Should I try to treat HBV and Lesion Info

[twinboys1girl4me]

So glad I found this site, as I've never personally met anyone else with HBV, so it's very lonely.  I've had HBV since birth and now I'm in my 40's.  I'm HbeAg negative, HbeAb positive, HbcAb positive, don't know my HbsAg quant (live in US and never heard of this test being an option), DNA never above 1,300 iu/ml, ALT is a little high in the high 20's to low 30's, Genotype A, no mutation.

I have ultrasound, CT, or MRI, rotating the mode of screening every 6 months.  All has been fine until this January a ultrasound showed a small lesion on the liver.  I freaked out.  My Hepatologst ordered a CT.  They found the lesion on CT and it was 6mm and couldn't diagnose but was hypodense on portal phase but not well seen on other phases.  It then reported that this lesion had the same characteristics from my baseline CT in 2006.  The report stated that since this lesion has been stable this long that it is probably beneign.  Good news, especially since I was not aware this lesion was there 9 years ago and never mentioned on any scan up until this January!!   Weird and I just hope they are right and this lesion doesn't end up to be anything.  I'm having an MRI in 2 more months.

Due to this scare it has made me worry much more about the risk factors that I know HBV brings.  I have had conflicting information regarding treatment.  About 2 years ago a GI doc I saw wanted to put me on antivirals and I hesitated, since my old Hepatologist said no for many years prior.  After the lesion came up I figured I needed to go back to my old Hepatologist and he again said antivirals won't do much good for me.  My question is, I read it helps cut risk from HCC, so why wouldn't I want to cut down my risk as much as possible?  Also, since I've had HBV so long and now in my 40's I worry too that these two factors may increase my risk of HCC.  What do you all think regarding everything I wrote.  Thanks for any and all help!

[rsm112672]

Hi Stef, I am new here and i was a hbv positive. I was also so depressed of this illness and I am looking for the cure. I am humbly request for your knowledge on how to cure hbv. Because I didn't follow your post. I have read also your post of increasing of drinking coffee to 4x daily, but some to told to erase of drinking coffee. Appreciate your thoughts on this.

Thank you. Hope you can response on my humble request.

[twinboys1girl4me]

Thank you Stef and will try all!

[stef2011]

Then once calcium is lower restart vit d3

[stef2011]

It is low range but that s due to high calcium.......so the best thing is stop vit d3, take vit k2 mk7, avoid all dairies in food (this means you have to check biscuits, bread, everything if it has dairies to make it) and then most important 2.5l of low calcium water, i ve found a brand with 2mg/l but also 7 can be ok.spring at highest mountains are poor of calcium while low quality water from low altitude springs are full of it

[twinboys1girl4me]

I think I found the correct intact PTH.  If this is it it says I-PTH is 23.4 pg/mL.  The range says 10.0-69.0 pg/mL.  Good or can it be better?

[stef2011]

Osteoporosis is independent from calcium, a lot of dairies in the diet promotes bone mineral loss.calcium will always be enough from all foods if vit d is normal...the key is having vit k to take calcium from blood and fix it in the bones

Do you also have your intact pth value?

[twinboys1girl4me]

I found your message for a week ago and responded.  I poked around all over the place yesterday and finally saw it this morning.  Sorry!

[twinboys1girl4me]

Thanks again Stef.  So, the Vitamin D is okay along with the Vitamin K 2 mk7, correct?  The crazy thing is that I've never been a big calcium (milk, cheese, yogurt) eater, so that is why I took vitamins.  On vitamins my calcium was 10.5-10.8, so not normal. It was this way for years and I thought it was a good thing (not!).   I want to go back on the Vitamin D and start the Vitamin K, so I think I will and just get my levels checked again.  I have a new appt. also with a endocrinologist, as I didn't think just stopping vitamins was the answer to begin with when I listened to the other endo doc.  Sure, it made the calcium go back to normal, but I wasn't taking huge amounts of calcium supplements or diet to begin with.  I did have a bone density and my bones are great, so he released me without a real answer on the high calcium....just said stay off all vitamins.  So, getting a second opinion on that too.  You are very smart Stef and I appreciate your input!

