Years before I got tested for both hbsag,hbeag and found them to be positive as mentioned in the reports. But my hbv dna was less than 100 iu/ml that's why the doctor insisted me not to start treatment at that point of time.Last year I again tested for HBV-DNA and found it to be 1070 iu/ml(LFT reports being normal).It has been from that time only(about 11 months ago) I have been on antivirals and got tested for hbeag and hbv-dna yesterday.
My report states HBeAG=Non-reactive(0.361 Index).
[Index =1 means reactive].
Does that mean my HBeAG has turned negative(from positive) or does it mean it's positive but non-reactive?Do non-reactive and negative mean the same?I am getting confused.My HBV-DNA and ultrasound results are awaited...
You have asked a very broad question, I am not an expert, I will give you my opinion.
The status of HBeAg is important because it allows doctors to determine what phase of HBV infection natural history the patient is in. As each phase has its characteristics, we have an idea what the patient has been through and where it may go.
For example, if you have very high viral load, but if your HBeAg is positive, you are likely to be in the Immune Tolerant/Clearance phase, need for treatment will depend on age, ALT, and fibrosis etc. However, if you were HBeAg negative, then most likely you are in the Immune Escape phase and treatment is indicated. These are very broad assumptions, other factors must be considered.
Generally,status of HBeAg also plays a role in deciding when treatment may be stopped.
My view is this: if you are HbeAg negative and HBeAb positive naturally, then you should be in a low replicative state as your immune system is keeping the virus under control. However, if you are HbeAg negative, mainly because you have a high population of hbv virus that have mutated to a form that does not produce HBeAg, then the virus has escaped Immune control, and treatment is needed.
Thank you Stephen, I was looking my test where it says hbeag nonreactive, but I am having my viral load going low from 905 iu/ml last year, now 225 iu/ml and alt,ast normal. I am trying to understand what phase i am. No treatment. Thank you again
Thank you Stephen for your reply.Actually I got confused regarding the index value of hbeag.My index value for hbeag is 0.361(non-reactive).If I stop taking antivirals does it have any chance to flare up in the future?
Stopping antiviral treatment is tricky. The guidelines stated that first your HBeAg must be negative, HBeAb positive. Then your viral load should remain undetectable for at least 12 months or more, the so called consolidation period. Research indicates the longer the consolidation period the better outcome after stopping. New research indicates qHbsAg would also be a good indicator. If you follow these rules, the success rate of staying inactive is about 30%. The key point is that close monitoring after stopping is important, and an initial flare up after stopping maybe transient. Guidance from an experienced doctor may be very helpful.
I admire you guys,steff, veteran, rome, that you have knowledge about hbv, and gave advice to people like us,giving important facts that even some doctors don't know. I am going to change my doctor,he is gastroenterolog but not expert to hbv. Unfortunately i don't know hbsag quantity ,here in usa is not their practice, i am going to do it in summer in europe. One more question: Do the people in inactive phase has symptoms? I feel sometimes pain in liver side,back pain,itchy in hands,gurgling in my stomach,feeling tired and sleeping a lot, i heard is it is our symptoms.Or could be something else? Anyway thank you to share your opinion.
Please remember, we are not doctors nor expert, so treat our comments with the usual caution and skepticism.
If your are in America, the Hepatitis B Foundation (HBF) website (hepb.org) has a directory of liver specialists, it is worthwhile to have a look. Liver specialists in America are aware of qHBsAg and do use it in their research. However, they think it is not yet ready for "prime time". That is a moot point.
Chronic Hepatitis B usually has no symptoms unless your liver functions are abnormal. Most patients complained of a dull pain in the upper right quadrant, but doctors have no satisfactory explanation as there are no nerve cells in the liver. However, some believe the sac enclosing the liver does have nerve endings and can cause pain when the liver is inflamed.
As for being tired, some of us do suffer from depression (from thinking too much about our illness??), feel tired and sleep a lot.
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