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hep B reactivation after HIDA test?
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hep B reactivation after HIDA test?

I've been told I have a case of resolved Hepatitis B infection, I had it as a child, now I'm 26. Was never treated or checked before, was always fine. My tests in Dec 2011 were:

HbSAG - Non reactive,
HBSAB - 747 IU/L
HBCAB Total - Reactive

With a 4/01/2012 HBV DNA PCR test stating: <15 IU/ML = Not detected

2 weeks ago I've done my nuclear gallbladder scan with a Technetium 99 injection and a cholecystokinin injection following after 1 hour of lying under the camera. I've been suffering from nausea, pain in my upper-right quadrant, yellow stool and headaches for about a year now and after that HIDA test just feeling worse.. US abdomen tests done in Jan 2012 were fine, and this test seems to be fine as well saying "Normal function of the gallbladder following CCK challenge". But I'm still afraid it can be that horrible reactivation, I also have H-pylori bacterium, small gallbladder polyps and reflux. Is it reasonable for me to get a Hep B blood panel done again or is it not as only 5 months passed from my previous tests? I did not take any chemotherapy or steroid drugs, only pantoprazole to treat my h-pylori and vitamin supplements. My GP said it cannot reactivate Hep B, at the same time he's not sure why I'm getting all those symptoms.

Thank you for your help guys
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Avatar_m_tn

pylori can be treated for few weeks if it doesn t clear it is useless to take those drugs for long periods because pylori has made resistance.taking antibiotics for long periods make more damage than pylori itself

alinia is active on pylori too and has no resistance but you need tocombo with at least one antibiotic you hve not used in the past.alinia has no sides on liver at all.
12 Comments Post a Comment
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Avatar_m_tn
I am not a doctor or specialist. However, I tend to agree with your doctor that you don't have HepB re-activation. As you know HepB usually does not have nausea or headache as symptoms. I have heard of pale, chalky stool as a symptom (I forgot the reasons why)

Still the nausea, headaches, and pain should be investigated: bile duct? How about an ultra-sound examination?
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Avatar_m_tn

h-pylori drugs have many sides, even fatal on liver, i took them too but i suggest to take them the shortest time possible and try to stop them to see if all the damage is you feel is due to these drugs

you may also use alinia+other h-pylori drugs to boost response and clear pylori fast, i remember i just took 2 antibiotics+omeprazole for about 3 weeks to clear it

Omeprazole can cause some very serious, even fatal conditions associated with the liver. Patients who regularly take omeprazole can experience liver failure, which can be fatal. Liver necrosis, which is essentially death of the liver, is another potentially fatal condition that may occur. In addition, patients may experience jaundice (yellow skin color) and elevated liver function tests while taking this medication.


Read more: http://www.livestrong.com/article/109095-dangerous-side-effects-omeprazole/#ixzz1tBPq6oeb
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Avatar_m_tn
Thank you very much guys, yeah I'm doing the 4th triple h-pylori therapy (Nexium before, now Pantoprazole) already cos it wont go away, it's been lasting since 2010, ALTs were pretty normal all the time, US abdomen done two or three times nothing found.

So it's not reasonable to do Hep B blood panel again?
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Avatar_m_tn

pylori can be treated for few weeks if it doesn t clear it is useless to take those drugs for long periods because pylori has made resistance.taking antibiotics for long periods make more damage than pylori itself

alinia is active on pylori too and has no resistance but you need tocombo with at least one antibiotic you hve not used in the past.alinia has no sides on liver at all.
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Avatar_m_tn
http://onlinelibrary.wiley.com/doi/10.1002/mnfr.201000174/pdf

there is place to vitamin d25oh level with pylori too:
3.1 Helicobacter pylori
One of the most common infections is Helicobacter pylori
with a prevalence ranging from 11 to 69% of the population
[54]. Cathelicidin is significantly upregulated in the presence
of H. pylori infection and may be expressed as a potential
host defense mechanism [55]. b Defensins are also
increased as the epithelium responds against potential
pathogens [56]. Vitamin D may be important to control the
inflammatory status in this disease [57]. A long term study
using a vitamin D analogue 1a-hydroxyvitamin D3 resulted
in a marked (greater than 50%) reduction of H. pylori
infection over 20 year [58]. Further studies are warranted in
this disease
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Avatar_m_tn
Thank you very much, very informative replies, but with Hep B panel, is it reasonable to do it again? I've got great abdomen pains, and I also have sore gallbladder (hope that's not liver), also fever and blood pressure... They said my gallbladder is ejecting too quickly, can all those ailments reactivate Hep B?
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Avatar_m_tn
Also do I need to check blood for HBeAg? I was never tested for it, as I'm not considered chronic. I've heard even if all markers are negative (like HBsAg and DNA) HBeAg can be still there and the person is infectious.
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Avatar_m_tn
I've also heard of occult HBV, which has everything negative and positive HBSAB but somehow the person is infectious to others, I'm scared...
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Avatar_m_tn
You will not have positive HbeAg if you are negative for HbsAg. HbeAg is a non-structural protein made by the virus, its presence, together with HbsAg, indicates active replication. If you have replication because your HbsAg is negative, how can you have HbeAg? Again you are unlikely to have occult HBV because you tested negative to hbvdna.
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Avatar_m_tn
Thank you Stephen, so replication cannot take place with neg HBsAg and undetectable DNA, am I right?
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Avatar_m_tn
That is correct.
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Avatar_m_tn
no sides effect possible therapy for pylori:
This study confirms that two tablets (500 mg/tablet) of burdock essence taken orally three times a day after meals can help abolish H. pylori infection

http://www.sciencedirect.com/science/article/pii/S1877860710600100

Peptic ulcer is a common gastrointestinal disease and produces mucosa erosion. The current study assessed the ability of burdock essence to repair gastrointestinal mucosa in clinical trials. In the experimental group, two tablets of burdock essence (500 mg/tablet) were administered three times a day after meals and a placebo was administered in controls. Four weeks after drug administration, the subjects in the study underwent an assessment for the efficacy of burdock essence as health supplements before and after administration of the drug. The presence of gastric mucosal lesions was determined in all of the peptic ulcer patients using electronic endoscopy before and after taking burdock essence. A rapid urease test on tissue samples from ulcers was conducted to verify Helicobacter pylori infection. Endoscopy confirmed gastric or duodenal ulcers in 30 patients. In clinical trials of 27 patients, 20 patients took burdock essence; 17 (85%) recovered completely and three (15%) did not. Of the seven patients who took placebos, five (71%) did not completely recover and two (29%) recovered. In the experimental group, the ulcer wounds of the three patients who had taken burdock essence did not completely heal, but wounds were reduced in size by 30%, 75%, and 33%. Moreover, 10 out of 11 patients who originally were positive for H. pylori infections no longer had the pathogen by the end of the trial. These results indicate that burdock essence has an inhibitory effect on H. pylori. This study confirms that two tablets (500 mg/tablet) of burdock essence taken orally three times a day after meals can help abolish H. pylori infection and promote the therapeutic effect of conventional medication on gastric mucosal repair in gastrointestinal ulcer patients.
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