High HBV-DNA load always refers to bad health status? How to help?

[Angkori]

Good day doctors,

I appreciate this website and the chance that you offer me to clear my doubt.

My Lab result is as below:

SGOT/SGPT= 24/25
Alb/glo= 4.22/3.11
HBeAg= Positive
HBVDNA= More that 40,000,000 copigs/ml

I do not know when was my infected time, but so far it's more than 15 years that I knew i have it. My health condition is normal, just sometimes my blood glucose down and make i'm vertigo (yet it's temporary only and will disappear after i have sweet and enough sleep). My mother also presents this Ag and she is in normal health as well, while my father has Ab.

I learn that viral loads that exceed 100,000 copies/mL is considered “clinically significant.” So does I have very very high level of virus? Will they harm me?

I'm seeking for your interpretation of that lab result and advices about my health condition. Your further recommendation is highly appreciated.

Best regards,

[Angkori]

You had great advisors! :-( poor me, i don't think i will have chance like you, but i will try. And also wish for the God's mercy just like Steve said, though i understand that we should not depend fully on fortune, but something is still out of our monitoring.

Best wish to you.

[Angkori]

Most of them i've never seen the abbr. Thanks for your information. That's also great things to learn.

Have a nice day!

[Angkori]

Thanks a lot and i hope God will have mercy for my new family too. I wish they all are free from this virus. I understand HepB is HepB and well noted that there is no double HepB. Of course, the best way is to consult with doctor, but as you may know, health system in lease developing country is not effective. For some reasons, doctor consider money as priority. I wish for the good chance for me in the future to have good doctor to consult, plus i will have to search for this education by myself.

Of course i hope i will be able t share my knowledge to the community, when i further learn more things about this, especially, when i experience it myself, then i will be able to prove about my case. This is really a study that i should do in my life.

Last but not least, again, thank you very much Steve for your great knowledge and advices. Keep in touch and i hope i will see you again later in this forum to discuss further about my case.

God blesses you!

[Angkori]

That's such a useful experience for me. I understand you were pregnance in inactive stage, so that all your kids are fine. I will learn my case more, and i will post my real case for further study when i get married and have children. Thanks for your sharing to me and i hope we will talk again about this later.

Good luck.

[zellyf]

Steven makes an excellent point about running all of this past a doctor first which I probably should not have assumed would be done.  I was under the care of an OB and an internist specializing in infectious disease and a pediatrician aware of the virus.  It was only after consulting with all three and a phone consult to a hepatologist at Stanford that I was given the go-ahead to breast feed (though I think its a pretty standard 'ok' now).  Things are constantly changing in the field so what was true for me 3 years ago may not be true anymore.

[tahoeunicorn]

Here is a link to a previous post with the abbreviations that are used in the Hepatitis Forums.
Everyone is right. The more knowledge you have of your disease the less scary it becomes.  

http://www.medhelp.org/posts/show/95114

Good Luck

Tahoeunicorn

[stevenNYer]

Anything that have to deal with HepB, treatment, and babies, I would rather you talk to your doctor.  Don't get ahead of yourself, just know that the odds are very very much in your favor that you  and baby will be fine.

But in general, doctors don't like to give you meds (including antivirals for HepB) during a pregnancy, especially during early trimesters.  But I think doctors favor the anitviral, Telbivudine if need early in the pregnancy.  During last month or two, other options may be available with the goal of just reducing viral load for delivery.  So just start this discussion when the actual time comes.

Re: if your future husband already have HepB.  Then, he need to monitor his disease as well, and it doesn't change anything.  You can't get double HepB.  HepB is HepB.

Dx = diagnosed.

And if this makes you feel better.  I probably had HepB since early childhood, never knew, then married, had kids, and they are all free of HepB by chance.  What can I say, God has mercy for stupid people like me :)  They all have since been vaccinated.

I hope when you folks get more educated, you will be regulars on this forum to support the next anxious person newly diagnosed looking for answers.  When I was new, it was "jboyhk", hoping that you will be next to help build community and support for HepB individuals.

[zellyf]

I was 28 when I had my first child.  I was diagnosed (dx) during the standard pregnancy screen when they check for such things.  It was a tremendous shock.  I don't know for certain when I was infected but it seems safe to assume that I contracted HepB as a child in Viet Nam.  My mother was tested after my diagnosis and she was negative so I did not get it at birth. I suppose I could have acquired it as an adult but it seems less likely.

In the 9 years since my diagnosis my DNA has been at undetected levels and thus I was considered to be inactive.  It has only in the past few months risen above that level. I have not yet received treatment.

The two injections were the HepB vaccine and a gamma globulin.  All three children had them.  I breastfed all of my children and had their titers done after weaning them (well, I haven't quite weaned the last one but we won't count that). They are fine and they are protected from the virus.

I don't know what changes if you are in an active stage of the disease.  That would be  good to find out but my understanding is that even with active HepB the real concern is not a transmission in utero but upon delivery when there is a lot of blood and skin trauma creating the perfect storm for transmission.  The two shots proves to be over 90% effective in preventing the transmission.

Best wishes!

[Angkori]

I hope my case and questions let everyone (who need help) have more knowledge about HepB. Thanks for all your kind sharing to me and to people who is seeking for consultation and advices here.

[Angkori]

Thanks for sharing me your experience. It's valuable for me and i learn that there's at least a family with the mother with HepB and the others are safe.

Could you let me know at around what age you give birth to your first baby, and if you got HepB since your birth? What is the max viral load that you had and the viral load during your pregnant? What treatment you took that make the virus DNA undetacted in your body?

