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very scared help!!!!
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very scared help!!!!

Hello,

First I want to thank you all for your support. My doctor want to start me on Viread but I took an appointment with Ann Lok who is an expert but have to wait until September 17th to find out if need medicine. Below is my full story so please let me know how it is possible that things changed that much from 2007 until now? And is it really that 50% of male who are born with HBV will end up with Liver cancer?

I was born with hep B and I'm now 36 years old. In 2007 I started to panic and went to see a doctor which did a biopsy and blood work. The biopsy in 2007 showed "well maintained architecture with minimal to no inflammation and fibrosis" Final Diagnosis: slight chronic periportal inflammation. All ALT/AST and blood work normal. I'm HB eag negative and in 2007 my viral load was 14500 iu/ml.

So I was happy with the results and continued yearly check of my blood work from 2007 until 2011 (viral load was fluctuating between 2600 iu/ml and 14500 iu/ml and all blood work within range).
In 2011 i did an ultrasound which showed coarse echotexture and the doctor told me it is ok. so I ignored it.

I didn't do any test from 2011 until 2014 which I decided to do ultrasound and blood work and the results are below:
Fibroscan: Median Score 7.6
Ultrasound (compared to ct abdomen biopsy from 2007): subtle coarsened appearance echotexture this can be reflective of hepatocellular disease. Correlate.
HBV DNA Viral Load: 1118 iu/ml
ALT: 20 u/l
AST: 18 u/l
Platelet Count: 233
WBC: 5.4
RBC: 5.02
Bilirubin Total: 1.2   (range 0.3 to 1.5)

I'm affraid because in 2007 biopsy showed no fibrosis and in 2014 Fibroscan showed median score 7.6 which is F2 i beleive moderate fibrosis :-(
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Avatar_m_tn
fibrosis is minimum but it will regress fast on tenofovir, nothing especial people on processed foods and 1 beer a day might have a much worst liver than yours.it is good you start tenofovir the earlier the better so when hbsag will be less than 1000iu/ml in the next decade you ll be able to clear hbsag forever by pegintf add on

liver cancer risk is very low, nothing like 50%
12 Comments Post a Comment
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Avatar_m_tn
fibrosis is minimum but it will regress fast on tenofovir, nothing especial people on processed foods and 1 beer a day might have a much worst liver than yours.it is good you start tenofovir the earlier the better so when hbsag will be less than 1000iu/ml in the next decade you ll be able to clear hbsag forever by pegintf add on

liver cancer risk is very low, nothing like 50%
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Avatar_m_tn
Thanks Stef2011 for your quick response and for the hope you giving me. All the research I did online say that because I'm born with it I have 30 to 50% chance of cancer and that made my life miserable :-( and can't stop thinking about it. I have a family to raise.  Is 7.6 mild or is it more moderate?

I will start on tenofovir but after i come back from my trip and meet with Dr. Ann Lok. I'm new to this forum and will let you know all my findings and data as I know more.
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Avatar_m_tn
My biopsy result was fibrosis 3, where my fibroscan result was 6.6kPa (fibrosis 1). So, nothing is certain.
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Avatar_m_tn
wow from 1 to 3 on fibroscan to biopsy? I wounder how was your ALT/AST etc... and also the ultrasound
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Avatar_m_tn
At that time (9months ago - before start treatment) my;

ALT: 140
HBVDNA: 557000000
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Avatar_m_tn
sorry, ALT was not 140, it was 190
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Avatar_m_tn
Yea my alt was never elevated and last one was 20 and the DNA viral load 1118 iu/ml
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Avatar_m_tn
fibroscan is not precise on little fibrosis but 100% reliable on severe fibrosis f3 and cirrhosis

biopsy can be totally unreliable as fibrosis is worse while it is very reliable on low fibrosis stages like f0-f1

since only severe fibrosis and cirrhosis are of interest fibroscan is the most reliable while there is no need to see difference from f0 to f1 because these mild fibrosis needs no treatment and is of no relevance
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Avatar_m_tn
So in my case fibroscan median is 7.6 which is F2 considered accurate or it could be more F1 or F3? Sorry to ask this again
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Avatar_m_tn
it doesn t matter to compare to f stages since biopsy is not used anymore for fibrosis staging..at least in italy and countries where firboscan machines are everywhere.now ultrasound machines have also new type of fibroscans so you have both tests together every 6months

after 8kpa there is increased risk of hcc and fibrosis is relevant so therapy is better be started.
hbvdna and alt cannot be used as a test for liver damage anymore,anything can happen:
hbvdna in the billions...no damage
alt in the 000, no damage

alt less than 30...damage

so use fibroscan for liver damage not other tests
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Avatar_m_tn
by use of tenofovir any fibrosis will get to 0 by a couple of years if you have a healthy lifestyle and not obese
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Avatar_m_tn
The only thing I miss is hbsag quantity and not sure if they do it in US. Anyone know?
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