HBV-AFP-Entecavir

[milou-w]

I am a HBV carrier, known since 1990. e-antigen is negative, anti-body positive. I have blood tested every 6 months and CT scan every year. Results have been stable: all tests including ALT are marginal or little high, AFP fluctuates in the range 200-290 since 1990. CT scan results indicates fibrosis but little change from report to report.

Recently I changed to see another doctor. I have 2 times DNA tests. Results are 250,000 (Dec. 2006)and 380,000 copes (March 2007). Fibro-scan result is 15.6. I have never done these tests before. Doctor advised me to take Entecavir (not yet started).

My questions are : Many articles said that patients with minior ALT elevation do not have to be treated .....Why is this? Am I in this not to be treated category? Should I take Entecavir? Why my AFP reading is always so high (200-290 since year 1990, without HCC)?

[jboyhk]

Its not that low AST patients are told not to treat. It is that patients that have normal AST do not respond to Interferon treatment.

I can't answer your AFP question except to say it is not a 100% predictor of HCC. AFP can be elevated for unrelated issues.

Also I don't know that a CT scan shows anything concerning fibrosis. That is something new to me if true but I think you might have misunderstood dr. A CT scan may show signs of cirrhosis not fibrosis.

Being that you have a DNA count over 100,000 and E antigen negative I think you can be classified as having a Pre-Core Mutant.

This is a little more difficult to treat than 'normal' HBV so I can only advise that you see a dr that has treated such patients.

There are no dr's on this forum.

[jboyhk]

btw, if you are in the US and received a Fibroscan, then you have a good dr as only a few in the US have it now. So I would listen to whatever they recommend.

[milou-w]

Thank you for quick response.

No doctors so  far can give me a definite cause for my high AFP other than
" regeneration of liver cells". I am puzzled because if regeneration is that serious for such a long period of time , the stiffness of my liver should be now more severe  than a fibro-scan sore of 15.6. ( Guess regeneration of cells is severe when AFP is as high as 250+ since 1990).  

I know cirrhosis do cause AFP to elevate but usually not as high as 250+.

The main reason to have CT scan every year is to make sure that in case of HCC, it is detected at early stage. It is not meant to check fibrosis. In fact, I don't know if I have fibrosis or cirrhosis ( I guess they both mean scaring of liver, the differences is the degree of scaring or stiffness of liver).

I know interferon is no use to me. That is why my doctor recommend Entecavir. I probably will listen to him since there  is no other choice at the moment.