What are the 2 injections doctor gave to your baby within their birth 12h? did all you littles get those injections? Did you feed your babies with your milk?

What does dx mean?

I wait to hear from you at when you could manage time to reply me.

I wish i have good luck like you.

Thxxx

[Angkori]

Steve, you are likely an expert rather than an experience patient. It's my luck to meet you here and get your advices. Of course, i feel quite release after i after talking and learning knowledge and experience from you and others here. Thxxxx... you are really a very generous and helpful person. I also wish one day i will have good experience or knowledge to share in this forum too.

As per your explanation, this is the case of my future's spouse is not HepB. How about if he is HepB as well? Will this case make thing more severe? How about the effects on my future baby? Any chance my future baby is negative?

Does this virus also contain in milk? Should the mother HepB feeds the born baby with her milk?

The medicine you said to be injected to baby within 12h from birth is HepB vaccine?

Could we use anti-virals during pregnant? Any toxic to the foetus?

I wish i will be the last person of my family that contain HepB as i don't want to transmit it to next generation and also don't want this virus spread up in next human generation, while scientists haven't found the drug to cure it yet.

Wait to hear from you at your convenient time. and also appreciate for other who have comments about this.

Thxxx

[stevenNYer]

Thanks for the referral...commission is in the mail :)

[zellyf]

I was hoping steven would give you an answer.  I want to add that I have chronic inactive HepB and I have three healthy little ones.  Knowing that you have HepB is key.  Had I not known the results could have been much different.  They had two injections shortly after delivery (within 12 hours).  They do not have  HepB and responded to the vaccine so they are protected.  I was encouraged to nurse them and did.  They have had their titers done to check for the virus and they do not have it and in fact are protected from it by the 3-part vaccine.

Every situation is unique (I had undetected DNA when I was given the greenlight to have more children)  but I assure you that there is lots of life and love with HepB.

My husband and I were married for a few years before my dx.  I certainly had the virus the entire time we were married.  He was negative for the virus and has since been vaccinated.  

Best wishes to you.  It is not an ideal situation and there is fear and sadness at times but it is not a hopeless situation by a long shot.  You can do this.

[jmjm530]

Your HBV knowledge might be helpful here: http://www.medhelp.org/posts/show/414382

[stevenNYer]

HepB is very common, especially in Asian countries.  Many people have HepB, they just don't know it.  Many find out by accident, including myself.  If it wasn't for one specific incident, I still won't know I have HepB.  So you type of case is quite common.

So once you become educated on HepB, it's less scary.  And if your future spouse is educated on HepB, it's unlikely that he would refuse you.  Such as, if he doesn't already have HepB and is not immuned, he should get vaccinated and chances are will become immuned to HepB.   And when it's time to deliver a baby, the baby will be given shots at birth that will prevent (with an above 90% success rate) him/her from getting HepB.  So if you are educated, chance are you will be last and only person with HepB in your new would-be family.  And with monitoring and treatment if needed, chance are you will live a full life and die of something unrealted to HepB, hopefully naturally from old age.

Now I think most doctors don't treat in the immune-tolerant stage is because your viral load is gigantic.  Without an immune response and relying soley on antiviral meds, the virus will have greater adaptive power, meaning that they could develop resistance to the antiviral meds.  That would be bad.  Again in this stage, little liver cell injury is occurring.  (Actually, going back to the previous point, I think this is the best time to have a baby because you are not on meds.  And some doctors treat at the final month or 2 of the pregnancy to decrease the viral load to further minimize the risk of transmission...make sense?)

Feeling sad and depressed is normal when you first find out.  Ask anyone here on this forum and they will tell you a similiar experience.  Once you get educated, you will feel better.

And lastly I going to include this in my post:  For HepB individual asking questions, please do post a reply to indicate that you are reading my response so I know I'm not wating my time.  Often times people ask a question and I never hear from them again.  I don't want to waste my time looking for and checking the post.  It does take time to do this.  And I do this to give back to this forum because I learned so much from here when I was newly diagnosed.

[Angkori]

Thank you very much for you precious information. It makes me much clear about the disease and my health. I understand that now i'm in the period of immune-tolerant stage, and i will have to monitor my health always.

I feel a bit relieve but i still always worry of my health in the future. I'm not yet married, and i'm afraid my future groom will refuse me when he know about this, and should i give birth to baby. Do you think i should seek for treatment at this stage or wait until i be sick? Is there any medicine/ method that can cure this disease, you know?

So far, have you ever known anybody that has the same case as me, and how are they at the moment? How old can they live?

Sometimes, i feel hopeless when i think i have this virus. I'm scare of the descrimination, and thus i've never let anyone know beside my family. But when i think too much, i become depressed and sick.

Again, thanks for sharing me your appreciated experience, where i don't think i could find from any other sources.

God blesses you!

[stevenNYer]

Firstly, for the most part, this is a patient to patient forum.  Like myself, most individuals who respond are not doctors but people who unfortuately have some type of hepatitis.

What you described is consistant with someone who was infected at birth.  You are probably in the immune-tolerant stage, where the virus replicates alot but your immune system ignores the virus and there is little liver cell injury (hence your normal range ALT).  Most doctors don't treat in this stage.

Eventually you will enter the immuno-clearance stage (usually 30-40 years old) where your immune system finally recognize the virus and attacks, this is where you get liver cell injury (high ALT).  Most doctors will treat at this stage to give your immune system a little help in battle.  And if all goes well, you become an inactive carrier.  But you still need to monitor for disease re-activation.  

Whether you treat or not.  Also higher viral count is correlated to higher incidents of liver cancer.  So you should definately monitor your HepB.  Hope this help.  Good luck.