So yeah, I really suck at waiting

[Da_Xiong]

Ok, I have hep B, just found out via medical test, no idea where I could've caught it and all that jazz but I need for it to not be chronic for a multitude of reasons, the most important one being me not wanting to deal with this for the rest of my life (I'm 18, and I know a LOT of you live with hepatitis comfortably, but I honestly don't know if I can handle it, and that's the God honest truth). Now, I've got three sets of results from three separate dates from three different places (it's a long story, I needed to get the results in a different language)...two are liver panels and one is your bog standard blood test. Now, they all tell me the same thing - I definitely have hepatitis B. The first test was done on the 19th of September, that was the normal blood test, and it said that my ALT was 182. My next test was on the 24th of September, it was a liver panel (which unfortunately was in Chinese) but I can decode that my ALT had gone down to 116, and my AST was at 70. This also told me that I'm positive for HBsAg, HBeAg and HBcAb, but theres a whole load of other stuff in here that I can't translate, cause my Chinese still isn't that great. My last blood test was on the 27th of September, this time in English, and the results were as follows:

ALT: 115.20 u/l
AST: 59.88 u/l
GGT: 43.95 u/l
ALKP: 64.13 u/l
Bilirubin - Total: 2.54 mg/dL
Bilirubin - Direct: 0.46 mg/dL

HBsAg: 309.7 COI
HBsAb: 8.49 IU/L
HBeAg: Positive
HBeAb: Negative
HBcAb: Positive

Now I've read and re-read these thousands of times, and I've looked up what they can mean (I believe I'm at the stage where it could either be late acute or chronic, but please correct me if I'm wrong), and while I wait for my doctor to tell me when I can see a heptologist (sp?) and tell me the results of the blood test I just got (1st Oct.), all I'm doing is burning with questions I need answered. I found this site, and there seems to be quite a lot of experts here, so any help will be much appreciated.

1)Chronic or Acute? All I've read is that it could be either, but will the ALT results indicate which infection it is?
2)What exactly does it mean by HBsAb - 8.49? Again, I've read (via the wonders of the internet) that anti-HBs is considered effective when the value is over 10, so should I be happy that it's risen that high and hope that it keeps going up, or will it stay at that number? This also ties into the HBsAg being at 309, the healthy range is supposed to be 0, so are my numbers unusually high?
3)I've had an ultrasound that tells me that my liver is alright NOW, but do I need a biopsy to truly tell me if it's alright?
4)What is the best thing for me to do? I've been resting as much as possible so far, but is it advisable for me to go out swimming or something?

Thank you all in advance
Da Xiong

[uscure6]

i pray that this goes away for you and i I hate this nightmare of this disease do you do any remedies to try to fight this disease or what can u take so you want be sick contact me at ***@**** thanks   i have had this infection since 2003 all i take is vitiamins!

[cajim]

Chance of seroconverting HBsAg for anyone is low, so why let it disturb you?

309 is not necessarily worse than 15, they are both positive.

Don't insist on worrying.

[Da_Xiong]

Do you know if I have a chance of seroconverting HBsAg? And is 309 a really high value for it?

[cajim]

Most people here are dealing with chronic Hep B and going on with their lives.  Do what needs to be done and go on with your life.  At age 18, this may be your first challenge in life.  Life is full of challenges and they make you grow.  I am confident you will handle it all right.

With HBeAg positive, you still have a chance of seroconversion and become inactive carrier for the rest of your life.  Do what is necessary, monitor or treat, and go on with your life.

[Da_Xiong]

My appointment is tomorrow, and I can't help but feel down again. I'm trying to stay positive about everything, but it's so hard when all the signs are telling me that this is a chronic infection. I don't have anti-HBc IgM or HBeAb, and (from my last test at least) my HBsAg is ridiculously high. I don't know what I'm going to do if I can't clear this, honestly.

[cajim]

Thank you and the same to you.

[Da_Xiong]

I wish you all the luck in the world.

I have a hospital appointment on the 13th, I'm guessing they'll take another blood test and based on that they'll tell me the best steps to take. All I can really do now is stay positive for the next couple of days and hope for any type of happy news.

[cajim]

To test in 1 month.

[Da_Xiong]

Fair enough...what's your viral load now? And what has taking the medication been like?

[cajim]

See here:

http://www.medhelp.org/posts/show/458687?post_id=post_2613318

[Da_Xiong]

That's great, it's always reassuring to have a glimmer of hope. If you don't mind me asking, what's your current status?

[cajim]

I think so.

[Da_Xiong]

Hmm...so are you telling me theres still hope?

[cajim]

A patient with acute Hep B infection may be tested at different time of his course and his course may be going different directions, 95% going to full recovery with immunity and 5% going to become chronic.

[Da_Xiong]

How do you mean?

[cajim]

Depending on where you are in the course of acute infection.

[Da_Xiong]

Well right now my throat is killing me, my neck and my shoulders have been hurting for the last couple of days, and I'm coughing a lot, but I don't know whether or not these are symptoms or whether or not it's just the flu

I don't quite understand though...are you saying that having anti-HBc IgG and not IgM could still be an acute infection?

[cajim]

HCC = liver cancer

During acute infection period you may have symptoms, anti-HBc Total, anti-HBs, anti-HBe, HBeAg, HBsAg, also you may not feel or test the above during the acute period.

