Hepatitis B active

I am a 71 years old man.  My blood test reports are as follows.
Hipatitis B Surface Antibody QL: Non-reactive
Hipatitis B core AB Total: Reactive
Hipatitis BE Antigen: Non-reactive
Hipatitis BE Antibody: Reactive
Hipatitis B Surface Antigen: Reactive
Hipatitis B Viral DNA
  HEP B Viral DNA IU/ML: 213000
  HEP B Viral DNA COPIES/ML: 589632
What tests should I have next?
I live in Vineland, NJ.  Please help me to find a hopatologist.

[stevenNYer]

Given your age, HepB antibodies, antigen status, you were probably an e-antigen negative chronic inactive Hep B.  

Over the years, the virus may becomes ACTIVE again due to natural mutations in the core area of the virus.  Given your high DNA, this could be the case.

You could ask your MD to do a genotyping test to determine if you have a mutant HepB strain.

Also you should monitor your ALT / AST level to determine if you have active liver cell damage.  If so, ask your MD about COMBINATION antiviral therapy.

Also you should screen for liver cancer by AFP (blood test) and liver sonogram.  Hope this helps.

Please discuss these things with your MD since we are not doctors.

[jboyhk]

I disagree slightly. Being your DNA count is over 100,000 , you would probably be considered a pre-core mutant . That is when you are Eantigen neg and have a DNA count over 100,000.

Luckily there is a brand new drug due to come out that is very good in handling this situation. Its called Viread (Tenofovir).

You are close to NYC where some of the top heptologists are so make use of them.

[stevenNYer]

I agree with you.  I think bloh was an e-antigen - inactive before.  But since he's 71 yo, he probably has some sort of core mutation and has now active HepB.  I think it's probably the core-promoter instead of the pre-core.  I remembered that HepResearcher once indicated that core promoter mutation eventually occurs in like 50% of e-antigen - patients.

Good to see your post.  I value your insight and information.  Since I don't see HR posting anymore...HepB threads need more good people.

[jboyhk]

http://depts.washington.edu/hepstudy/hepB/mgmt/hbsag/discussion.html

Found this site which is probably what HR was talking about.

To be defined "Chronic Immune Active HBV (Precore and Core Promoter Mutants)"

the lab profile would be


HBsAg positive longer than 6 months
HBeAg negative, anti-HBe positive
Serum HBV DNA greater than 10^4 copies/ml
Persistently elevated or intermittently normal hepatic aminotransferase levels



So a count over 10,000 cp/ml and elevated AST/ALT tests would be needed.

Its interesting tht you would be classified as Inactive Carrier if you have less than 100,000 cp/ml if you always have normal ALT levels

[stevenNYer]

Yes, it would be interesting if bloh post his or her ALT / AST levels.  My guess is that it's probably be somewhat elevated.  But it also indicates that it could  intermittently normal hepatic aminotransferase, so I'm thinking the levels could be within range and sometimes out of range.

Maybe that's why my MD told me he focuses more on the DNA count for e-antigen negative patients.

[africanboyz]

am 31 years old my recent dna  copies 834687 copy\ml
hbv dan 143417 iu\ml
what should be my line of action,
AFRICAN BOY

[cajim]

1.  Best to start your own thread.

2.  Your HBeGa, HBeAB, ALT and AST?  Symptoms?