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Chronic Hep B, not sure when or how I became infected
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Chronic Hep B, not sure when or how I became infected


*I have posted this in the Infectious Disease forum as well...  am hoping to get some insight considering my situation is kind of odd.  Most people at least have a general idea as to how they became infected with viral hepatitis...  but I am clueless.*

I am a 26 year old female who was diagnosed with Hepatitis B almost 2 years ago (blood work confirms Chronic Hep B).  I was 17 weeks pregnant with my third child and my OBGYN detected it during my first visit.  I have no clue as to how long I have been infected, nor do I have any idea as to how I became infected.  I am not an IV drug user (terrified of needles so I never was an IV drug user), but I am a recovering drug addict, and I have been with the same man, faithfully, 5 months shy of 7 years (promiscuity is not a possibility either).  
My question is, how long after being infected with HBV would it take for my AST and ALT levels to elevate?  AST and ALT elevation progression is as follows:
9-30-2010: Hep B discovered.  AST 85, ALT 67
10-21-2010: AST in the 900s, ALT in the 700s
10-26-2010: AST in the 1100s, ALT in the 900s
11-18-2010: AST 1346, ALT 1209
11-25-2010: AST 535, ALT 487; tested again later that night, AST 342, ALT 289
12-2-2010: AST 109, ALT 92
As of 12-9-2010, my AST and ALT levels have returned to and remained normal.  I took 4000mg of milk thistle every day, but only long enough to go through 2 bottles of 90 1,000mg capsules (1 capsule 4 times daily) starting 11-18-2010.  I have not taken it since.
I had also retrieved medical records that go back as far as the 5th week of my first pregnancy (my first OBGYN appointment; 2008) and are as recent as my 6 week postpartum visit after my second pregnancy (February 2010) to have my most recent OBGYN (who also treats me in my substance abuse program) look for any indicators of infection during that time frame.  There were none.  I am the only person (out of 5, including myself, my husband, and our 3 children) in my family that had not received the immunization, as well as the only one who tested positive for the virus.
Considering all of the uncertanties surrounding my experience with this particular virus, I have been trying to get close to figuring out time of infection, as well as how I came to be infected since I found out I had the virus.  Making these attempts for as long as I have is driving me to the brink of madness.  Trying to figure this out, as well as another issue that my doctor's are doing extensive tests over, has me losing a lot of sleep and my gears constantly turning.
If you could, please, try to tell me how long I have had this virus (I will be grateful for just your best guess) based on the elevation progression of my AST and ALT levels, I would greatly appreciate it!  It would help me keep a little bit of my sanity.  Thanks!
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7 Comments Post a Comment
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Avatar_m_tn

at birth or very very young, adults almost never get cronic (chronic).

your tests are not useful to monitor hbv status, fibroscan and hbsag quant in iu/ml are the main tests
complementary tests: hbvdn, ast/alt, US, hbeag
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Avatar_f_tn
That thought had crossed my mind, but no tests run before 9-30-2010 had indicated infection with the virus.  I had asked my mother if she could have been a carrier, as her father was infected with Hepatitis (not sure which) during his time in the Korean War from walking through feces infested rice fields.  She donates blood regularly, and nothing that would indicate that she is a carrier of the virus, or infected with it (now or previously) has ever been present.  
However, do you think it may be possible that I may have become infected during any surgeries I had at a young age?  When I was 8, I had to have surgery to repair a broken elbow (2 pins were used to set it) and when I was 12, my appendix ruptured, and after about a week the surgical site had abcessed so bad that they drained 2.5lbs of infection out of it.  
I just don't understand why no other labs would have caught it before I was diagnosed.  The doctor who discovered it even thought I knew about it prior to his finding it.
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Avatar_f_tn
I have had all of the tests you mentioned.  The only numbers I can remember are the AST/ALT levels and that all of the antigens came back positive, as well as anything else that would indicate infection.
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Avatar_m_tn
I would like to share my experience. I found out I have HBV when I was 21 years old. I went for medical check up for my pre-employment medical test. I was shocked as it was my first job and I had many things planned for the future. Felt like it was the end of the world then.

Now in 2012, we have effective medicines for HBV like tenofovir and inteferon. Though they wouldn't cure HBV, at least we don't suffer liver cancer. Moreover, the life expectancy for HBV patients are similar to healthy people.

Hope this cheers you up.
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Avatar_f_tn
Thank you, that did cheer me up.

I haven't been actively avoiding treatments, but my doctor has advised me not to undergo treatment until my liver destabilizes due to the harsh side effects they have. An infectious disease specialist I saw quite some time ago gave the same advice.  I should really get around to seeing another infectious disease specialist, as the one I mentioned also told me that 4 months worth of weekly hepatitis panels and other blood work to check liver enzymes and function (and one week of the same blood tests being performed twice a day) had to be a false positive because I wasn't jaundiced.  Jandice only occurs in about 20% of people infected with Hep B.  And I probably should start receiving treatment for it, but at the moment I am undergoing a battery of tests to be checked for Lymphoma.  Can't seem to catch a break with all of the health issues.  I remain optimistic though.
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Avatar_f_tn
I am assuming I was diagnosed while still in the acute viral phase, as AST and ALT levels in the thousands of units per liter are usually indicative of acute viral Hep B, but progressed quickly to the chronic phase.  I could be wrong about this, but every bit of research I've done on the subject has implied that is the case.  
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Avatar_m_tn
You're right. During acute phase the immune system fights the virus and if sucessful, our body develops natural antibody to HBV. If they fail, we become chronic HBV carriers.

Complete all tests. Quantification of HBsag is the most important because loss of HBsag is the nearest to cure. Monitor it  when you on medication.

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