Just got my first viral load and HBsAg Quantification results, do i need treatment?

[Stone505]

Hello everyone it's really been awhile for me coping with the HBV infection. Please house i just got the result of the first DNA viral load and HBsAg Quantification i did and am hoping the house could help me out here because my doc seems to have a different view of some parameters which i raise during the process of analyzing the result to me. Please here are the details;
HBV viral Load By Real Time PCR............  133  Result (copies/mL),   .........  22.21 Units (IU/mL),  ............ 1.35 (Log), ................ 15 LOD (IU/mL)
HBsAg Quantification by Electrohemiluminiscense .................  27,230  Units (IU/mL)

With these results my doc says i can't commence treatment yet stating that my DNA viral Load is 22 and that it is below 2000 IU/mL. I raise a point to him that my HBsAg Quantification is above 2000 IU/mL, which is 27.230 IU/mL. He said what they look and consider before treatment can commence is the Viral load values and not the HBsAg Quantification. Please house i was not too ok with his interpretation hence i brought it up here to get me more detail advice. Please house i want to know if my doc is right with his conclusions not to commence treatment on me yet, and also i have been having severe abdominal pains for the past seven months now though the pains come and go for few days and resurface again, i have been having the pains most below my right rib cage and behind it too, sometimes on my back and sometimes on my left rib cage too although i am an ulcer patient. Please i need your sincere advice on these and way forward for me too, Stef and Sorte over to you guys thanks.

[Stone505]

Alright, thanks so very much Steven I will wait and believe that my immune system will help out on reducing the level of HBsAg but if one is to ask further what can I really do now medically to reduce the level of HBsAg because am still not too comfortable with the value I have. thanks

[Stone505]

Thanks Airquake, I will be 39yrs come next month. And this is my first DNA test results that I just did since I discovered i am Hbv infected. funny enough I don't even know when and how long I have been infected but got to know about it last year when I wanted to undergo a minor surgery. my biggest challenges now is how to get rid of my abdominal pains and maintain the low DNA and as well try to reduce my HBsAg value.

[Stone505]

Thanks man. I will certainly repeat the liver function test and DNA viral load in 6 months time as even advice by my doc and am planning to go for a liver biopsy soon to know the state of my liver. But I will need suggestions if any on how to try and reduce the HBsAg level and even get an undetectable Hbv DNA without treatment. thanks

[Stone505]

Also am HBeAg  negative and HBeAb positive  Thanks

[Stone505]

Thanks Sorte, i even wonder's so myself because it still beats my imagination too to see or get a result as mine with low Hbv DNA and a very high HBsAg I bet you am still not comfortable but will hops and leave everything to my immune system to help fight this out. But i hope to see or get results fast. So, at this what's your candid advice on ways or how I can get to reduce the high level of HBsAg since I can't start treatment now as stated by my doc. thanks

[Aduiski]

Fibroscan

[Aduiski]

Stone,

Due to high HBsAg and elevated ALT, it would be good idea to check your ALT and DNA at least every 6 months. I would personally check it every 4 months or so if I would be in your place.
Take Fibriscan as well..,

[sorte]

I wonder is there a tight relation between HBsAg count and hbv dna on HBe- ? Above example shows that not always. Stone has high HBsAg and very low Hbv dna but maybe it's just exception.

[StephenCastlecrag]

The level of serum HBsAg is related to the total amount of cccDNA in the liver. At the moment, it is really up to your own immune system to reduce the serum level of HBsAg. Antivirals, by greatly reducing the production of new virions, thereby limiting the re-refurbishment of the cccDNA pool in the liver, may lead to a gradual reduction of cccDNA due to liver cells turnover.
It is believed by some of us that when serum level of HBsAg becomes less than 1,000 iu/ml, parts of the immune system are revived and help to reduce infected liver cells further. All these take time and we cannot predict what will happen. As long as your viral load is very low, liver disease should not progress. You should be happy and wait for a cure to happen.

[Stone505]

Yes my HBsAg is very high and am not comfortable with that so please how can i bring it down? am so worried.

[StephenCastlecrag]

At the moment your own immune system is keeping the HBV under control. To maintain it, you should, like everyone else, eat a healthy diet, regular exercise under the sun, no smoking, no drinking alcohol, and have at least a yearly check up of your hbvdna and liver functions. There is no approved drug to lower HBsAg, except Interferon, but I think your level is too high at the moment.

[Stone505]

Thanks again Steven, my doc suspects same that u stated bile duct by gallstones.. pls how can I maintain or get an undetectable DNA value and a reduction in HBsAg value thanks

[StephenCastlecrag]

Sorry for the pain. We are not doctors here. If the pain is severe and can travel to the back, it may be due to blockage of bile duct by gallstones. You need to consult with your doctor. Within the liver there is no pain receptors, so normally liver feels no pain.

[Stone505]

Thanks Steven, but what do u suggest I do now because am really in pains here from my mid chest to upper and lower rib areas and my back hurts too it has been so for about 6-7 months now. Do u suggest I do a liver biopsy to check my liver? pls your advice will be welcome. And about my Ast  & Alt values are they within range? thanks. Urgent advice is needed on what to do to stop the pains that i feel. pls help guys.

[Airquake]

Stone... Can you give us some background? Age, how long have you had so low DNA count, when were you infected etc. I have low DNA as well, don't know my SAG, no treatment required and my ALT/AST tests are below 20.

[StephenCastlecrag]

I agree with your doctor - the decision to treat or not depends mainly on viral load (hbvdna), ALT, and degree of fibrosis/cirrhosis. Serum HBsAg level is a marker that may be used to predict outcome during treatment or future s-seroconversion. It is seldom affected by oral NUCs, but maybe lowered by Interferon treatment.

[Stone505]

Thanks Royal36 my Ast ..... 34 u/L
Alt ..... 43 u/L
Please are these values too high? and what should I do or take about my abdominal pains? Thanks.

[Royal36]

Yes you have a very low viral load(hbvdna). Would you mind to post your Alt & Ast result ?