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I.l.b.s. delhi (india) suggestion / treatment

60 yrs male
Hbsag +ve hbeag negative  anti hbe positive hbv dna 242iu/ml hbsag 302 iu/ml fibroscan 3,2 kpa afp 2.52ast 28 alt 36  normal endoscopy of abdomen .ct upper abdomen shows flash hemangioma ,widened interlobar fissure early signs of parenchymal disease..
Advice are 1) zevit ( vitamin b and c complement) 2) no Hepatitis treatment needed as of now 3) monitor Alt at 3 months  ,it should not rise above 42 (4) test hbv  dna ,afp ,cbc,lft ,kft at 6 month interval .( 5) do family screening for hepatitis b


57 yrs female
Hbsag   negative  anti hbs ag 5.63 mIu/ ml  anti- HBC Ag  1.54 ( positive) anti hepatitis B envelope antibody - total 0.22 positive
Advice  1) INJ ENGERIX B  1ml  at 0,1,6 moonths intradeltoid 1/M
17 Responses
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Avatar universal
Hello all ,
As per doctor's opinion , we checked sgpt aftr 3 mnths ,it came as 38u/l (ok zone)
After another 3 mnth it came as 76u/l (danger zone)
We rushed to a local available doctor and did the following tests
Hbeag -ve
Hbeab + ve
Cbc normal
Kft normal
Lft normal (sgpt 43.3 iu/l , sgot 29iu/l , just after 1 day )
Afp serum 2.70 iu/ml
HBV DNA QUANTITATIVE  450,000 IU/ML
it also says , internal control -ct value 25.50
Sample ct- value 24.40
I am  worried  for this viral load .( is it possible to rise this so fast , 6 months back it was somewhere 34 then 242iu/ml)

Doctors blamed it on the medicines ,(itrconazole 200 mg) taken for hand infection ,(happened recently).

Appointment at ilbs is in december .
What should i do ?
Is it safe to wait till that period ?
He is on vitamin B &C complex + ursodeoxycholic acid tablets )
Local doctor also suggested for tenofovir .

Please guide .
Regards
Helpful - 0
Avatar universal
I am 34 yr old male.
I am taking Liv 52 HB.
It was detected in 2008.
I have done ultrasound and fibrscan in dec 2015.All is ok.
Fibroscan is 4.0.

thanks
Helpful - 0
Avatar universal
Hi jsoo2 ,
In my limited knowledge you need these things to know ...
Hbsag (quantitative in iu/ml)
Hbv dna
Hbeag
Anti hbe
Fibroscan /biopsy
Ast/alt
Hbv genotype ( to know which type of  antivral meication will suit you )
Vit d level
I will suggest you not to do tests as of now ,,coz your reports are only 3 mnths old and most probably they will do the tests there .
There first a junior doc of mr, sareen will see you and will suggest ,then you will go to sareen ..tests will be afterwards.
In my case endoscopy was done to rule out symptoms of varices etc in intestine/deodenum ,as father was not good in bowl movements for a while .
I guess they normally do a ultrasound or ct scan to get a general picture of liver .
Liv 52 ds by himalaya is a liver tonic , no harm in taking .
Your stay wil depend on the tests prescribed.
In my opinion they will call you again with test results , so any way you have to  come back again .
They might be having skype consultation for nri guys , better ask there .

How old are you ? Male / female ? When did you find out your hbv status ?

Regards
Helpful - 0
Avatar universal
Thanks
I take a appointment for Dr Sarin On 30th March.
My Last result is as below:dec 2015
Hbv Dna:3000 Iu/Ml
HBeAg: 0.24 Non Reactive
Anti-HBe: 0.01 (<1.0 Reactive) Dr Lal Path Lab
ALt:95 U/Lt
AST:43 U/Lt

As per  my doc in BBSR,I am taking LIV 52 twice daily.
I am planning to do the above test again and will take the report with me during appointment with Dr Sarin.

Do they(ILBS) accept other lab report .is it mandatory to do the test only in ILBS.

CT scan and endoscopy are mandatory for all patients or case to case.
Do you recommend to do other test before going to Dr sarin.

I will stay 0nly 1 day (30March) in delhi.Do you feel it is ok or to stay one more day.
In your case you first meet Dr sarin then go for test or vice versa.

