What are the symptoms of a flare up?

[mpc88]

Does anyone know what are the symptoms of a flare up?  I was diagnosed with Hep B few years ago. For the past few days, I have been experiencing fatigue, loss of appetite, muscle and abdominal pain.  I wonder if I am having a flare up.  Anyone knows what damage does a flare up cause to the liver? I had a liver biopsy done 2 months ago and the result was stage 1 grade 1.  My doctor said not to start treatment at this point.  Is it normal to not to start treatment based on the result.

My lab test results were:  VL: 114,000, ALT 19, e antigen neg, u/s normal.

Your response is appreciated.

[Filo1993]

Hello I was recently diagnosed with chronic hep B at Age 29. I am male, asian. I didnt know about this disease until I exhibited jaundice and dark urine. Immediately went to the doctor and got tested. I am hbsag postive, antihbs negative, hbc igg positive, hbeag positive. Doctors said im chronic.

During peak of symptoms ALT was 2000 (very high) but after just a week it went down to 500. Next test would be after 1 month.

Doctor prescribed Tenofovir because DNA viral load is at 200,000.  

He said I had a flare up and didnt know what caused the flare up. I am worried now.

To add, i didnt start taking antiviral. I would like to check the labs again after the 1 month time frame. Liver Ultrasound is normal but that’s only it no biopsy etc done on me yet.

Hope you could help me advise if the decision not to take the antiviral med yet is okay.

Thanks

[cajim]

Do you have other test results?

[ronald143]

im in state of shocked and depression right now...both my AST and ALT are both above 400 level which is very high...i dont know what would be the degree og liver damage i have right now..have my doctor appointment in couple of days for discussion of my result....im very very worried....any idea...

[mpc88]

I am in my early forties, don't know when I was infected.  My doctor recommended me to start treatment based on my VL, but my ALT and other results are all normal.  Since there is no endpoint to my treatment, I told my doctor I don't want start treatment unless it's really necessary. He then suggested a liver biopsy, which my result was grade 1 stage 1.  He said if my VL doesn't go up and stays about the same, I can hold off on the treatment but I would have to do another biopsy in a few years.

[stevenNYer]

The is always viral activity for us B Heppers.  It's hard to determine what's going on with 1 or 2 set of labs.  You need a series of regular labs to make a guess on what's happening.

Two important pieces of info to clarify are your age and age of infection.

[Ann8]

Your DNA VL is high considering your are e antigen -ve. There are 2 deferring opinions among the experts on HBV treatment plan :

i)  High VL - treat w/o looking at ALT level, high DNA VL is bad.
ii) High VL + elevated ALT - yr Dr probably fall into this grp (same as mine).

The tricky thing is ALT doesn't reflect the disease progression....How old are you? You probably infected for long time, have you checked out the e antibody?

[mpc88]

Ann8:  the unit to measure my VL is IU/ML

Confuseguy:  Thank you for your advice and support.  Sometimes it is just so hard not to worry. It is great that all your results are normal and I hope it stays that way for you.  Good luck and we are all hoping for a cure soon.

[confuseguy]

Mpc88,

First of all, calm down. I'm not sure what you're experiencing but I think fatigue is common among us Hep Ber even without flare. I think your #s almost matches mine with my VL being ~49,500 copies/mL almost 3 months ago and e ag neg.

I've been experiencing join paint, sometimes chest pain, and general weakness overall.

I'm trying to convince myself that it's all in my head. Maybe it is, that all of these worries are getting to me. I've done all the tests, with the exception of CT and biopsy. They have all come back normal.

I think if we go through worrying like this for the next 40 years of our lives, we will not be able to live a full happy life. I'm still trying to convince myself not to worry too much these days.

Anyhow, go see your doctor for a peace of mind. That's what I find useful. We're in this for a long haul until they find a cure for it (God, please let it happen), we have to be proactive and ask the doctor the questions. I find that the more proactice we are about the disease and find ways to help ourselves, the weaker the disease will seem to be, at least from a positive frame of mind. Good luck!

[Ann8]

what is unit used to mesaure your VL? IU/ML or Copies/ML?

[mpc88]

Thank you all for your responses.  My VL has been fluctuating between 110,000 to 190,000.  I was never on treatment.  I should call my doctor if my symptoms persist.  Thanks again for your comments.

[cajim]

>>>Does anyone know what are the symptoms of a flare up?

Have you recently received treatment?  If not, what you are experiencing may not be a flare-up.  Flare-ups usually are indicated by the changes for your values of ALT, AST, DNA, etc.

Hope this helps.

[zellyf]

114,000  is borderline for  a treatment point for e-neg hep B.  Is it usually lower?  Your ALT is good, your biopsy is great.  

Flares can cause varying degress of damage.

If you have any concerns that you're having a flare you should see your doctor.