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I NEED ANSWERS
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I NEED ANSWERS

I first diagnosed with hep b in 1999, I had a liver biopsy that same year, the doctor said my liver was fine and that my blood work shows reversal of surface ag, so for over ten years I didn't worry about it, then I went back in 2012 to make sure my condition didn't change, my lab results in 2012 was Hbsag+, Hbeag-, Alpha Feto Protein was normal, Hbv DNA was undetected, Ultrasound is normal, I have the same results for the last four years. So what do you guys think? thank you
11 Comments Post a Comment
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Avatar m tn
I guess your ALT was allways bellow 35 if you are a male?
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Avatar m tn
Thanks for your response, yes I am a male, but the doctor never ordered ALT test, for the last four years io only do hbsag, hbsag, hbv Dna, AFP AND Ultrasound, that's all he wants
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Avatar m tn
Thank you for your response, yes I am a male, my doctor never ordered ALT test
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Avatar m tn
It seems that at the moment your immune system is controlling the virus very effectively.

Im addition to what your doctor is doing I would add ALT every 6 months and fibroscan once every year.

Hep B for some people tends to start active around the age of 40 (time when our immune system starts to slowly weaken), so when u get around that age you might start to monitor DNA, AFP and ultrasound also every 6 months.
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17779239 tn?1460018074
agree with Aduiski (why even do a biopsy at first place?), ALT/AST, γ-GT, every 6 months + fibroscan once a year, i do ultrasound once a year also, just to be sure, AFP is not specific for hepatocellular carcinoma.
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Avatar m tn
Thanks guys, the biopsy was done in 1999, so all these years I never took any medication or even worry about it, but now that I'm getting older and learning more about this disease, that's why I went back to the doctor in 2012, I guess I have to insist on AST/ ALT and fibroscan to the doctor, it's sad but I don't think some of these doctors are very knowledgeable about this disease
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Avatar m tn
As you just crossed 40, if you want to be extra safe you can schedule appointment with a liver specialist every 6 months, and few weeks before each appointment do the following tests:

- DNA
- ALT (liver function tests)
- Ultrasound and AFP (this is for liver cancer screening that all of us do)

Once per year you can do Fibroscan,

So long your results are in following range:
- DNA bellow 2000 IU
- ALT less then 30 IU
- Fibroscan less then 6 kPa.
- AFP and ultrasound should be normal
then you are in excellent shape.
If one of these (sometimes in future) returns irregular then you could follow your virus more closely - do DNA and ALT tests every 3 months...and if the virus then keeps causing damage then you simply start taking a medicine (tenofovir or entecavir) that are nowadays very developed...but based on the results you have so far it seems you don't need them now.
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Avatar m tn
Thank you so much, the doctor I'm seeing now is a liver specialist, my family doctor referred me to him, I will have to suggest all this to him
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Avatar m tn
When diagnosed with HBV as an adult and without any history, a biopsy is a reasonable way to find out about the state of the liver. Fibroscan was not available then. AFP is not specific for HCC, but it is still sensitive and is still widely used as a marker for liver cancer. ALT is always part of the liver function panel.
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Avatar m tn
Thanks Stephen for your insight, I will go for the ALT test today
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Avatar m tn
Generally with hbvdna undetectable or very low (less than 2,000 iu/ml), the person is not very infectious and also ALT is  expected to be normal. This is because the amount of hbv virus in the blood is low (and even lower in bodily fluids) and according to some scientists, some of these virions may also be coated with HBsAb.
Because we don't measure our hbvdna daily, there may be periods when the hbvdna is high and causes inflammation(high ALT), so it is good idea to check ALT regularly(it is a much cheaper and fast test).
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