepatitis B surface antigen) - This refers to the outer surface of the hepatitis B virus that triggers an antibody response. A "positive" or "reactive" HBsAg test result means that the person is infected with the hepatitis B virus. This can be an "acute" or a "chronic" infection. Infected people can pass the virus on to others through their blood.
* HBsAb or anti-HBs (hepatitis B surface antibody) - This refers to the protective antibody that is produced in response to an infection. It appears when a person has recovered from an acute infection and cleared the virus (usually within six months) or responded successfully to the hepatitis B vaccine shots. A "positive" or "reactive" HBsAb (or anti-HBs) test result indicates that a person is "immune" to any future hepatitis B infection and is no longer contagious. This test is not routinely included in blood bank screenings.
* HBcAb or anti-HBc (hepatitis B core antibody) - This refers to an antibody that is produced in response to the core-antigen, a component of the hepatitis B virus. However, this is not a protective antibody. In fact, it is usually present in those chronically infected with hepatitis B. A "positive" or "reactive" HBcAb (or anti-HBc) test result indicates a past or present infection, but it could also be a false positive. The interpretation of this test result depends on the first two test results. Its appearance with the protective surface antibody (positive HBsAb or anti-HBs) indicates prior infection and recovery. For chronically infected persons, it will usually appear with the virus (positive HbsAg).
Adults and HBV
Will I recover?
The first question most people ask is whether or not they will recover from a hepatitis B infection. The answer is directly related to that age at which a person is infected. Most infected adults will recover without any problems, but unfortunately, most infected babies and children will develop chronic hepatitis B infections.
Acute Vs. Chronic
A hepatitis B infection is considered to be “acute” during the first 6 months after being exposed. This is the average period of time it takes to recover from a hepatitis B infection. If you still test positive for the hepatitis B virus (HBsAg+) after 6 months, you are considered to have a "chronic" hepatitis B infection, which can last a lifetime.
What should I do if I am diagnosed with chronic hepatitis B?
Make an appointment with a hepatologist (liver specialist) or gastroenterologist familiar with hepatitis B. This specialist will order blood tests and possibly a liver ultrasound to evaluate your hepatitis B status and the health of your liver. Your doctor will probably want to see you at least once or twice a year to monitor you and determine if you would benefit from treatment.
Most people with chronic hepatitis B can expect to live long, healthy lives. It is important to know that you can pass the virus along to others, even if you don’t feel sick. This is why it’s so important that you make sure that all close household contacts and sex partners are vaccinated against hepatitis B.
Will I recover from a hepatitis B infection?
The answer depends on whether you are infected as an adult, a child, or a baby. Most infected adults will recover without any problems, but unfortunately, most infected babies and children will develop chronic hepatitis B infections.
Adults – 90% will get rid of the virus and recover without any problems; 10% will develop chronic hepatitis B.
Young Children – 40% will get rid of the virus and recover without problems; 60% will develop a chronic hepatitis B infection.
Infants – 90% will become chronically infected; only 10% will be able to get rid of the virus.
What is the difference between an "acute" and a "chronic" hepatitis B infection?
A hepatitis B infection is considered to be “acute” during the first 6 months after being exposed. This is the average period of time it takes to recover from a hepatitis B infection. If you still test positive for the hepatitis B virus (HBsAg+) after 6 months, you are considered to have a "chronic" hepatitis B infection, which can last a lifetime.
Consider following these helpful tips:
* Avoid alcohol and smoking as they can be extremely harmful to a liver already infected with the hepatitis B virus.
* Talk to your doctor before taking any prescription, over the counter medication, or herbal remedies.
* Although there is no special diet for people who have chronic hepatitis B, a healthy, well-balanced diet that is low-fat and includes plenty of vegetables is recommended.
* Avoid eating raw shellfish, since they can contain bacteria that are harmful to your liver.
Is there a cure for chronic hepatitis B?
Right now, there is NO cure for chronic hepatitis B, but the good news is there are treatments that can help slow the progression of liver disease by slowing down the virus. If there is less hepatitis B virus being produced, then there is less damage being done to the liver. Sometimes these drugs can even get rid of the virus, although this is not common.
With all of the new exciting research, there is great hope that a complete cure will be found for chronic hepatitis B in the near future. Visit our Drug Watch for a list of other promising drugs in development.
Should I be on medication?
It is important to understand that not every person with chronic hepatitis B needs to be on medication. You should talk to your doctor about whether you are a good candidate for drug therapy or a clinical trial. Be sure that you understand the pros and cons of each treatment option. Whether you decide to start treatment or not, you should be seen regularly by a liver specialist or a doctor knowledgeable about hepatitis B.
