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Confused about hepatitis B test results
In june i was diagnosed with chronic hepatitis B(exposed during childhood). I am now 21 years of age. After my test results my doctor told me that he is not putting me on medication. He said that even though my hbv viral load is high and my ALT is high i do not have liver damage. my liver is fine. Im still confused about why im not on medication and why my liver is fine with such a high viral load and ALT.
One more useful test is hbsag QUANTITATIVE test (done in IU units), but this one due to political reasons (most likely corruption) is not available in USA where I understand you are.
On your place I would measure ALT and HBV DNA again 3-4 months apart from the first measurement, and if ALT is over 25 AND HBV DNA over 20.000 I would start taking medicines. You have 3 options of meds: interferon, entecavir and tenofovir. If you plan on getting pregnant then it would be preferable not to be on entecavir as it is not certain whether it can negatively impact the child.
You are tired because your body is fighting the virus which is now relatively high. That will change down the road...
On your place I would measure ALT and HBV DNA again 3-4 months apart from the first measurement, and if ALT is over 25 AND HBV DNA over 20.000 I would start taking medicines. You have 3 options of meds: interferon, entecavir and tenofovir. If you plan on getting pregnant then it would be preferable not to be on entecavir as it is not certain whether it can negatively impact the child.
You are tired because your body is fighting the virus which is now relatively high. That will change down the road...
you guys are wonderful. Very informative. Are there any other tests besides the fibroscan? I had an ultra sound of my liver and its fine no inflammation and its at normal size. beside that I get nauseous and tired a lot. It's really annoying. if you guys have any routine that you do, like excerise or drinking tea suggestion or welcomed :)
i 100% agree with you her chances of developing cancer before age 40 is almost slim to none even with a high viral load. being female with chronic hep b has its advantages, if she was male her chances would be much much higher in developing hcc with her specific genotype.
Maggie you have absolutely no reasons to worry, absolutely none.
You just have to monitor regularly the virus and if needed get on medication.
I estimate that in about 10 years from now there will be medicines that will cure hepatitis b (we just have to wait until the medicines that are currently in development get past clinical trials and get effectively tested in combination therapy). For females is it close to impossible to get cancer before the age of 35-40, but you need to monitor the disease just to be on 100% safe side. You'll be cured before you are 35-40.
You just have to monitor regularly the virus and if needed get on medication.
I estimate that in about 10 years from now there will be medicines that will cure hepatitis b (we just have to wait until the medicines that are currently in development get past clinical trials and get effectively tested in combination therapy). For females is it close to impossible to get cancer before the age of 35-40, but you need to monitor the disease just to be on 100% safe side. You'll be cured before you are 35-40.
She is just 21, it is close to impossible for her to get cancer in next 15 years weather on treatment or not. But yes if her viral load doesn't improve in few months I would advice treatment so as to eliminate any risk of liver fibrosis.
Looking at your test results most doctor would treat you now because you are hbeag + , hbv dna higher than 20,000 iu/ml and alt 2x over the uln.fatty liver can cause alt to raise but of course these are just guidelines. What is important is for you to get a fibroscan not a fribrosis test. fibroscan measures liver stiffness and is just as reliable as a biopsy. if you have no liver damage from firbroscan results, you can consider not treating. if you have a first degree relattive with hcc, you should start treatment right away.
I'm not over weight I'm 145lbs. Before I came to the U.S. I was vaccined for hep b and hep A. I have hep A antibodies but none for Hep B. that was in 1999. I want to start treatment because I'm only 21. And this whole situation is really depressing. I have another fibrosis test in December. Doctor wants to see how I look after 6 months.
if there is no liver damage it is best to wait for some immune response and then start tdf so response will be better on both hbvdna and hbeag
alt 46 is very low i regressed my cirrhosis with those alt levels and also a little higher, once we see fibroscan is normal it is ok to keep monitoring until some immune response get started
alt 46 is very low i regressed my cirrhosis with those alt levels and also a little higher, once we see fibroscan is normal it is ok to keep monitoring until some immune response get started
You Can ses m'y post and results on (my feedback).
You and me we are in the same conditions and my doc also decide to do not put me on treatment.and I will see her on November after 6month from the Las result.
