Questions about Hep B and Reading Results

[KimGG]

Hello All,

I'm a 32 year old female with chronic Hepatitis B.  I just found out last month.  I had no idea I was carrying this.  I was told that it was probably passed on vertically.

As I've read through all the posts on Hep B, everyone here seems to be pretty knowledgeable, so I'm hoping you'll be able to answer some of my questions.  

I took an initial Hep B test and it came out:
HBsAg:          Postive

I then took more tests and talked to a doctor.  Actually to a physician's assistant (PA) who is actually qualified to diagnose and prescribe medication.  I go to a very good GI/Hep doctor, but he is always in surgery or at the Hospital, so he has a medical assistant.  She didn't seem to check for everything from what I can see, but maybe she knows what she is looking for.  I'm a little nervous because she isn't the doctor.  She took more blood tests because of very high ALT levels and very high HBV DNA levels.
This is what is written:

Ultrasound Results:  Hepatic size, configuration and parenchymal echogenicity are normal.  No hepatic lesions are identified.  Conclusion:  Normal examination.

Hepatitis BE Antibody:     Reactive
Hepatitis Bc Antigen:       Non-Reactive

AST:    178 H
ALT:     324 H

HBV DNA (IU/ml)       1,948,900 H
HBV DNA (Copies/mL)   11,300,000 H

I'm sorry if these questions seem simple.  I am very new to this and I would like as much information as possible before I meet with the PA again next week.  I felt so helpless the last time and had no idea what to ask.  Here are my questions if you can answer them.  Thank you in advance.

1)  My ALT seems to be super high.  I am so scared that this is doing a lot of damage overnight to my liver.  Will I start to develop cirrhosis/cancer soon?

2)  In general, what will my treatment look like, so I know what to ask and question?

3)  I know everyone is different, but approximately how long will treatment take before the viral load and ALT goes down?

4)  I am 32 years old.  Will I need to take this for the rest of my life?  

5)  I have read so many positive things about treatment of chronic HBV and being able to live a full and healthy life.  I've also watched videos of some professors/speakers on HepB.org and it doesn't seem that promising, although their website says it is.  As you can imagine, I am terrified.  I am married, almost 2 years now, and would like to have a baby soon.  Will I be able to have children and more importantly, will I live a long enough life to to watch my children grow old and do all the things that parents want to do with/for their children?  All I can think about is not living long enough to do that.  I also feel badly for my husband who is a lot more positive than I am.  I know this is a loaded question, but also, how badly off am I that I might not be able to respond to treatment and stay healthy?

6)  I've not done a lot of research, but in your opinion, do you think that they will find a cure someday in the near future or is it almost impossible?  A video that I watched of a doctor on HepB.org said it was almost impossible.

Thank you for your responses.  This forum has answered so many questions for me and I am so appreciative.  You are all so positive and it keeps me positive too.

-Kim

[stef2011]

conisder that for the most it is benign illness, only 5% develop cronic hbv as infected adults and only 3% gets active disease with liver damage, all the others have no illness and no liver damage

[satimis]

Hi,

> I realize that having hbv is a roadblock, but not the end of the world

Absolutely no.  A chronic Hep B carrier can live in normal life, not being alone in desperation.  There are people worldwide willing to help the carriers without reserve.

However we must observe that Hep B is highly infectious disease.  Up to the present movement there is no cure.  We must act in concern to stop it spreading otherwise we will really approach to the end of the world.


satimis

[KimGG]

Thank you so much for all of your responses.  You are all so knowledgeable and I am greatful for your replies.  I will be meeting with the doctor next week to talk about what's next for me.  I don''t feel as helpless and hopeless anymore.  I realize that having hbv is a roadblock, but not the end of the world. :-)

[satimis]

Hi KimGG,

Following thread is for your reference.
http://www.labtestsonline.org/understanding/analytes/hepatitis_b/test.html#what

Please refer to;
What does the test result mean?

B.R.
satimis

[cajim]

In reply to your questions about my high ALT and AST, I actually haven't had a drink in over a year (I wish I knew a long time ago so that I would've never had a drink in the first place.) and I don't do drugs.  This bloodwork was done at the end of June.  I did just realize that I had been going to a acupuncturist, not for anything in particular, just to relax.  He also gave me some herbs to drink.  I took it from about the end of February to the beginning of June.  Do you think that could be a cause of it?

You also asked about my HBeAG.  I have no idea.  The only thing that I see listed is HBeAB and it says "Reactive."  I've been looking for that and I don't see it.  There's nothing else.  I don't know why the PA didn't order that.  Do you think that this PA knows what she is looking for?

--If you are HBeAB+, you are more likely HBeAg-.

Should I switch to someone else?

--Best is to educate yourself.