Please understand that it usually takes 20-40 years of chronic Hepatitis to develop cirrhosis it doesn't happen over night or a few months.
What is the link between hepatitis B and liver cancer?
The most common risk factor for liver cancer is chronic infection with the hepatitis B virus (HBV). Individuals chronically infected with HBV are 100 times more likely to develop liver cancer than uninfected people because the virus directly and repeatedly attacks the liver, which over time can lead to progressive liver damage and liver cancer.
Alarmingly, with chronic HBV infections on the rise in the United States, there is a growing incidence of primary liver cancer and it has become one of the three fastest growing cancers in the country. While the overall incidence of cancer has stabilized, and in many cases decreased, primary liver cancer is an increasing public health threat and has a five-year survival rate of less than 10% (making it the 2nd deadliest cancer in the U.S.).
Hector
Be sure to carefully discuss your blood test results with your health care provider. Understanding your hepatitis B blood test results can be confusing, so you want to be clear about your diagnosis - do you have a new infection, have you recovered from a past infection, or do you have a chronic infection?
You may want to take a copy of this information with you to your appointment to use as a reference guide. In addition, it is helpful if you request a written copy of your blood tests so that you fully understand which test is positive or negative.
To understand your tests,you will need to understand two basic medical terms:
* Antigen -a foreign substance in the body, such as the hepatitis B virus.
* Antibody -a protein that your immune system makes in response to a foreign substance. Antibodies can be produced in response to a vaccine or a natural infection. Antibodies usually protect you from future infection.
Common Hepatitis B Blood Tests
* HBsAg (hepatitis B surface antigen) - This refers to the outer surface of the hepatitis B virus that triggers an antibody response. A "positive" or "reactive" HBsAg test result means that the person is infected with the hepatitis B virus. This can be an "acute" or a "chronic" infection. Infected people can pass the virus on to others through their blood.
* HBsAb or anti-HBs (hepatitis B surface antibody) - This refers to the protective antibody that is produced in response to an infection. It appears when a person has recovered from an acute infection and cleared the virus (usually within six months) or responded successfully to the hepatitis B vaccine shots. A "positive" or "reactive" HBsAb (or anti-HBs) test result indicates that a person is "immune" to any future hepatitis B infection and is no longer contagious. This test is not routinely included in blood bank screenings.
* HBcAb or anti-HBc (hepatitis B core antibody) - This refers to an antibody that is produced in response to the core-antigen, a component of the hepatitis B virus. However, this is not a protective antibody. In fact, it is usually present in those chronically infected with hepatitis B. A "positive" or "reactive" HBcAb (or anti-HBc) test result indicates a past or present infection, but it could also be a false positive. The interpretation of this test result depends on the first two test results. Its appearance with the protective surface antibody (positive HBsAb or anti-HBs) indicates prior infection and recovery. For chronically infected persons, it will usually appear with the virus (positive HbsAg).
Adults and HBV
Will I recover?
The first question most people ask is whether or not they will recover from a hepatitis B infection. The answer is directly related to that age at which a person is infected. Most infected adults will recover without any problems, but unfortunately, most infected babies and children will develop chronic hepatitis B infections.
Acute Vs. Chronic
A hepatitis B infection is considered to be “acute” during the first 6 months after being exposed. This is the average period of time it takes to recover from a hepatitis B infection. If you still test positive for the hepatitis B virus (HBsAg+) after 6 months, you are considered to have a "chronic" hepatitis B infection, which can last a lifetime.
What should I do if I am diagnosed with chronic hepatitis B?
Make an appointment with a hepatologist (liver specialist) or gastroenterologist familiar with hepatitis B. This specialist will order blood tests and possibly a liver ultrasound to evaluate your hepatitis B status and the health of your liver. Your doctor will probably want to see you at least once or twice a year to monitor you and determine if you would benefit from treatment.
Most people with chronic hepatitis B can expect to live long, healthy lives. It is important to know that you can pass the virus along to others, even if you don’t feel sick. This is why it’s so important that you make sure that all close household contacts and sex partners are vaccinated against hepatitis B.
Will I recover from a hepatitis B infection?
The answer depends on whether you are infected as an adult, a child, or a baby. Most infected adults will recover without any problems, but unfortunately, most infected babies and children will develop chronic hepatitis B infections.
Adults – 90% will get rid of the virus and recover without any problems; 10% will develop chronic hepatitis B.
Young Children – 40% will get rid of the virus and recover without problems; 60% will develop a chronic hepatitis B infection.
Infants – 90% will become chronically infected; only 10% will be able to get rid of the virus.
What is the difference between an "acute" and a "chronic" hepatitis B infection?
