Total bilirubine too high

Hello

I was an acute hepatitis B patient. After taking lamivudine 100mg treatment about 30 months, it has recovered and developped Anti-HBs (40 UI/l, blood test 21th February 2009) but still, total bilirubine was as followed:

1st  Total bilirubine  : 49,0 μmol/l (N: < 17,1) (15 Dec 2008)
2nd Total bilirubine   : 42,2 μmol/l (N: < 17,1) (17th Jan 2009)
3rd Total bilirubine   : 32,9 μmol/l (N: < 17,1) (17th Oct 2009)

Could you please answer my questions?
1- Why total bilirubine still high? What is the cause?
2- May you advice me about dietary food to get rid of hyper bilirubinemia?

I stopped using lamivudine 100mg after recovery. In my country, the doctor who is specialized in hepato-gastro-Enterology are still not available.

yours,

[Thomas D Schiano, MD]

you should check the HBV-DNA as the HBV could possibly come back or you can develop a lamivudine-related mutation (although unlikely in the setting of a (+) surface Ab).  Fractionate the bilirubin level--if mostly indirect it thus probably is Gilbert's disease (which is nothing to worry about).