Chronic hepatitis b - need advise on treatment

Dear forum members, i was detected with chronic hepatitis b in april 2012 during a minor surgery. At that time my Hbsag quant was 237iU/ml. Alt was 60. Liver ultrasound normal. No pain in stomach and no yellowish urine. In december 2012, i had the test again, hbsag quant was 1572iU/ml. Alt was 42. Fibroscan was normal. liver ultrasound showed fat liver and coarse echotexture. Doctor has not advised any medication to me as of now. But i constantly feel a pain on right side of my stomach, it feels like a swelling. Urine is slightly yellowish all the time. Doctor is saying that it is due to gas and fat liver but i am feeling this symptoms for first time in my life and really worried if my treatment is on right path. During this period i had alcohol only 4-5 times, but recently when i had a small amount of alcohol, i had a severe irritation on right side of stomach next day. I am really worried, please advise.

[Rome70]

You should do ultrasound to check the pain reason, normally HBV is not associated with pain until the last stage when your liver does not function.
I do not think that it is the case because even if your doctor is not the biggest expert in HBV he would have noticed that you have serious liver problem.
The pain or discomfort is most likely comming form gal bladder and you will see it on ultrasound. also you need to do fibroscan to check if you have fibrosis.

[Ank1986]

please advise guys.

[Rome70]

Do you have dna test for viral load?

Since your hbsag increased  you probably have high viral load and may need teatment.

[Ank1986]

Hi Rome70, Doctor advised me to get periodic hbsag quant test done only. I have no idea about the viral load, i will get it done. at my stage what sort of treatment I will get? Will it effect my worklife? how long I will be able to survive? sorry for bombarding you with question but I am really tensed...I feel like my life has changed...not able to concentrate on anything

[Rome70]

First read this hbvadvocate.org.
And do not panic hbv now is pretty managable while not fully currable desease.
I think you should go to another doctor to ask for a second opinion.
You should also do ultrasound and fibroscan and liver function test.
Then you can decide on treatment.

[Ank1986]

Thanks rome70. I still can not understand y i have so much discomfrt on right side of my stomach. Its becomng more irritating with each passing day. Is there a way to get relief from it even if i am not startng treatment.

[Rome70]

You should do ultrasound to check the pain reason, normally HBV is not associated with pain until the last stage when your liver does not function.
I do not think that it is the case because even if your doctor is not the biggest expert in HBV he would have noticed that you have serious liver problem.
The pain or discomfort is most likely comming form gal bladder and you will see it on ultrasound. also you need to do fibroscan to check if you have fibrosis.

[Ank1986]

my ultrasound report showed fat liver, gas, coarse echotexture. Fibroscan report came out to be normal. Bu tthis pain is feels more like a bruise inside my stomach on right side...is it possible that hep b might have damaged my liver to end stage in one year and tests might hav missed it? would you suggest any other test after ultrasound and fibroscan?

[Rome70]

When did you do ultrasound and fibroscan?

[Ank1986]

in december. at that time i was having this problem already bt its more irritating now

[Rome70]

Do you know why you have fatty liver? Are you overweight,  alcohol abuser?

[Ank1986]

i had a bit of alcohol in december but after knowing abt hep b i have refrained a lot from drinking alcohol...may b 2-3 glass on weekend...my overweight by 7kg only...my weight is 77kg and height is 170cm.

[Ank1986]

i had alcohol for only 1 time in 2013, tht too only 2-3 glass....in last 8 months i wud have drank only on 9-10 occassions.

[Rome70]

I do not think You could develop any serious liver problem since december. Your pain is probably because of gal bladder.

You have a lot of extra weight with 170 cm you should be 65 kilo max.

With hbv you should seek to have a very good liver.

Keep healthy lifestyle and good diet.
No processed food, meet almost never, mainly fish and veg all organic. Alcohol is not good.

30 min of aerobic exersize a day.

If you can afford advance life research food suplements would be good to fight fatty liver, but it all useless if you do not hold your diet.

[Ank1986]

thnks a lot mate. really helpful. i will try to get my weight in order but i have always been this much overweight so why is it now i am feeling these symptoms? is fat liver getting accentuated due to hep b?

Can you suggest few life research food suppliments which might b useful with daily exercise?

Also, do you think i should get tested for colitis? my pain and irritation is just below the rib cage on right side of stomach.

many thx.

[Ank1986]

and what can be the reason if its due to gall bladder? how to treat it?

[Rome70]

The fact that you have been always overweight means nothing, we have to pay in the end anyway.
Hbv changes metabolism in the liver, we have oxidative stress problems, high cholesterol sometimes, lack of vitamins D, E, B, Probably fatty liver accentuated due to hep b.

http://www.advanceliferesearch.com/ - full package

And check hbv dna

[Ank1986]

how do i chk for lack of vitamin D, E & B. thanks again for  ur invaluable advice.

[Rome70]

Blood tests
25(OH)D for vit D

And blood tests for othe vits..

[Ank1986]

thx man. what might be the reason for problem in gall blader if there is any? how to detect it?

[Rome70]

Gall blader is well seen on ultrasound.
I think your discomfort around the liver maybe also  coming from your inner fat. I actually had the same feeling until i lost a few kilos.

[Ank1986]

ohh ok. I think i should lose my weight soon as this discomfort is now troubling me a lot. Any medicine u wud suggest which might help get temproray relief in meantime? i took ursocol in januray but it did nt give me any relief what so ever.

My gall bladder was normal in december ultrasound. but i have noticed this discomfort started from a single point in my stomach which i could sense in august 2012 but kept on increasing slowly. now it has actually become very discomforting. it feels like a wound which has grown slowly.

[Rome70]

If ursocol did not help it is not the gallbladder. My suggestion is that the liver being enlarged due to fatty liver condition, pushes against inner fat in the abdomen.
I have no idea about the drugs that could help it because the reason of the pain is unclear.
I would do ultrasound now when there is this symptom maybe it will show something.
Does the discomfort increased when you stopped ursocal?

[Ank1986]

discomfort has grown linearly over a period of time...there was no effect of ursocol what so ever..along with  pain i get a slight wound like sensation also concentrated at few points

[imran4535]

I get the same pain, ive been searching and searching to find out what it is. Pain almost always is never a good thing. In the Hep C forums, a big scientist, who went by the name of HepatitisResearcher posted that its by the swelling of the capsule that surrounds the liver which can swell because of previous or current liver inflammation.

Many people in the Hep C forums say the same thing, but ofcourse there could be other reasons too. Ive seen members here and over there have it resolved by certain diet changes, supplements that support the liver and have anti-fibrotic properties.

[imran4535]

One more thing is dont ever report your results here or anywhere as NORMAL. What your lab or doctors interpretation as normal, may not be actually normal. Many doctors and labs are very ignorant. Here are the test results you need to post:

Group 1: (more frequent, like 3 to 6 months)
1. HBV DNA in iu/ml
2. ALT/AST
3. HbSAg quantity
4. Overall liver health blood tests

Group 2: (every 6 months)
5. Fibroscan scores
6. EAntigen Status (repeat only if positive)
7. AFP score
8. Ultrasound of liver

Group 3: (important but not tested frequently)
9. Genotype test
10. HBV mutations