Hep. B and contraception pill

Dear Doctor,

My wife is Hep. B carrier since birth. Recently she attended a liver specialist who examined her and looked at her preliminary test results. Those showed that all liver function test including ALT were within normal. The doctor then directed her to do the HBeAg, alphafetoprotein and HBV-DNA tests which she did and now she is waiting for results which she will get when she sees the doctor again (November). During the cunsultation we asked the doctor whether it was ok to take oral contraceptive "the pill" which contains estrogen and he said "no problem, she can take it". But on the warnings on the directions for pills, it says that people with significant liver damage should not take it.

Can you please throw some light on this issue?

Thank you

Alex

[Jim759]

Id like the answer to this question also as I am in the same situation.  What we were told though, was that she can take the pill as long as she is not currently taking treatment for Hep. B.  I really would like a second opinion also.

[zellyf]

What kind of doctor?  Gyno or liver specialist?

According to my gynecologist, active liver disease is more of a concern but with an oral contraceptive you do get a first pass through the liver.  What about an IUD which releases low levels of estrogen locally or a copper IUD which doesn't release any?  The estrogen still gets into the bloodstream but at low levels.  According to my gyn this is a better option and my gastro seems perfectly fine with it.

That doesn't prevent me from wondering if its *really* okay but then, I have trust issues :)

[cajim]

Also she is not with significant liver damage at all.  Many HBV carriers have little or no liver damage.