Hepatitis B Results

Please help i am kinda paranoid with my Hepa B results. Kindly interpret my results. I got this results two years ago. Thank you.

Sgot (AST) -  17.2 u/l
sgpt (ALT) - 38.4 iu/l
alk-phos - 155.8 u/l

Hbs AG - 646.7 Reactive
Anti Hbs - 3.56 Non Reactive
Anti Hbe - 5.61 Non Reactive
anti hbc lgG - 0.012 Reactive
anti hbc lgM - 0.080 Non Reactive
HbeAG - 1554 Reactive
Hbvdna - 547021120 copies/ml (93989880ui/ml)

[cajim]

You have HBeAg+ HBV with normal liver function.

Are you taking the conventional, Western-medicine route or some other route?

If the former, according to AASLD Hep-B Guideline 2009 Update,

If you are HBeAg+, HBV DNA (PCR) >20,000 IU/mL ALT 40 years, ALT persistently high normal-2x ULN, or with family history of HCC.  Consider treatment if HBV DNA >20,000 IU/mL and biopsy shows moderate/severe inflammation or significant fibrosis.

If you are HBeAg+, HBV DNA (PCR) >20,000 IU/mL ALT >2 x ULN, then, observe for 3-6 months and treat if no spontaneous HBeAg loss.  Consider liver biopsy prior to treatment if compensated.  Immediate treatment if icteric or clinical decompensation.  IFNa/pegIFNa, LAM, ADV, ETV, TDF or LdT may be used as initial therapy.  ADV not preferred due to weak antiviral activity and high rate of resistance after 1st year.  LAM and LdT not preferred due to high rate of drug resistance.  End-point of treatment – Seroconversion from HBeAg to anti-HBe.  Duration of therapy: IFN-a: 16 weeks;  PegIFN-a: 48 weeks;  LAM/ADV/ETV/LdT/TDF: minimum 1 year, continue for at least 6 months after HBeAg seroconversion; IFNa non-responders / contraindications to IFNa -> TDF/ETV.

If you are HBeAg-, HBV DNA (PCR) >20,000 IU/mL ALT >2 x ULN, then, IFN-a/peg IFN-a, LAM, ADV, ETV, TDF or LdT may be used as initial therapy.  LAM and LdT not preferred due to high rate of drug resistance  ADV not preferred due to weak antiviral activity and high risk of resistance after 1st year.  End-point of treatment – not defined.  Duration of therapy:  IFN-a/pegIFN-a: 1 year; LAM/ADV/ETV/LdT/TDF: >1 year; IFNa non-responders / contraindications to IFN-a -> TDF/ETV.

If you are HBeAg-, HBV DNA (PCR) >2,000 IU/mL ALT 1- >2 x ULN, then, consider liver biopsy and treat if liver biopsy shows moderate/severe necroinflammation or significant fibrosis.

If you are HBeAg-, HBV DNA (PCR) <=2,000 IU/mL ALT 2,000 IU/mL—Treat, LAM/ADV/ETV/LdT/TDF may be used as initial therapy.  LAM and LdT not preferred due to high rate of drug resistance; ADV not preferred due to weak antiviral activity and high risk of resistance after 1st year.  HBV DNA6 months; 2. Serum HBV DNA >20,000 IU/mL (105copies/mL), lower values 2,000- 20,000 IU/mL (104-105 copies/mL) are often seen in HBeAg-negative chronic hepatitis B; 3. Persistent or intermittent elevation in ALT/AST levels; 4. Liver biopsy showing chronic hepatitis with moderate or severe necroinflammation.

