Increased HBV DNA and E Antigen -ive

First of all thank you very much for taking the time to read this and I appreciate your comments.

Now my history: 1993 diagnosed with chronic Hep B. Interfron A for 4 months. Then Famciclovir first 250 mg then increased to 500 mg both in 1995-1996.

Test Results 1996:

HB S Antigen +ive
HB E Antigen +ive
HB E Antibody -ive
HBV DNA 25.3 pg/ml
AST 32, ALT 42

Had biopsy in 1998, diagnosis: chronic Hep B with minimal interface and lobular activity and had achieved E Antigen seroconversion. Unfortunately I have lost the full results.

Had a full set of blood tests done in Feb 2005. Results:

HBV DNA PCR 596 IU/ML
HBV DNA PCR 1070 copies/ml

HBS Antigen +ive
HB Core AB +ive
HB E Antigen -ive
HB E Antibody +ive
AST 24, ALT 29

The last blood tests I have had were in Jan 2006 with the following results:

HBV DNA PCR 2950 IU/ml
HBV DNA PCR 5960 copies/ml

HBS Antigen +ive
HB Core AB +ive
HB E Antigen -ive
HB E Antibody +ive

Did not perform AST and ALT tests.

Now to the quesions:

1)Why has the DNA count increased over the past year, if I am in the inactive non-replicative stage?

2)Could it be due to the fact that I am from the caspian sea region and my age (31) I have developed the precore mutant strand of the virus and the virus has infact reactivated?

I would very much appreciate your comments on this matter as for the first time in the past 12 years, this disease is weighing heavily on my mind. Thank you so much.

Kindest Regards.

[Kevin Pho, MD]

A positive Hbs antigen suggests chronic infection.  If the DNA count has increased, it is possible that the hepatitis is flaring up again.  

A liver biopsy as well as measuring the ALT/AST level should be considered to determine if treatment should be re-instituted.  It is difficult to comment further without knowing a liver biopsy result.  

2) I cannot comment as to whether the virus has "mutated".  More likely, a re-activation of the old virus occurred.  

However, you may want to discuss this possibility with your personal physician or hepatologist.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_b