Viral Load (HBsAg)

Last October 2008 I had my blood test for HBsAg w/ titer and the result is = 211.800, then last December 2008 I took a blood test again and the result was 230.9 (method used was Elecsys 2010). My SGPT & SGOT are normal.

What should I do? My doctor only prescribed vitamins. Is it better for me to start taking anti-viral?

please help!

[cajim]

What is your HBeAg and VL?

[che79]

my HBeAg = 628.600

[cajim]

Ａｎｄ　ｖｉｒａｌ　ｌｏａｄ？

Ａｃｃｏｒｄｉｎｇ　ｔｏ　２００７　ｇｕｉｄｅｌｉｎｅ：

Suggested follow-up for patients not considered for treatment HBeAg_, HBV DNA _ 20,000 IU/ml and normal ALT
● ALT q 3-6 months, more often if ALT becomes elevated
● If ALT levels are between 1-2 _ ULN, recheck ALT q1-3 months; consider liver biopsy if age_40, ALT borderline or mildly elevated on serial tests. Consider treatment if biopsy shows moderate/severe inflammation or significant fibrosis
● If ALT _ 2 _ ULN for 3-6 months and HBeAg_, HBV DNA _ 20,000 IU/ ml, consider liver biopsy and treatment.
● Consider screening for HCC in relevant population
Inactive HBsAg carrier state
● ALT q 3 months for 1 year, if persistently normal, ALT q 6-12 months
● If ALT _ 1-2 _ ULN, check serum HBV DNA level and exclude other causes of liver disease. Consider liver biopsy if ALT borderline or mildly elevated on serial tests or if HBV DNA persistently _20,000 IU/ml. Consider treatment if biopsy shows moderate/severe inflammation or significant fibrosis
● Consider screening for HCC in relevant population

[che79]

I only have the following blood test, will it help?

OCTOBER 2008:
                                                   Normal Value
HBsAg w/ titer = 211.800                 COV - 1.0
Anti-HBS = <2.00                            COV - 1.0
HBeAg = 628.600 Reactive               COV - 1.0
Anti-HBe = 5.85 Non Reactive           COV - 1.0
Anti-HBe Igm = 0.361 Non Reactive   COV - 1.0
Anti-HAV Igm = 0.307 Non Reactive  COV - 1.0
SGPT = 48.00                                  9 – 53

NOVEMBER 2008:
   Test                       Ref. Value          Method
SGPT = 33.3 U/L    F: Up to 33 U/L    COBAS C111
SGOT = 29.2 U/L    F: Up to 32 U/L    COBAS C111

DECEMBER 2008:
HBsAg = 230.9          method:Elecsys 2010

[cajim]

You were not tested for VL, but given you are HBeAg (+) and SGPT 48, some doctors would just monitor.  What is your age?

[stevenNYer]

SGPT or ALT 48 is actually high.  Your 48 will show as "normal" since your range is 9-53.  It should really be no higher than low 30s.  If your SGPT (ALT) is persistently elevated, discuss treatment with your doctor.

[che79]

im 29, female

[che79]

Last October my SGPT = 48.00 (normal value: 9 – 53) and last November  SGPT = 33.3 U/L (F: Up to 33 U/L, method: COBAS C111)

[cajim]

Given you are female and under 30, your SGPT is kind of elevated.  Your HBV DNA could suggest treatment or not.

[stevenNYer]

Your SGPT was fluctuating and mildly elevated, which could indicate active immuno-response.  I agree with cajim that you should monitor your DNA to help determine what's happening.  If it also fluctuates, I would ask my doctor to consider treatment.  Good luck.

[che79]

I  went to another doctor and he prescribed Hepsera & Sylimarin, Hepsera is very expensive, I cannot afford to take the medicine daily. I only bought 12 pcs. for now since my budget is not enough. What will happen if i cannot continue taking the medicine?

Please give me some advice.

[stevenNYer]

Hepsera needs to be taken daily.  If you could only afford 12 pills, that's only 12 days.  It's not going to help much.  In my lay opinion, I don't think it's even good to introduce a antiviral for a short period of time and stop.  You may have a symptomatic hepatitis flare-up.  It won't control viral replication for long and it may help the virus adjust since their numbers are high and antiviral power is limited and short.  So I would save my money and hope to have a successful eSeroconversion naturally. And most people with HepB eSeroconvert and become inactive without doing a thing.  Hopefully this will be your case.  I would further discuss with your doctor.  Good luck.  

[che79]

My HBsAg increases every month;

October 2008 = HBsAg w/ titer and the result is = 211.800
December 2008 = HBsAg = 230.9 (method used was Elecsys 2010)
January 2009 = HBsAg w/ titer and the result is = 254.900

Please explain,what should I do?

[cajim]

Antiviral medications, once started, cannot be easily stopped.  Therefore, please consider Steven's feedback seriously.  For the same reason, I have not started antiviral medications even though my insurance does cover its use.  I am using a treatment that does not use IFN or antiviral drugs.  The result will take 2 years or so to show.

[zellyf]

Although they look like increases they are insignificant changes.  If they continue to climb then I might take a closer look but to me, w/o any medical background, this results look stable.

[stevenNYer]

"Although they look like increases they are insignificant changes."

I agree with Zelly.

[che79]

Thanks for all your support, I'm really worried about my HBsAg results. I returned the Hepsera at the pharmacy and luckily they accepted it.

Please keep up your good work we need you here. All your comments and suggestions are helping me a lot. Thank you!

[stevenNYer]

I hope you stick around and keep us informed.

[che79]

Surely will keep you updated,  I will post any changes with regards to my health. I am grateful that there are group of people like you.  

[rivelyn]

Hi,

I was suffering reactive HBsAg for 12 years and the last test was May 2010 and still reactive. For those years I have not experienced a normal SGPT count. I had my blood tested for SGPT last August 24, 2010 and the results are SGPT=25, SGOT=20, ALP=10, Bilirubin: (Direct=.5, Indirect=.3, Total=.8), WBC=94000, Neatrophil=70, Lymphocyte=28, Monocyte=1 and Esophil=1. This is my first time to receive 25 on SGPT. What does this mean. I was just taking Korean Red Ginseng extract for experimenting it on my body. Is it really helpful?

[geravishankar]

HI I have HBV with Viral Load of 177000 Copies\ml. This is because i stopped Lamivir 100mg for 60 days.. If i continue tablet will viral load get reduce...

[stef2011]

first of all lamivir is not an hbv drugs from many years, hbv itself will make you much less damage than lamivir

now you have to make a test to see all the hbv mutants you have after taking lamivir

then you have to check liver damage by fibroscan or bopsy and if no liver damage there is no reason to take antivirals

last thing you have to check for you hcc risk:
genotype test, bcp mutants test, precore tests.only genotype a and d are relatively safer for hcc while c is the most dangerous

so that you have a clue of what you are doing hbvdna is not the virus and when hbvdna is undetactable it doens t mean you have no virus or no replication....antivirals are only for damaged livers to prevent and regress damage, they have no effect on virus and infection and they will not clear it

be very careful, drug makers messed up with weak useless antivirals like lamivudine, adefovir and telbivudine.they are all weak, they all make hbv mutations so you ll have to take more drugs for longer.....

the only drugs on giudelines for hbv are: tenofovir (zero mutations and resistance), entecavir (cant be used on lam users because virus mutates), interferon.all the rest will worsen hbv making an untreatable monster virus

[stef2011]

if you have liver damage and you need to take antivirals you have only one left after you have used lamivudine......tenofovir which is the only with no resistance or interferon which has no resistance too