What do these results mean?

[cally44]

I just received my new lab results and am very disappointed:(  I
guess I am precore.  I was hoping for my DNA to stay undetectable like last year but it actually has really increased.  I wonder if there is a fault in the lab b/c I didn't receive my dna results immediately (in fact quite a delay) from when I received the other results.
  
  Anyhow, here is the results and here are my questions
  
  1.  Do I need to go under any treatment, if so, what kind?  Do you recommend I just try something natural first.  I am kinda of scared to go on any antiviral and stay with it for life.
  
  2.  Why is there a low decrease on ALT and AST and all of a sudden a high increase in DNA?  Shouldn't my ALT and AST also increase with the DNA?
  
  3.  Since I am precore mutant (as the results do show), and my AFP also went up, am I at serious risk for liver cancer? Also, what do you think causes the AFP to rise, the DNA levels?
Am I in the immune-tolerant stage?

Here are the results from last April and the new results as of today.
  
  APRIL RESULTS

        ALT:  13
  AST: 18
  everything else also normal *didn't check dna yet*
  
  
MAY RESULTS

  Prot Total 7.0
Albumin 3.5
AST/SGOT 20
ALT/SGPT 16
ALK PHOS 75
BILI TOTAL 0.3
BILI DIRECT <0.07
HBV DNA PCR TESTING 842 iu/ml and 1550 copies/ml

  
  September RESULTS
  
  AST  42
  ALT 63
  (Everything else normal) didn't check DNA yet*
  
  
  OCTober RESULTS
  AST 29
  ALT 40
  ALK 96  (all normal)
  DNA undetectable  <100 copies
  AFP 5.7
  
  NEW RESULTS of TODAY
  
  AST 21
  ALT 26
  DNA  HBV DNA, QN, PCR
(IU/mL)----------------------------------------15300 IU/mL (<100)
[a]

     RESULT WAS REPEATED AND VERIFIED.

*HBV DNA,QN PCR (COPIES/mL)--------------------------------- 34882
copies/mL

  AFP 7.1 (<6.1) out of range

[jboyhk]

There is nothing I see out of the ordinary here. Studies have shown that over a period of time you go from undetectable to small detectable in DNA count for an inactive carrier.

Don't quote me on this number but I believer precore mutants would generally have well over 100,000 DNA copies (and usually millions). Precore mutants would also have raised AST/ALT which you don't have.

Your AFP is notthing to worry about at those levels and it just seems you are  a normal inactive carrier.

Also the DNA test usually does take a couple of weeks to get back so nothing unusual there.

[jboyhk]

http://www.hivandhepatitis.com/hep_b/tests/6.html

This is how I would classify you

"(i) Chronic HBV carriers with no detectable HBV replication. Small amounts of HBV DNA may however be detected in these patients with recently developed highly sensitive PCR-based assays. Ongoing studies are aimed at determining the threshold above which HBV replication should be considered clinically relevant."

A few years back, the best tests were only able to detect above 150,000.

Treatment with antivirals is not recommended for your very low viral count. It will ebb and flow (detectable to nondetectable) but very low.

You should get treatment if your AST/ALT rises and your DNA rises over 100,000.

[cally44]

Thanks jboyk

Does DNA determine how much liver damage is going on or does alt/ast?
Also, how can one go from undetectable to all of a sudden 15,000? I'm just curious what causes such a fluctuation.

Also, what does it mean when your dna fluctuates and alt stays in normal range?  Shouldn't both be high if one fluctuates?

Thanks again

[jboyhk]

DNA undtectable does not mean that you have no virus in you. As long as you are S antigen positive that means the virus is replicating (S antigen is released when the virus reproduces).

It means you have little virus circulating in your blood but it still is replicating in your liver. There is a correlation with DNA in your blood and damage to your liver but not in the low numbers you have. Some people have counts in the billions.

Its a cycle. Sometimes the virus becomes dtetecble and then it goes undetectable and so on.