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Please Help my Labs test
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Please Help my Labs test

Albumin 4.2/ Alk Phosphatase 52/ Protein Serum 8.4 /. SGOT(AST) 24 / SGPT ( AlT) 44
HBV, DNA , PRC 2.0 (A)
(A) interpretive information: Hep B virus DNA quantitative , Real time PCR
The quantitative range of this assay is 1.3-8.2 log IU/ ml ( 20 -170,000,000 IU/ ml)
HBV Ultrasen Detected
Anti-HBE positive
Hepatitis Be Ag negative
HBV IU 110
I was on baracldue for 1 year this is my recent lab test. Now doctor wants to put me on Viread  because I am 12 weeks pregnant . Should I take Viread.
Your questions are not easy to answer for most of us here are not doctors. I copy information from the July HBV Review by Christine Kukka from hbvadvocate.org. It would seem to me that you can either stop or switch to Tenofovir. Please do consult your liver specialist and obstetrician. Congratulations and all the best.

Experts Describe When to Treat Pregnant Women with Antivirals
Two U.S. hepatitis B experts have crafted guidelines for doctors to use when deciding when to treat pregnant women infected with the hepatitis B virus (HBV) with antivirals in order to safeguard the women's health and prevent infection of newborns.

More than half of new hepatitis B infections result from mother-to-child (vertical) transmission and despite immediate immunization and administration of HBIG (hepatitis antibodies), about 30% of infants born to women with high viral loads become infected. Additionally, women who want to become pregnant may already be treated with antivirals because of liver damage.  There is little medical guidance on whether treatment is safe over the entire pregnancy.

Does pregnancy worsen hepatitis B? Generally it does not unless the woman has cirrhosis (severe liver scarring.) Studies show a pregnant woman's viral load generally does not increase over a pregnancy, but after the baby is born and the woman's hormone levels change (akin to a sudden decline in steroids), some women experience a "flare" and their alanine transaminase (ALT) levels may increase due to moderate liver cell damage. Because of these flares, doctors must monitor new mothers carefully for several weeks after childbirth.

When should pregnant women be treated? Starting in the second or third trimester of pregnancy, antiviral treatment is recommended when women have high viral loads—exceeding 1 million copies per milliliter or 200,000 international units per milliliter. However, if women are already receiving antiviral treatment when they become pregnant, treatment should probably continue over the pregnancy to prevent worsening liver disease.

Which antivirals are safe to use during pregnancy? The experts recommend tenofovir (Viread) in the event the woman continues to need antiviral treatment because this drug has a very low rate of drug resistance, or telbivudine (Tyzeka). Both have been shown to be safe and cause no birth defects when used in pregnant women infected with HIV or HBV.

What if women have elevated ALTs before becoming pregnant and have never been treated? The experts recommend these women should be treated with antivirals (not interferon), and if possible their viral load should be reduced through antiviral treatment before becoming pregnant. Their liver health should be monitored carefully during the pregnancy.

What about women with normal ALTs and high viral loads? Women in this immune-tolerant phase of infection should be monitored carefully during pregnancy and should be given antivirals during their second or third trimester if they:

    Continue to have viral loads exceeding 1 million copies per mL
    Have already had a child who became HBV-infected
    Or if they experience premature labor.

Is it safe to use antivirals during the entire pregnancy? If women have been using antivirals, or require treatment because of liver damage (ALT flares) during pregnancy, antivirals should be used to safeguard the women's health, according to the report published in the June issue of Seminars in Liver Disease. They recommend using tenofovir in this situation, because it is fast-acting, potent, and has no record of causing birth defects.

Monitoring after delivery: Because of the risk of hepatitis flares after delivery, and after treatment stops following delivery, the new mother should be monitored every four to six weeks for at least 12 weeks after antiviral treatment stops.

Can a woman taking antivirals breastfeed? Trace amounts of the antiviral have been found in breast milk, so experts do not recommend breastfeeding if antiviral treatment is ongoing.

Source: "Antiviral therapy for chronic hepatitis B in pregnancy" by Pan and Lee.Semin Liver Dis. 2013 May;33(2):138-46.
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