[Da_Xiong]

Also, what's HCC?

[Da_Xiong]

That's a reassuring story I guess, theres always a chance I could clear this myself...I've got a question though: is IgM-HBcAb the only marker that can tell me whether or not this is an acute infection?

[cajim]

Whether your girlfriend had or did not have HBV did not mean much to your HBV status.

I read about this young man with HBV on the Chinese site.  He was an electronic engineering student at a Chinese university.  When the school found out he was positive with HBV and elevated ALT, he was sent home for 1 year, with the condition that if he could not test normal with his liver tests, he should not come back.  He was worried to death, went from hospital to hospital, and tried Chinese herbs and Western pills.  Some of what he took temporarily got his ALT to normal level but pretty soon it became abnormal again.  When he visited this last doctor, he was a nervous wretch!  The doctor looked at him and asked him, "How old are you?"
"20."
"How long do you expect to live?"
"What?!"
"Hepatitis now, cirrhosis in 10 years, HCC in 5 years, how about 15 years?"
Dead silence.  
...
"Why school?"
"The degree."
"Why the degree?"
"A good job to feed the family."
"But if you are dead, who do you feed?"
...
Three months later he happily called his last doctor, "All my readings are normal!"

1996年考取北京计算机学院以后，即感觉食欲不好，腹胀、右胁微疼，疲乏无力。又去北京第二传染病医院门诊检查，发现又是乙型肝炎表面抗原阳性，乙型肝炎e抗原阳性，乙型肝炎核心抗原阳性；医生又给予益肝灵等保肝药物。他隐瞒了病情，偷偷摸摸地吃药，继续上学。可是一年之后，血检各项指标依然不正常。没有不透风的墙，他的病情终于被校方知道了。由于疲乏无力，而且具有传染性，校方让他休学一年。1998年，他吃了大量的治疗肝炎的中药，然而血检各项指标还是不正常。眼看休学一年的期限还剩四个月，他急得要死。  
1998年5月14日上午，他找我来了。我看着一大堆化验单和中药处方，用眼睛的余光看了看这个年青人。发现他坐立不安，这是一个急性子。  
我突然说：“你多大了？”“大夫，我20岁！”他伸直了脖子说。“你还想活几年？”我漫不经心地说。“大夫，您说什么？什么想活几年？”他瞪大了眼睛看着我。我掰着指头算了算：“现在是肝炎，过十年是肝硬化，过五年是肝癌。你再活15年，行不行？”他安静了，不说话。“怎么？我算得不对吗？”我接着气他。  
病人说：大夫，我明白您的意思。现在不把肝炎治好，将来是麻烦事。  
我说：对了！好一个聪明人。  
病人说：大夫，可是我要上学呀。  
我说：不错，要上学；可是为什么要上学呢？  
病人说：大夫，为了拿文凭！  
我说：为什么要拿文凭呢？  
病人说：大夫，为了能够找到好工作！  
我说：为什么要找好工作呢？  
病人说：大夫，为了挣钱养家！  
我说：是呀，是要挣钱养家；可是人死了，你养谁？  
病人说：大夫，那么您说怎么办呢？  
我说：脑子里不要想得太多，当务之急，除了治病，什么上学呀，什么文凭呀，什么挣钱养家呀，都不要考虑！  
病人说：好，大夫，我听您的！怎么治？  
我说：很好，要口服...。  
病人说：大夫，不用吃别的药？  
我说：是的，不用！  
于是他告辞了我；可是走到门口，他又站住了，小声地问：“大夫，您说我能够三月见效吗？”唉，年青人的顾虑太多。我大声地回答：“应当没问题！”  
过了三个月，1998年8月2日上午，他拿着化验单兴冲冲地来了，高兴地说：“大夫，您看大三阳都转阴了。我能上学了！”  

[Da_Xiong]

I understand completely what you're saying, and it is the logical train of thought, but it's not as simple as that. Without being able to get that visa, it means that for a year I'll be stuck in one country not being able to do what I love, and without the year spent in China I'm afraid a lot of doors won't be able to open for me later in my life, which is terrible to think of, to even imagine. I've talked to the last girl I had unprotected sex with, and she told me her results came back telling her that she doesn't have HBV. She's waiting on claryfication as to whether she had it and became immune or if she's never had it at all. What would it mean if she's never had it?

[cajim]

Given your data, you may be in immune tolerance phase.  Your DNA could be high.

At your phase, you may become HBeAg negative and HBeAB positive without treatment and become an inactive carrier, which is good.  You may also need medication to help your body to get the job done.  Either way you need the advice of your doctor.

Sadly, fast time is not on your side and mentioning of patience may not be what you want to hear.

But that is the truth: even if one can clear HBV, it takes a lot of time and patience.

Right now the work visa may be your whole world, but it is not true.  When you take care of your liver and become healthy again, you will have many many opportunities coming your way, only you must have a good health to seize them.

Agree?

[Da_Xiong]

Understood...I dunno, this is the lowest I've ever felt, and I know with time I'll feel better but I don't want or have the time. I NEED to clear this, if I don't I can't get a work visa to go back to China, and if I can't get that visa I don't see the point in anything anymore. Is there 100% no chance that I'll clear this soon?