Inactive HBsAg carrier state: 1. HBsAg-positive >6 months; 2. HBeAg-, anti-HBe+; 3. Serum HBV DNA 20,000 IU/mL after a 3-6 month period of elevated ALT levels between 1-2 ULN, or who remain HBeAg positive with HBV DNA levels >20,000 IU/mL and are >40 years old, should be considered for liver biopsy, and treatment should be considered if biopsy shows moderate/severe inflammation or significant fibrosis. Patients who remain HBeAg positive with HBVDNA levels>20,000 IU/mL after a 3-6 month period of elevated ALT levels >2  ULN should be considered for treatment.
HBeAg- patients:
● HBeAg-negative patients with normal ALT and HBV DNA <2,000 IU/mL should be tested for ALT every 3 months during the first year to verify that they are truly in the “inactive carrier state” and then every 6-12 months.
● Tests for HBV DNA and more frequent monitoring should be performed if ALT or AST increases above the normal limit.

Side effects:

IFN-a and PegIFN-a:  initial influenza-like illness: fever, chills, headache, malaise and myalgia. Other common side effects include fatigue, anorexia, weight loss and mild increase in hair loss. The most troublesome side effect of IFN-a is emotional lability: anxiety, irritability, depression and even suicidal tendency.

Lamivudine:  very well tolerated.

Adefovir Dipivoxil (bis-POM PMEA, Hepsera):  Nephrotoxicity has been reported in 3% of patients with compensated liver disease after 4-5 years of continued adefovir therapy.

Entecavir:  a similar safety profile as lamivudine in clinical trials.  Studies in rodents exposed to doses 3 to 40 times that in humans found an increased incidence of lung adenomas, brain gliomas and HCCs.

L-deoxythymidine (Telbivudine/LdT, Tyzeka):  well tolerated when used as monotherapy and has a safety profile comparable to lamivudine.   However, cases of myopathy and peripheral neuropathy have been reported.

Tenofovir:  has been reported to cause Fanconi syndrome, renal insufficiency as well as osteomalacia and decrease in bone density.

[mitch12345]

what do you mean by HBeAg+ HBV with normal liver function?. Sorry I am not that familiar with medical terms. please help. i haven't even seen a doctor yet coz i don't feel any symptoms. By the way i am already 23 y/o female from Philippines. Thank you very much.

[stef2011]

do not start any therapy because you are immune tollerant, the best state of hbv with no liver damage, if you start therapy and immune system reacts it leads to liver damage

check liver damage by fibroscan or biopsy to confirm immune tollerant state, all drugs are useless in your state and will start liver dmage if you take them

[cajim]

what do you mean by HBeAg+ HBV with normal liver function?

--You are at stage 1 of 4 stages.  Regular monitoring till HBeAg goes negative.  Then hopefully you become very stable and become a healthy carrier.  Live liver-friendly.

[stef2011]

Anti Hbs - 3.56 Non Reactive

i din t notice this but most of the assays are useless in quantification and numbers don t reflect real antigens antibody state so probably all i say is wrong but check if 3.56is in miu/ml unit or remake these tests by abbott architet and also hbsag by same assay in iu/ml

if it turns out that:
antihbs 3.56miu/ml
hbsag decreasing made by iu/ml unit
hbeag decreasing made by PEI unit

you are close to seroconvertion and if hbsag decrease you are getting rid of infected liver cells, after hbsag decreases and antihbs increases also hbvdna gets down

[mitch12345]

thank you very much.. i really appreciate your answers.

[mitch12345]

Hi stefano,

what do you mean by seroconvertion? is that a very serious case?

[iphone2539]

guys this is my latest result hope someone will interpret this for me..THANKS

BLOOD CHEMISTRY

   alkaline phosphatase              89.81             less then or equal to270U/L    
   SGOT                                   13.20             less than or equal to 40U/L
   SGPT                                    7.44              less then or equal to 40U/L

HEPATITIS PROFILE

  HBsAG                                 2,378              REACTIVE
  ANTI-HBs                                2.0               NON-REACTIVE
  ANTI-Hbe (reverse)                  1.05               NON-REACTIVE

HBV DNA VIRAL LOAD (REAL TIME PCR)

   result:    HBV DNA DETECTED LESS THAN 6 IU/mL

   remarks:    HBV DNA DETETCTION 6-110,000,000 IU/mL

note:   rest test are normal

please guys interpret this for me..