hepa profile interpretation

[koby24]

please give me some opinions regarding the hepa profile result of my brother;

SGPT=42.80
SGOT=22.30
ALT=54

HBs Ag= 157.87 REACTIVE
Anti-HBcIgG=0.140=REACTIVE
Anti-HBe= .032=REACTIVE

Anti-HBs=NON reactive
Anti-HBcIgM=NON reactive
Anti-HBcAg=NON reactive

[cajim]

You have HBeAg+ HBV.

Are you taking the conventional, Western-medicine route or some other route?

If the former, according to AASLD Hep-B Guideline 2009 Update,

If you are HBeAg+, HBV DNA (PCR) >20,000 IU/mL ALT 40 years, ALT persistently high normal-2x ULN, or with family history of HCC.  Consider treatment if HBV DNA >20,000 IU/mL and biopsy shows moderate/severe inflammation or significant fibrosis.

If you are HBeAg+, HBV DNA (PCR) >20,000 IU/mL ALT >2 x ULN, then, observe for 3-6 months and treat if no spontaneous HBeAg loss.  Consider liver biopsy prior to treatment if compensated.  Immediate treatment if icteric or clinical decompensation.  IFNa/pegIFNa, LAM, ADV, ETV, TDF or LdT may be used as initial therapy.  ADV not preferred due to weak antiviral activity and high rate of resistance after 1st year.  LAM and LdT not preferred due to high rate of drug resistance.  End-point of treatment – Seroconversion from HBeAg to anti-HBe.  Duration of therapy: IFN-a: 16 weeks;  PegIFN-a: 48 weeks;  LAM/ADV/ETV/LdT/TDF: minimum 1 year, continue for at least 6 months after HBeAg seroconversion; IFNa non-responders / contraindications to IFNa -> TDF/ETV.

If you are HBeAg-, HBV DNA (PCR) >20,000 IU/mL ALT >2 x ULN, then, IFN-a/peg IFN-a, LAM, ADV, ETV, TDF or LdT may be used as initial therapy.  LAM and LdT not preferred due to high rate of drug resistance  ADV not preferred due to weak antiviral activity and high risk of resistance after 1st year.  End-point of treatment – not defined.  Duration of therapy:  IFN-a/pegIFN-a: 1 year; LAM/ADV/ETV/LdT/TDF: >1 year; IFNa non-responders / contraindications to IFN-a -> TDF/ETV.

If you are HBeAg-, HBV DNA (PCR) >2,000 IU/mL ALT 1- >2 x ULN, then, consider liver biopsy and treat if liver biopsy shows moderate/severe necroinflammation or significant fibrosis.

If you are HBeAg-, HBV DNA (PCR) <=2,000 IU/mL ALT 2,000 IU/mL—Treat, LAM/ADV/ETV/LdT/TDF may be used as initial therapy.  LAM and LdT not preferred due to high rate of drug resistance; ADV not preferred due to weak antiviral activity and high risk of resistance after 1st year.  HBV DNA6 months; 2. Serum HBV DNA >20,000 IU/mL (105copies/mL), lower values 2,000- 20,000 IU/mL (104-105 copies/mL) are often seen in HBeAg-negative chronic hepatitis B; 3. Persistent or intermittent elevation in ALT/AST levels; 4. Liver biopsy showing chronic hepatitis with moderate or severe necroinflammation.

Inactive HBsAg carrier state: 1. HBsAg-positive >6 months; 2. HBeAg-, anti-HBe+; 3. Serum HBV DNA 20,000 IU/mL after a 3-6 month period of elevated ALT levels between 1-2 ULN, or who remain HBeAg positive with HBV DNA levels >20,000 IU/mL and are >40 years old, should be considered for liver biopsy, and treatment should be considered if biopsy shows moderate/severe inflammation or significant fibrosis. Patients who remain HBeAg positive with HBVDNA levels>20,000 IU/mL after a 3-6 month period of elevated ALT levels >2  ULN should be considered for treatment.
HBeAg- patients:
● HBeAg-negative patients with normal ALT and HBV DNA <2,000 IU/mL should be tested for ALT every 3 months during the first year to verify that they are truly in the “inactive carrier state” and then every 6-12 months.
● Tests for HBV DNA and more frequent monitoring should be performed if ALT or AST increases above the normal limit.

Side effects:

IFN-a and PegIFN-a:  initial influenza-like illness: fever, chills, headache, malaise and myalgia. Other common side effects include fatigue, anorexia, weight loss and mild increase in hair loss. The most troublesome side effect of IFN-a is emotional lability: anxiety, irritability, depression and even suicidal tendency.

Lamivudine:  very well tolerated.

Adefovir Dipivoxil (bis-POM PMEA, Hepsera):  Nephrotoxicity has been reported in 3% of patients with compensated liver disease after 4-5 years of continued adefovir therapy.

Entecavir:  a similar safety profile as lamivudine in clinical trials.  Studies in rodents exposed to doses 3 to 40 times that in humans found an increased incidence of lung adenomas, brain gliomas and HCCs.

L-deoxythymidine (Telbivudine/LdT, Tyzeka):  well tolerated when used as monotherapy and has a safety profile comparable to lamivudine.   However, cases of myopathy and peripheral neuropathy have been reported.

Tenofovir:  has been reported to cause Fanconi syndrome, renal insufficiency as well as osteomalacia and decrease in bone density.

[bossing101]

please help me understand my hepa profile
hbsag - positive 1.967(c.o. 0.658)
hbeag - positive  >3.000(c.o. 0.621)
anti-hbs - negative 0.291(c.o. 0.709)
anti-hbe - negative >3.000(c.o. 1.321)
anti-HBCIgM - negative 0.341(c.o. o.796)
anti-HAVIgM - negative 0.405(c.o.0.741)
remarks:for anti-hbe, anti-hbc igG, and anti-HAV IgG count below the cut-off value is considered "reactive"
my hbv dna viral load is >110,000,000 and the defined ranged is only 110,000,000.
i greatly appreciate any suggestions coming from you.

[koby24]

hi tnx for ur attention...we are on the process of internalizing this problem my mother and my brother went to the doctor yesterday and advised to do the DNA VIRAL TEST. my brother did not take any medications yet. WE have just knew this last week because of his medical exam qualification for abroad.

yeah maybe ur right it is a chronic type,that was also the finding of my friend who's a doctor.
i'll tell you then when i got the result on his DNA results. Thank you so much.God bless.

[NashPred]

Looks like a chronic HBV infection.

ALT is a little on the high side but can still be within the normal range depending on his lab's referance ranges.

Hopefully he is being monitored on a regular basis.

Do you have his viral load (HBV DNA) results?

Is he taking any form of treatment at this time (if needed)?