hep b test results

[gomez357]

Hi all, I stumbled upon this site (and so glad that I did) while searching the internet for anything and everything I could find out on hep B and I'm hoping somebody on here will be able to help me. My son, 28,  has just been diagnosed with hep B about a month back while undergoing routine medicals. Two years ago he had tested negative for hep b. Could someone please tell me how serious his condition is. His lab results are as follows:
Hbsag: 2.053 reactive; cut off value 0.142
Hbeag: nonreactive
HBV DNA: 54 iu/ml
LFTs: Normal. All his other blood work is also normal and he is totally asymptomatic.

I would like to know exactly how infectious he is. I have a daughter who has already been immunized for hep b at birth but I'm still worried she may contract it. What are the odds of him converting to hbsag nonreactive. His doctor wants to start him on some meds but we're not sure. Also does anyone know how to convert the hbsag value to iu/ml? I've searched and searched the net but have not found anything.

Any help would be greatly appreciated.

[hepdecko81]

what is with your results about hbv?

[stef2011]

saying is that right now his condition is benign and he does not need any medications

yes this is what happens to most but do follow regularly liver function and fibrosis by fibroscan, we are not all the same.usually people getting infected at birth have less problems until 30-40yo

if his hbsag is low then it would be a good idea to start him on meds, right?
yes, and wait for better drugs or for interferon lamda which should be available by about  2 years

He hasn't done a biopsy/fibroscan as yet but will be getting an ultrasound in the next few days and hopefully it will be ok

very bad, only fibroscan or biopsy can see liver damage.ultrasound and all blood tests are normal even on cirrhosis and when they start to be abnormal cirrhosis is so advanced that it is dangerous for life.i had cirrhosis too and regressing it and only fibroscan showed it

ultrasound can only see liver cancer or fatty liver, it cannot detect liver damage, it can only detect very advanced cirrhosis by the regenerative nodules but it is better to detect any damage much much earlier.he has no fibrosis 99% but since it is so dangerous to develop severe fibrosis and cirrhosis we have better be 100% sure

Since his hepatitis B is benign, I guess he is not very infectious, right?
he is infectous and become very infectious if hbvdna gets high, but in the periods hbeag is negative and hbvdna und or very low he is less infectious
if your country has mandatory vaccine at birth this shouldn t be a problem at all

be very careful about healthcare settings and hairdresser and avoid them as much as possible.for people with hbv there are two deadly dangers, hcv and hdv infections.in case you have to use dentists be sure he is the first of the day (no people before him) and everything perfectly sterilized, hdv can even spread in the air with saliva and infect hbv carriers (hdv can only infect hbv carriers not other people)
in case of hospitals same thing he must always be the first because sterilization is not enough for hdv if previous person was hdv carrier
i just know because i had to use dentist and researchers in pisa told me this

[gomez357]

Thanks a ton stefano for your reply. So what you're saying is that right now his condition is benign and he does not need any medications; however, if his hbsag is low then it would be a good idea to start him on meds, right? Well I'll try and find a lab that checks hbsag quantity and will also check his vitamin D level. His blood sugars, lipid profile, creatinine, etc. are all within normal limits.

He hasn't done a biopsy/fibroscan as yet but will be getting an ultrasound in the next few days and hopefully it will be ok. Will update you on that as soon as we get the results.

He exercises quite a lot, goes to the gym for about an hour 4-6 days a week. Previously he would exercise about 2 hours 6 days a week. His weight is good.

Since his hepatitis B is benign, I guess he is not very infectious, right?

Thanks once again for your help and hope to hear from you again.

[stef2011]

also check that your son has vitamin d levels between 50-60ng/ml, on hbvers 95% times vit d is low, cholesterol low or within ranges.
vit D, blood sugars, cholesterol are all needed by the virus to make high numbers of hbsag, you will not eradicate hbv by correcting these to correct ranges but at least you will help less the virus and keep better general health

also excercise, normal wheight, low fat/meat/sugars diet helps keep good health

[stef2011]

if you want to test hbsag quantity you have to look for abbott architect machine and labs tht make diluition to detect the values higher than 250iu/ml.this test might be more important than hbvdna for your son because if it comes out very low (1500iu/ml or lower) then the chances of eradication are high and it might be good to thin about interferon and nitazoxanide now if the value is that low

[stef2011]

how serious his condition is.

benigne on most, only a smll percentage gets to cirrhosis/liver cancer by decades/all life of liver damage.it is important to check and monitor those who might develop cirrhosis liver cancer and those who will not, usually this happens after 40yo
to check liver damage a fibroscan monitoring yearly is needed and ultrasound every 6months for liver cancer prevention/early detect

Hbsag: 2.053 reactive; cut off value 0.142
Hbeag: nonreactive
HBV DNA: 54 iu/ml
LFTs: Normal. All his other blood work is also normal and he is totally asymptomatic.

therapy is not needed with hbvdna 54iu/ml, what is biopsy/fibroscan result?that s the only way to know liver damage, all blood tests have very poor meaning for this

I have a daughter who has already...
just check hbsab titer if it goes lower than 10miu/ml a booster vaccine is needed, if higher no worries at all

Also does anyone know how to convert the hbsag value to iu/ml?
it is not possible, the test you have done is not quantitative, that number is just reagent and detects hbsag when reagent number is between 0.142> there is no quantification of hbsag

if the liver has no damage, very probable, i'd wait for better therapies or at least for interferon lambda which has very mild sides, a long therapy with interferon lambda+nitazoxanide might have good chances to get rid of hbsag

there are also entrey inibitors on trial in germany and hbsag secretion inibitors too, hopefully they will reach the market when the patent on viread and baraclude will expire (about 2017)

avoid all antivirals called nuc (tnf, etv, lam, adv, telbivudine,ftc), those are needed only in case of liver damage and have no influence on hbsag