Fibroscan Result 10, 3, all other tests normal, please help me interpret

[zhw2008]

Hello, I'm 30 years old and I've been a chronic HBV carrier my whole life, and started taking Viread 7 years ago.  My blood tests and ultrasounds have always been normal, and my last biopsy in 2008 showed no signs of fibrosis.  However, I just got my first Fibroscan test, and it showed that I was a 10 kPa.  This really scares me, as it shows F3 fibrosis and very close to F4.  I eat relatively healthy, I'm not overweight at all, and I exercise regularly.  Can anyone tell me how this is possible?  What can I do to help myself?  Below are my latest labs.  Thank you.

AFP 2.0
Albumin 4.8
Bilirubin,Total 0.2
Alkaline Phosphatase 39
AST (SGOT) 21
ALT (SGPT) 35

[stef2011]

before making questions browse the community, all answers are already there 99.9%

[Blessedat30]

I have alot of questions you all seem to be very educated about the disease please help I've been trying to contact stef but no luck so far.

[Blessedat30]

Hello guys im new here and looking for friends who share my experience with hepatitis b I really dont know how to use this site please add me

[heal_123]

Hi, Did you got for another fribroscan? What was result ? Similar thing has happened to me. At one center fibroscan result was 7.7 and in another one done within a week 4.8.

[Aduiski]

You might also look for a place which has a fibroscan device that can measure both fibrosis and liver fattiness/steatosis. These devices measure CAP parameter which correlates with liver fattiness.

[zhw2008]

Thanks Aduiski, I will do that.

[Aduiski]

Your APRI index is excellent indicating no significant fibrosis. This off course contrasts your fibroscan results, as fibroscan is usually considered a more reliable measure of fibrosis. Considering rhat all your previous results were good, there might be something else other then fibrosis causing your high values on fibroscan like fatty liver. Take an ultrasound and see if it finds something, if it doesn't I would go for MRI.
You now need to follow this up to find out the reason for your high fibroscan results.

[stef2011]

fatty liver can happen also to slim persons, double check your ultrasounds i remember they did not tell me about fatty liver until my fibroscan was not improving and then they said maybe its your fatty liver

i was slim and eating healthy, probably not the right supplements/food at that time to clear fatty liver

a low hdl can also help confirm fatty liver or metabolic disease and also insulin resistance tests

[zhw2008]

Thanks, I'm going to order some of the supplements you mentioned and watch what I eat and exercise more rigorously.

[Aduiski]

if you have a copy of your fibroscan results go ahead and post all of the details of your fibroscan results.

[zhw2008]

http://imgur.com/a/yBk1j

Here are the results

[Aduiski]

Do you have a recent result of your platelets count?

[zhw2008]

Aduiski, yes, they are from a couple weeks ago.  None of my test results have really changed in the past 5 years.
White Blood Cell Count 6.47x10E3/uL
Red Blood Cell Count 4.48x10E6/uL
Hemoglobin 14.0g/dL
Hematocrit 42.8%
Mean Corpuscular Volume 95.5fL
Mean Corpuscular Hemoglobin 31.3pg
MCH Concentration 32.7 g/dL
Red Cell Distribution Width-SD 42.8 fL
Red Cell Distribution Width-CV 12.3%
Platelet Count, Auto 310 x10E3/uL
Mean Platelet Volume 10.0fL
Nucleated RBC%,   0.0
Absolute Nucleated RBC Count 0.0 X10e3/Ul

[StephenCastlecrag]

Your Fibroscan result is unusual considering that you have been taking Viread for 7 years. What is your viral loads history? Did you eat before your Fibroscan? What is your HBeAg status? How experienced is the doctor/technician taking your Fibroscan?

[zhw2008]

Viral load has been undetectable since I started taking Viread.
Hep B Surface Ab Quant <10
Hep B E Antigen Positive
Hep B E Antibody Negative
HBV DNA Quantitative PCR Not Detected

I had the test done in the morning and did not eat or drink anything since the previous evening. I was told to not eat 4 hours prior.  I am not sure how experienced the technician was, but would that really matter?

[StephenCastlecrag]

Thank you. I am scratching my head. After 7 years of undetectable viral load, you are still HBeAg positive. Yes, Fibroscan results can be affected by the operators, but your report looks professional. I have no explanation for your Fibroscan result, other than to suggest another Fibroscan?

[stef2011]

you can also use liposomal curcumin, resveratrol and glutathione to help liver

pomegranate is also good (life extensions has extract pills) or you can juice fresh if you find them

silymarin also helps

if fibroscan test was not wrong the problem is not hbv but diet and deficiencies, are you also sure no fatty liver?

[zhw2008]

Thanks Stef.  I am not sure no fatty liver, but I assume that fatty liver would be people who don't take care of their bodies/diet.  I've also never thought about fatty liver as my test results and ultrasound have always been normal.  

I will check out the supplements you've suggested.  Do you have any brands that you like and thoughts on dosage?  There are so many choices out there, I am a little lost on where to start.

[stef2011]

repeat test by 6 months and change diet to fresh organic and a lot of juices

also check vitd25oh and intact pth, if you dont supplement be aware that you must, especially being on tdf.at conferences vit d3 supplementation was strongly suggested for all hbvers and tdf users

hbv carriers have low vit d already and tdf lowers vit d even more and increase intact pth.vitamin d deficiency itself makes liver fibrosis and kidneys function 50% less.maybe this is the problem, post vitd25oh and intact pth results

[zhw2008]

I don't think I've ever been tested for vitd or pth...
My doctor runs a basic metabolic test with the following:
Sodium 143
Potassium 4.7
Chloride 104
Total CO2 29
Glucose 92
GFR Estimate >89
Creatinine 0.9
Urea Nitrogen 16
Calcium 9.7
TOTAL PROTEIN 6.7

I can ask the doctor to see if those levels should be tested.