Also, what exactly does keeping the viral load down and liver functions normal do?

--They mean less chance for liver damage.

  From what I understand the virus is still replicating and destroying liver cells.  Is it obvious and I'm just asking a silly question?  

--No question is silly if you learn from asking it.

[Zottie64]

Mr Sendoh ano ng balita sa count mo okey na ba?

[stef2011]

Do you think that could be a cause of it?
if needles are not thrown away after every patient that is the cause of your hbv 100%
100% sterilization is not possible, dentists have still 23% hbv hcv infections on their patients despite sterilization
also hair dressers are a place to catch hbv if the tools are not used and cleaned properly,

yes you are hbe positive from the reports, interferon is the best drug although sides and weekly injections, on 11% even clears hbv complitely

hbe negative and hbvdna und will block liver cancer risk and liver damage, the low undetactable replication cannot make any damage

[stef2011]

1)  My ALT seems to be super high.  I am so scared that this is doing a lot of damage overnight to my liver.  Will I start to develop cirrhosis/cancer soon?

in your case being hbe positive and if not acute i'd start interferon right away, although sides can be very very heavy this is the best drug as first try since has best seroconvertion rates and it is possible to understand if it works in 12-24 weeks and stop it.
if interferon fails tenofovir is the best second drug but i'd start this only if fibrosis is higher than f2 and you are older than 35-40yo, only in case of family story of liver cancer i'd start it younger
alt 300 is high only if continuous and it takes years to develop cirrhosis if not decades

3) interferon is very slow on alt and hbvdna because works with immune system but it is the only to lower antigens hbe and hbs fast, at first alt will get higher good sign under interferon means it works

4) only if you choose tnf but i strongly suggest not to start with this one, it is a life therapy and what they said about stopping if hbe becomes negative is bull......

5) once you know you have hbv you are very safe, just choose the right drugs suggested by guidelines and monitor liver damage by fibroscan

6) the cure is already there (replicor) just a matter of time and drug makers choices

[KimGG]

Thank you so much for your reply cajim!

In reply to your questions about my high ALT and AST, I actually haven't had a drink in over a year (I wish I knew a long time ago so that I would've never had a drink in the first place.) and I don't do drugs.  This bloodwork was done at the end of June.  I did just realize that I had been going to a acupuncturist, not for anything in particular, just to relax.  He also gave me some herbs to drink.  I took it from about the end of February to the beginning of June.  Do you think that could be a cause of it?

You also asked about my HBeAG.  I have no idea.  The only thing that I see listed is HBeAB and it says "Reactive."  I've been looking for that and I don't see it.  There's nothing else.  I don't know why the PA didn't order that.  Do you think that this PA knows what she is looking for?  Should I switch to someone else?

Also, what exactly does keeping the viral load down and liver functions normal do?  From what I understand the virus is still replicating and destroying liver cells.  Is it obvious and I'm just asking a silly question?  I'm just really trying to understand.  Thank you.

[cajim]

1)  My ALT seems to be super high.  I am so scared that this is doing a lot of damage overnight to my liver.  Will I start to develop cirrhosis/cancer soon?

--No, but you need to be followed by your doctor.  Your ALT and AST are high but not the highest.  Do you drink? take any drugs or herbs?

2)  In general, what will my treatment look like, so I know what to ask and question?

--What is your HBeAg?  If positive then your high HBVDNA is expected.  Your treatment range can be antiviral ************** to just monitoring.

3)  I know everyone is different, but approximately how long will treatment take before the viral load and ALT goes down?

--They can come down fast, in months, but that does not mean you are cured, or even better.

4)  I am 32 years old.  Will I need to take this for the rest of my life?  

--Antiviral drugs usually are taken for years.

5)  I have read so many positive things about treatment of chronic HBV and being able to live a full and healthy life.  I've also watched videos of some professors/speakers on HepB.org and it doesn't seem that promising, although their website says it is.  As you can imagine, I am terrified.  I am married, almost 2 years now, and would like to have a baby soon.  Will I be able to have children and more importantly, will I live a long enough life to to watch my children grow old and do all the things that parents want to do with/for their children?  All I can think about is not living long enough to do that.  I also feel badly for my husband who is a lot more positive than I am.  I know this is a loaded question, but also, how badly off am I that I might not be able to respond to treatment and stay healthy?

--If you take care of your liver, not necessarily kill all the viruses but learn to co-exist with them, then you should expect to live your full natural life span and enjoy being a mother.

6)  I've not done a lot of research, but in your opinion, do you think that they will find a cure someday in the near future or is it almost impossible?  A video that I watched of a doctor on HepB.org said it was almost impossible.

--Anyone who says "impossible" will be wrong, but when is hard to say.

Best.