Follow up ILBS ,INDIA

[Ashutoshh]

Hello friends ,
My father age 61 diagnosed with hep B accidently a year ago .At that time test results were hbseag NEG HBEAB POS hbv dna 242 iu/ml hbsag quantification 300  ast 35 alt 30 afp 2.52mg/ml .fibroscan 3.3kpa.
Doctors adviced no treatment needed and put him on vit b &c .
We checked after 3 mnth again ast/alt came normal within 40.
Meanwhile he contracted hand inffection and took antibiotics for 2 months.
After 6 mnths we tested again and results were not good
Alt 80
Dna load 4lakhs iu/ml.
We went for tests again at ilbs after 8 months and results came back to normal .(antibiotic stopped , on vit b&c)
Ast/alt 25 both
Hbv dna 142 iu/ml  lft /kft normal afp 2.6
Not docs told no treatment needed as of now ,alt to be monitored every 3 mnth , lft/kft /dna load /ultra sound to be tested after 6 months.
He told treatment is suggested when either
1)alt is high for a prolonged time
2)fibroscan is more than 8
3) biopsy comes abnormal .
Viral load keeps fluctuating .

Any comment is appreciated.
Good luck.

[varsa]

Not getting clearly what is your father status now as per aasld guidelines for hbeag negative patient if Hbv DNA >2000 Lft 2× normal limit of sgpt and sgot
Fibroscan not normal then treatment required so what is your father status now

[Ashutoshh]

What i could relate to is , due to that antibiotic (itraconazole) his lfts were affected ,which came back to normal after stopping it for 2 mnths. As doc said , dna  load is nt marker for start of treatment . Its 3 points which i mentioned above in the post . She said dna load keeps fluctuating .we were also frightened to see the results .May be that 4 lakh test was not correct .
What i learnt from this episode is  ,to wait and retest ,not to panic by seeing high viral load .regular monitoring is required to come to any conclusion.

Take care all the best.

[varsa]

Ilbs Delhi is very reputed organisation for Hbv so I think your father previous report hbv DNA more than four lakhs is wrong

[StephenCastlecrag]

I would agree with you doctor. Because your father's liver is in very good condition (Fibroscan 3.3Kpa), I suspect he was infected as an adult and not at birth, so his prognosis is very good. Do follow his doctor's advice.
Just my opinion.

[Ashutoshh]

Thank you stephen .
God bless you

[Ashutoshh]

What makes you believe that he was not infected at birth ?
One of my uncle does have hep B ( he regulary takes needle for sugar problem )  , Status of grand ma is not known

[StephenCastlecrag]

I based my opinion on the fact that his liver fibroscan is 3.3 Kpa, no fibrosis. If infected at birth, one would expect after 60 years of HBV, the score would be higher.

[Royal36]

Agree with stephen.