A hepatitis B infection is considered to be “acute” during the first 6 months after being exposed. This is the average period of time it takes to recover from a hepatitis B infection. If you still test positive for the hepatitis B virus (HBsAg+) after 6 months, you are considered to have a "chronic" hepatitis B infection, which can last a lifetime.
Consider following these helpful tips:
* Avoid alcohol and smoking as they can be extremely harmful to a liver already infected with the hepatitis B virus.
* Talk to your doctor before taking any prescription, over the counter medication, or herbal remedies.
* Although there is no special diet for people who have chronic hepatitis B, a healthy, well-balanced diet that is low-fat and includes plenty of vegetables is recommended.
* Avoid eating raw shellfish, since they can contain bacteria that are harmful to your liver.
Is there a cure for chronic hepatitis B?
Right now, there is NO cure for chronic hepatitis B, but the good news is there are treatments that can help slow the progression of liver disease by slowing down the virus. If there is less hepatitis B virus being produced, then there is less damage being done to the liver. Sometimes these drugs can even get rid of the virus, although this is not common.
With all of the new exciting research, there is great hope that a complete cure will be found for chronic hepatitis B in the near future. Visit our Drug Watch for a list of other promising drugs in development.
Should I be on medication?
It is important to understand that not every person with chronic hepatitis B needs to be on medication. You should talk to your doctor about whether you are a good candidate for drug therapy or a clinical trial. Be sure that you understand the pros and cons of each treatment option. Whether you decide to start treatment or not, you should be seen regularly by a liver specialist or a doctor knowledgeable about hepatitis B.
Please understand that it usually takes 20-40 years of chronic Hepatitis to develop cirrhosis it doesn't happen over night or a few months.
What is the link between hepatitis B and liver cancer?
The most common risk factor for liver cancer is chronic infection with the hepatitis B virus (HBV). Individuals chronically infected with HBV are 100 times more likely to develop liver cancer than uninfected people because the virus directly and repeatedly attacks the liver, which over time can lead to progressive liver damage and liver cancer.
Alarmingly, with chronic HBV infections on the rise in the United States, there is a growing incidence of primary liver cancer and it has become one of the three fastest growing cancers in the country. While the overall incidence of cancer has stabilized, and in many cases decreased, primary liver cancer is an increasing public health threat and has a five-year survival rate of less than 10% (making it the 2nd deadliest cancer in the U.S.).
Hector
COMMUNITY LEADER
Xeljanz (tofacitinib) works by blocking certain enzymes in the body that affect immune system function. Xeljanz is used to treat moderate to severe rheumatoid arthritis (RA) in adults who have tried methotrexate without successful treatment of symptoms. Xeljanz is sometimes given in combination with methotrexate or other arthritis medicines.
I know nothing about RA as it isn't related to liver disease so I can't help you with more insight there.
Prednisone is an anti-inflamatory drug which I am familiar with . But 5 mg is the dosage the body normally produces itself, so I am not sure why your doctor is giving it to you. It is not a dosage used with liver disease to treat anything pre transplantation that I am aware of.. Again we are here to support people with cirrhossi of the liver and are not experienced with RA or other conditions.
If you have cirrhosis your doctor's job is to figure out why you have liver disease and if possible, treat the underlying cause of your liver disease before ir progresses further.
If hepatitis B virus caused your liver damage over decades of infection there are treatments available which can help you control it. You must know what has caused your liver disease in order to know if there are treatments.
You might want to refer to the "Hepatitis B Community" to learn more about it.
In both cases you need to talk to your doctors to better understand you health issues before thy get worse. Only your doctors know you true health issues. You must learn to communicate with them no one online can diagnose you or treat you.
If you have any questions about cirrhosis or its complications we would be glad to help.
Good luck to you.
Hector
I know nothing about RA as it isn't related to liver disease so I can't help you with more insight there.
Prednisone is an anti-inflamatory drug which I am familiar with . But 5 mg is the dosage the body normally produces itself, so I am not sure why your doctor is giving it to you. It is not a dosage used with liver disease to treat anything pre transplantation that I am aware of.. Again we are here to support people with cirrhossi of the liver and are not experienced with RA or other conditions.
If you have cirrhosis your doctor's job is to figure out why you have liver disease and if possible, treat the underlying cause of your liver disease before ir progresses further.
If hepatitis B virus caused your liver damage over decades of infection there are treatments available which can help you control it. You must know what has caused your liver disease in order to know if there are treatments.
You might want to refer to the "Hepatitis B Community" to learn more about it.
In both cases you need to talk to your doctors to better understand you health issues before thy get worse. Only your doctors know you true health issues. You must learn to communicate with them no one online can diagnose you or treat you.
If you have any questions about cirrhosis or its complications we would be glad to help.
Good luck to you.
Hector
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