[sorte]

good summary, would like to see some more recent ones like this

[stef2011]

Very stupid thing to stop vitamins, you have to stop high calcium diet that s to say stop alla dairies which arenvery unhealthy evn those in processed foods.calcium is what makes all cardio diseases when it stays in blood instead going to bones

start vit k2 mk7 200 to 500mcg daily, this k2 form stay in blood more than mk4 and the duty of vit k2 is take calcium from blood and fix to bones.after 1 month on this recheck calcium
drink 2.5l of low calcium water daily, 2-8mg/l, this will wash excess of ca

i was too on high range of norm for calcium in 3 weeks it went kn down norm

[twinboys1girl4me]

Thanks Stef for all of your info!  My Vit D OH and PTH was recently done because for some reason my blood calcium is usually high when checked on all my routine bloodwork.  I was taking basic vitamins and was told to go off to lower calcium.  I did and blood calcium was lowered to normal.  After I was off supplements my PTH was 11 pg ml and my Vit D3 OH was 38.  I'm nervous if I take Vit D that it will raise my blood calcium again, since I know increasing Vit D does have a relationship to increasing calcium.  What do you think?

I'm going to Mayo for the first time in a few weeks and hopeful to get some fresh information.  I'm going to ask about hbsag quant, something I've never heard of measuring. Do you think the virus in me is weak with my numbers (even though I've had my whole life).  I am starting to think of what do I have to loose by trying meds and getting tired of the wait and see approach, especially after the lesion that I for sure thought was HCC.  Thanks again!!

[twinboys1girl4me]

Thanks for your post and help.  I logged on and no messages?  Where is Liverlab?  I have new insurance and have an appt with Mayo in a few weeks, so I'm encouraged to hear they have Fibroscan.  Have you had it anywhere in Phx yet?  This is the first I've heard they have it somewhere here.  I'll keep you posted after I meet with Mayo.

[stef2011]

As suggested by stephean it would be best to check everything like hbsag quant and fibroscan

my point of view is...go at war with the virus especially when weak.especially be ause after 50yo there isn t much benefit anymore by losing hbsag as regards hcc

the good things to do immediately are
increase your vitd25oh to 100ng/ml and decrease intact pth to less than 20pg ml.this can cut to half the risk of hcc

4caps of coffee per day, this also cuts risk by half

vit k2 mk4, this prevents hcc in cirrhotic, the level of prevention was very hgih compared to placebo so this definitely worths be taken.dose is 45mg per day and be sure pills have no calcium, only vit k2 mk4

[Scaredpreg]

I found interesting fact sheet to read.

http://www.hbvadvocate.org/hepatitis/factsheets_pdf/HBV%20AASLD%202011.pdf

[hitman76]

I am also planning to go for fibroscan here in phoenix. Looks like there are 3 facilities here...Liverlab, Mayo and St Joseph Hospital.

For looking at your messages, log in to medhelp , click on MedHelp top left and there would be a link to "messages" near Account Settings. Since you are in phoenix, I just wanted to share contact...it might be of help.

[twinboys1girl4me]

Hi Stephen,

I'm new to this site and don't know where the "Best Answer" came from because your information was great.  I don't know if they have Fibroscan available in the US, but will ask at my next appintment.  It sure sounds better and more informative than Other imaging modes.  I have had 2 liver biopsies and the last one last year was great and said no fibrosis, but the Fibroscan would be great because of the information given without the need for invasive biopsy testing.

It's so frustrating to be in this middle mode of no treatment but HBV keeps on going.  Thanks again for your input.  :)

[twinboys1girl4me]

Hi, I'm getting used to this site, so bare with me.  I didn't see a message in my "My MedHelp" or my email.  Do I look elsewhere?

[StephenCastlecrag]

I am not a doctor. First of all, I think you should determine whether you need treatment or not. Since your viral load is < 2,000 iu/ml and your ALT is persistently normal, treatment is generally not recommended. I suppose you can arrange to get a Fibroscan to ascertain the state of your liver to see your stage of Fibrosis if any.
It seems to me you have been monitored very regularly, so I don't think there will be anything unusual.
It seems to be the case that antivirals can reduce the risk of HCC but cannot eliminate it. Risk of HCC general increases with viral load, but since your viral load is low already, I don't know whether antivirals can reduce the risk further. In the context of a lower viral load, research seems to show a low qHBsAg indicates a lower risk.
You are right, HCC risk does increase with age, and the best action is regular monitoring by imaging and AFP, which you are doing anyway.