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HBV viral load
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HBV viral load

My dad has HBV viral load 74.3IU/ml. ALT 35,fibroscan normal, HBe Ag negative, Any further management for him?
9 Comments Post a Comment
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Avatar_m_tn
I am not a doctor. Your Dad's viral load is low and ALT is normal. If the Fibroscan indicates he has minimal or no fibrosis, then I would think treatment is not needed at the moment Please do make sure he has regular checkups.

Just my opinion.
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Avatar_m_tn
Could you please relay you Dad age and when did he discovered HBSag positive.
It would be wiser to do one more test HBSag quant to nonitor as well how many cells are infected on tyhe cliver and as stephen suggested regular checks every 6 months is the result did not have major changesafter 1 year then test every year but if affordable i would tyest every 6 months.
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Avatar_f_tn
Thanks to both of u.
His age is 53years. HBsAg quantity is 3900.
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Avatar_m_tn

what is fibroscan result?normal is too generic, what is the kpa number?

the age is very important because after 45-50years old the risk of liver cancer is increased and high hbsag also correlates to liver cancer risk on hbeag negative:

it is best to know hbv genotype, history of liver cancer in the family and precore, bcp mutations

if you want to be very very safe on liver cancer after you know hbv genotype you d best start tenofovir and add peginterferon when hbsag lowers to 1500iu/ml or less or get rid of hbsag definitely

in your case liver cancer is increased because:
hbsag is more than 1000iu/ml (on asian genotypes B and C lower hbsag may be required to lower cancer risk)

genotype C is very dangerous for liver cancer

mutations like precore and bcp, probably present at this age, are at very high risk of liver cancer

you may also just monitor
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Avatar_m_tn
sorry mistake:

and get rid of hbsag definitely because this sequential treatment has a very high percentage of hbsag clearance

you may also just monitor by US every 6 months and fibroscan every year, so if a liver cancer is detected you re on time for resection by this strict monitroing
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Avatar_f_tn
Fibroscan 6.8kPa
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Avatar_f_tn
Fibroscan 6.8kPa
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Avatar_m_tn

it is abnormal but not yet allarming, if it goes at 7kpa it is better to treat at ages over 45-50yo, if it comes out genotype is C it is best to treat indipendently from serum or fibroscan due to the high hcc risk
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Avatar_f_tn
Genotype cant b determined in our country. It s not available here. What should i do ?
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