Hi, guys.
I ( from Asian) have been diagnosed chronic hepatitis B for more than 15 years. HBsAg is positive. Anti-HBs is negative, HBeAg is positive.Anti-HBe is negative. Anti-HBc is positive too. HBV-DNA has been in 10^7 to 10^8 over the years. My ALT typically is around 20-40. I have been in the immune tolerant state till 2008. But, in recent 2-3 years, my enzyme level starts to increase. I have done routine Ultrasound examination yearly, but everything is normal. Two years ago, I have done a MRI scan to screen HCC. Everything was normal. My latest test results (this month) show ALT 298, AST 138, very high HBV DNA at 9.8*10^8.
Also, I have high AFP (116), which is quite scaring. I will do a MRI scan soon.
I have discussed with my doctor to start the anti-virus treatment immediately to reduce my liver damage. Since I have been treated with Lamivudine in 2000 for 11 months, which was totally not effective (HBV-DNA did not decrease). But, at that time, my ALT was 40. I should not given this drug considering my immune tolerant state! However, I probably can not blame my doctor too much if it dates back ten years ago. But, this failed treatment may induce LAM-resistance in my body. So, I have to take
either tenofovir or Truvada (Tenofovir 300mg/Emtricitabine 200mg). I prefer to take Truvada at the first begining, then switch to Tenofovir after HBV-DNA is undetectable.
Also, I have big concern about my AFP. I am wondering if it is because of liver cell renaissance after damage. Or it is related to HCC?
Thank you so much for you input.