Thanks in advance

Helpful - 0
Avatar universal
Hello js002 ,
Dr. Sarin is the most reputed doctor for hep b ,as far as i know and i.l.b.s is a specialized hospital for liver and biliary issues
Opd is open there all days except sunday . For doctor sarin u need to take a prior appointment which comes after 1 month or more .
As far as testing is concerned ,it depends on case to case .
I'll suggest you to come in fasting condition so that if possibe give samples on that day itself .
We took 2 days for ,,,blood test ,fibroscan ,ct scan , endoscopy +appointment .
Litte time saving things that you may do is ,,give blood first cause without kft reports they dont do ct scan , book endoscopy then ,,if you ae administered anesthesia it wll take minimun 3 -5 hrs , then go for ct scan , and at last fibrocan ,as they give report of fibroscan hand to hand .

Few bood report take days to come ,in that case you need to book appointment again ,best is to book on that day itself .
Best part is ,you can see your reports online .
Take care ,god bless you .
Any query is welcome
Helpful - 0
Avatar universal
Hi sorte ,
Yes she was vaccinated 10 yrs back ( 3 doses ) , and recently with a booster dose in novemberr '15 . I am concerned because
1) my father recently diagnosed with hbsag positive .
2) while doing family screening 1 month back my mother had hbsag negative ,anti hbc igm 1.54 ,,,positive  , anti hbe  positive , anti hbs 5.6 negative . I did a test yesterday which shows anti hbs  69.7 positive .
In my limited knowledge it seems that she just recovered from an acute infection . Her anti hbc total was 0.98 . While 1.0 is border for positive .
I just administered 1 vaccine of hep b as told by doctor .

What is your input on this ?
Thanks and best regards
Helpful - 0
Avatar universal
Was she ever vaccinated ?
Helpful - 0
Avatar universal
Hi Ashutosh,
I am staying in Dubai .I want to consult Dr Sarin.
Can u tell me which days, He is available in OPD.
Is it possible to test and checkup in ILBS in one day.

How Dr Sarin is. Is he allow consultation through Email.
Helpful - 0
Avatar universal
Hi , got my mother tested .Her results are as follows -
HbsAg non reactive , anti Hbs  69.64 mIU/ ml  ( greater than 10 is reactive ) , anti HBC total 0.98 ( less than 1 is non reactive) . Vit D- 25 OH  22.84 nmol/l ( less than 75 is insufficient)

Please comment on her status .
What amount of vit d is adviced for her ?
Helpful - 0
Avatar universal
Hello steff , Will there be any problem if i give her vaccine (zenvac -B) right away , instead of waiting for few months ?
Helpful - 0
Avatar universal
just check hbvdna and make her vitd25oh max ofnormal
Helpful - 0
Avatar universal
What makes you say that my mother has recovered ? Is it anti hbe  positive ??
My mother had 3 shots of hbv vaccine 10 yrs back followed by 1 vaccine recently . Why is her hbs ab  still low ? (Wrong vaccine ??)  She had jaundice 11 yrs back .does that relate to anything ? She is not feeling well for last 20 days .can that be due to this acute infection ?  

does my father has any chance to clear this without medication ? What suggest that he is a chronic carrier ?

I'll get everyone in my family checked for vit d ( vitd25oH + intact pth ,as suggested by you ) .

Thank you
Helpful - 0
Avatar universal
Thank you steff ,your advice is always enlightening ,,, i am a big fan of yours .
God bless you for this beautiful duty.
Helpful - 0
Avatar universal
just check your mother hbvdna and if undetectable you can use vit d3 supplements to boost hbsab, in any case since it was acute infection i d not use hbv vaccine and just monitor hbsab by few months, she ll porbably get it higher
Helpful - 0
Avatar universal
hbsag 302iu/ml you can easily clear bby peginterferon, treatment is not needed if you want to keep hbv but if you do pegintf you ll clear it or reduce it so low that it will clear itslef

your mother cleared hbv already, nothing is needed for her, vaccine will boost her hbsab but if hbvdna is undetectable no so important
check her vitd25oh and keep it 60-90ng/ml to prevent general diseases and cancer and keep her healthy from aging diseases, higher vitd25oh may help boost antibodies too instead of hbv vaccine

Her anti hbc IgM is positive 1.54 ,  does this mean an acute infection ?

yes this means acute infection and that she already cleared it
Helpful - 0
Avatar universal
Hi , varsa ,,,thank you . I am visiting dr. Sarin only (supervised by dr. Madhumita) . Could you suggest any thing for my mother (57 yrs female) .which state she is in ?
Thank you
Her anti hbc IgM is positive 1.54 ,  does this mean an acute infection ?
Helpful - 0
Avatar universal
Very good result. Ilbs is best for hbv treatment specially Dr s k satin u r in right direction
Helpful - 0
1 Comments
Sorry Dr s k sarin spelling mistake
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