HBeAg- negitive, but high HBV DNA

[person4]

I always thought HBeAg negative means low viro load. But I am HBeAg negative, HBeAb positive, but with a HBV DNA of 2000000 (2e6), ALT 50s, as of now.  My HBV DNA has been fluctuating between 2000000 (2e6) to 80000000 (8e7) since year ago. The whole time I have been HBeAb positive. There is some damage to the liver according a few ultra sounds.  

I first noticed that I had high viro load was about 2 years ago. At that time I was HBeAg positive, ALT at 30s, HBV DNA of 8000000 (8e6). The doctor at the time told me that I was at the immune tolerance phase and refused to offer me and treatment.

I always feel tired right now and there is a constant right chest pain. I am starting to suspect that it could be caused by the HBV. Should I start a treatment? Any advise is appreciated.  

[chiranjeevi104]

Hai Raja

       In Hyderbad fibroscan is available at AIG and other labs.  

[April9903]

raja1972

Thank you for your advice. I'll check  25(OH) D3 test and HbsAg in September when I go to another country. In my country my HbsAg shows only " >1000" not the exact quantity and the test is not available. What worries me all the time is I am 43 years old and I am not on any treatment. I am scared of the prospect of having liver cancer and sometimes I cannot sleep. My doctor here is "good" I think. He is a EASL member and he always travels wherever there is a liver conference. The only problem is he has about 150 patients a day . I see him almost every month and for about 3-4 minutes. But I re-check his decision with stef2011 and it seems to be ok for the time being. Anyway, I will post my results in end September.

Person5
You should make all the test that raja1972 mentioned and the expert members will help you with your results.

[raja1972]

april9903,
your fibroscan and DNA count is going up and it is better to check with a good heaptalogist in your country who has up-to-date knowledge and yes it is treatment time.  You have to check your HBSAG in iu/ml using abbott architecture.  this will help to decide your treatment.  if you are already taking hepatitistech prodcuts then please continue and don't stop.  it will help you to bring down your fibroscan readings from the current level

Person5,
Pls check your HBSAG in IU/ML , take fibroscan and check a good heaptalogist.  YOu can also post your results in this forum and experts like stef2011 can guide you properly

[person4]

Wow, your condition is really samilar to mine, except that I am a male and you are a female, I heard that could make some differences some time. I guess I just got to get a few more done to get a better idea.

[person4]

I am 30 right now, I had HBV when I was 4 or 5. I was HBeAb positive the whole time when I was in 20s. It seems that a couple years ago I turned HBeAb negative for a while then went back to HBeAb positive again now, but viro load had stayed in the 2000000 range for over a year now. Will my viro load gradualy go down over time since I am HBeAb positive again now?

[April9903]

I am also HbeAg- and HbeAb+.
Last year hbv dna was 5000 iu/ml ( Abbott m2000rt Real Time PCR )
alt/ast -- always around 40 to 50
HbeAg -- Negative
ultrasound -- normal
fibroscan -- 3.5 kpa

this year (03-04-2011) hbv dna  38,002 iu/ml ( Abbott m2000rt Real Time PCR ) same lab as last year.


In a different lab on (02-05-2011) :
hbv dan 1,775,100  copies/ml  (Test methodology by COBAS Ampliprep/COBAS TaqMan HBV Test)
Log equivalence 6.25 log
Viral Load (HBV DNA) =  305,000 iu/ml , Log equivalence = 5.48

Total Protein       7.8 gm/dl       normal   6.5 - 8.1
Albumin 4.4 gm/ml       normal 3.5 - 4.8
Globulin 3.4 gm/dl        normal 2.5 - 3.5
Direct Bilirubin   0.1  mg/dl       normal 0.1 - 0.5
Total Bilirubin     0.7  mg/dl       normal 0.4 - 2.0
Alk. Phosphatase 54 u/l           normal 38 - 126
SGOT/AST     53 u/l high 15 - 41
SGPT/ALT 50 u/l high 0 - 44
Gamma GT 13 u/l normal 7 - 50
AFP 4.2 ng/ml normal 0.0 - 9.0
ultrasound   normal
fibroscan     4.2 kpa

Up to now I have no treatment yet. My doctor said my alt levels are not high enough for interferon and he's also not giving me antivirals yet.

For the pain you have, may be you can try hepatitis technologies medicines. I am taking them now.
I remember that one of the members said this medicine helps with her pain.

[raja1972]

You need to immediately check for
(1) HBSAG quantitative in iu/ml - using abbott architecture
(2) HBV DNA - in iu/ml using Real time PCR
(3) Fibroscan to quantify the liver damage - this is the alternative and correct approach instead of liver biopsy
(4) LFT (liver function test)
(5) LIVER ULTRASOUND
(6) Vitamin D 25OH

Based on the results, the forum members will comment on the medications/treatment.

[4est]

before make any decision I suggest to made some more investigation and consider a fibroscan if available in you country or a biopsy.

I don't know the criteria that the immune tolerant phase is recognize, but usually a high viral load, HBeAg positive and no liver damage is correlated to this phase and base on what you say that the viral load drom from 8e7 to 2e6 it can be that you are now in immune clearance phase (this is only a supposition and have to be cheek with a doctor ). Anyway, decision to go or not under medication have to be based also on the liver condition.

Do you have any other HBV DNA or only this 2 ? (first with HBeAg positive and second with HBeAg negative)

What exactly ultrasound detect on the liver ?  - maybe a closer look on this will help because the problems can be related also to some other causes and not exclusively on the HBV.

Regarding the right chest pain (a details location will help) I don't know, usually the liver is not painful, but if the liver is bigger it can causes some pain in the area, but the pain in  right chest can be caused by multiple causes.