Here's a little background information first
at 13 hepatitis B was found. Once it cleared I got vaccinated again( i had already been vaccinated as a newborn)
Every since I was routinely tested but my test were always negative. At 17 i wanted to join the military so i got tested for everything to make sure i would be able to join. My blood test showed elevated liver enzymes but i hepatitis b negative. i got retested when i arrived at basic training and it was negative. I was really sick during basic training but thought nothing of it because> four months into basic i went to medical and got tested 3 times for hep b and only the third test showed hep b reactive. it also showed i am a chronic carrier and that my liver enzymes were even more elevated. I got medically seperated and started having back to back doctors appointments that didnt answer any of my questions. 3 different doctors told me not to worry and to just monitor my enzymes. its been a year and a half since i found out. all my doctors have done is give me the same test with worse results each time. One told me treatment was available but i havent been prescribed anything.
Here's my question.
I read a forum about a woman with much lower alt and ast numbers than me who has already started treating hers. Why havent i started yet? My whole life has changed(mostly for the good) because of this but im tired of being scared and i want my liver to be functioning better than what it is. I stopped seeing all three of my doctors and i havent been checking on my liver enzymes because i can no longer afford to pay for pointless apointments. Is there a certain number your liver enzymes have to be before i start treatment?
blood test cannot show liver damage at all and also ultrasound cant, if you are so unlucky to be in US you have the wrost healthcare, even worst than third world countries as regards hbv
you have been lucky they didn t treat you, in US they prescribe antivirals easly and prior entecavir and tenofovir, so about 2006-2008, they used weak hiv antivirals that made resistance to hiv and lost much business......the same happened with hbv.those antivirals lamivudine, adefovir, telbivudine used monotherapy just made hbv mutations much less treatable
to understand where you stand the main tests are:
fibroscan (not available in US), if you cant move to canada or europe easily and this is not an expense for you move there.europe is the best for hbv and germany has the best hospitals with all tests, also those at research level according to the hospital, available
if you have to stay in US biopsy is the only way to know your liver damage
UltraSound is just useless for this, they keep using it in US but it can detect cancer and fatty liver only.if you see a cirrhois by ultrssound it is so advanced to have less chances to regress
once you know if you have liver damage check:
hbsag quantity by abbott architect or roches hbsag quant.available in africa, nigeria, ghana, india, china, europe but US hasn t this test which is available from earlier than 2005...
hbsag will tell you stage of infection, an idea of the number of infected cells and a clear degree of your immune strenghts and chances with therapies to clear hbv
after these main tests:
hbvdna, alt/ast and other viral markers can help to get a cleare picture but these last tests alone are almost meanless
the alt number as a marker of liver damage is something preistoric, it just shows liver damage in the moment you make the test, not the damage accumulated by years of abnormal alt.
and finally alt can be perfectly normal but liver damage happening anyway done by residual hbvdna
the damage is not made by the virus but but the oxidative stress due to your immune system failing to clear hbv.
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