Hi! I was diagnosed with chronic hepb in 1988. Found out when the doctor did a test during my pregnancy.Nothing was done then. I'm turning 48 in January. I had a liver, right lobe,needle core biopsy done few weeks ago. The diagnosis was - chronic hepatitis b,grade 0-1, stage 0-1.My lab tests results are:
A/G Ratio 1.4
Hep B viral DNA QT 102000 IU/mL
Hep B VIRAL DNA QUANT 594000 copies/mL.
The doctor said that I have to be monitored every 6 months. Will do some ultrasound and blooodwork. She said that there is nothing that I can do right now. Any comment on this?
very good you have no liver damage, but at the age of 48 the liver cancer risk is increased so you may have additional tests to see if hbv can be cleared and if there are furthur risk of hcc from genotype and mutations.if you are not in Us you will easily find these most important tests to define hbv for any patient otherwise there is nothing to do unless you want to ship blood sample to europe or india for the tests prohibited by FDA in US
the tests are:
hbsag quantity by abbott architect, if hbsag is about 1500iu/ml or less hbv can be cleared by interferon+antivirals with the highest chances of clerance.hbsag gets lower by age you may easily find it low at 48yo
genotype of hbv, this is available in US too.genotype B and C have increased risk of hcc so antiviral would be a good choice because hbvdna suppressed to less than 50iu/ml has very low risk of hcc
precore and bcp mutations, this should be available too but not easily in US.these mutants increase hcc risk very much, again if present antiviral might be a good choice
even if hbsag is high suppression of hbv by tenofovir or entecavir for 1-2years and add-on of interferon for 1-2 years had a 40% clearance of hbv and hbsag decrease on all patients.
in 1-2years interferon lambda will be available, this interferon type is more potent with very mild sides so it is probable that in case of decreasing hbsag long term courses of interferon will be done
in case of no clearance:
after interferon the antivirals can be safely stopped if wanted and if virus is not cleared or the antiviral can be kept to deacrease hbsag slowly and retry interferon again a few years ahead
Thanks for the info. I guess I just have to wait and see. Unfortunately I'm in the US, so there is no way for me to do those additional tests. My medical insurance will not pay for it. Again thank you so much. I appreciate it very much.
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