You and me we are in the same conditions and my doc also decide to do not put me on treatment.and I will see her on November after 6month from the Las result.
are you overweight?is US showing fatty liver?what is your fibroscan (fibrotest not very reliable)?
you are probably immune tolerant and it is best to monitor close and not to start treatment.if alt 46 is due to other things and not hbv (you ll know from fibroscan, US) starting treatment now is useless because not needed/not useful under immune tolerance
you are probably immune tolerant and it is best to monitor close and not to start treatment.if alt 46 is due to other things and not hbv (you ll know from fibroscan, US) starting treatment now is useless because not needed/not useful under immune tolerance
I didn't c the picture. If ur viral load as I said is above guideline limits initiate the treatment right now as u have already elevated alt.
Her viral load, if I am reading it right from the attached picture, is over the upper limit of readability of the test, over 170 million, maybe billions of IU/ml.
This is what British Nice guidelines say:
"Offer antiviral treatment to adults who have HBV DNA greater than 20,000 IU/ml and abnormal ALT (greater than or equal to 30 IU/L in males and greater than or equal to 19 IU/L in females) on 2 consecutive tests conducted 3 months apart regardless of age or the extent of liver disease."
Links: https://www.nice.org.uk/guidance/cg165/chapter/1-Recommendations
Same advice from Canadian guidelines:
http://www.hepatology.ca/wp-content/uploads/2012/06/2012HepBGuidelines_CJG.pdf
It is your own decision, but you could measure your ALT and DNA again 3 months from the time you measured them last, then print a copy of British Guidelines to your doctor and ask him to treat you. You can also change the doctor.
This is what British Nice guidelines say:
"Offer antiviral treatment to adults who have HBV DNA greater than 20,000 IU/ml and abnormal ALT (greater than or equal to 30 IU/L in males and greater than or equal to 19 IU/L in females) on 2 consecutive tests conducted 3 months apart regardless of age or the extent of liver disease."
Links: https://www.nice.org.uk/guidance/cg165/chapter/1-Recommendations
Same advice from Canadian guidelines:
http://www.hepatology.ca/wp-content/uploads/2012/06/2012HepBGuidelines_CJG.pdf
It is your own decision, but you could measure your ALT and DNA again 3 months from the time you measured them last, then print a copy of British Guidelines to your doctor and ask him to treat you. You can also change the doctor.
If ur viral load is less than 2000iu then u don't need meds right now since ur fibrosis is low. All u keep doing is 6monthly monitoring of viral load, alt, and fibroscan. Over years ur disease may shift to more liver fibrosis when u may need medication. Since ur alt is above normal it means liver injury is ongoing and over years fibrosis is likely.
Prophylactically u may take tenofovir for 2-3 years and then go for 1-2years of interferon therapy as other members recommend here to eradicate the virus with 65% chance. Though watching the guidelines u don't need medications and taking it shall be ur consideration. Tenofovir has minimal side effects.
Prophylactically u may take tenofovir for 2-3 years and then go for 1-2years of interferon therapy as other members recommend here to eradicate the virus with 65% chance. Though watching the guidelines u don't need medications and taking it shall be ur consideration. Tenofovir has minimal side effects.
your doctor rates you in immune tolerant phase of hep b. high dna , hbeag + , no fibrosis. Some doctors recommend treatment since ALT is over 30 and some do not. here is a link to the guidelines and natural history of hep b.
http://www.easl.eu/medias/cpg/issue8/Report.pdf
http://www.easl.eu/medias/cpg/issue8/Report.pdf
ALT: 50H
6-29 (U/L)
Hepatitis B surface antigen : Reactive
Hepatitis B Core AB total: Reactive
Hepatitis A AB Total: Reactive
Hepatitis BE antibody: nonreactive
HBV genotype: D
Precore mutation: not detected
polymerase mutations: not detected
BCP mutations: not detected
Other mutations Detected
polymerase: not detected
Precore: C1858T
BCP: not detected
6-29 (U/L)
Hepatitis B surface antigen : Reactive
Hepatitis B Core AB total: Reactive
Hepatitis A AB Total: Reactive
Hepatitis BE antibody: nonreactive
HBV genotype: D
Precore mutation: not detected
polymerase mutations: not detected
BCP mutations: not detected
Other mutations Detected
polymerase: not detected
Precore: C1858T
BCP: not detected
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