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Elevated hep dna

I have been inactive hep b carrier for 20 years. My liver function has been normal and hep b DNA runs between 2500 to 14000 in these years . My last GI doctor many years ago told me as long as my ALT is normal and hep b DNA is under 20000. He will not give treatment. Today, my primary doctor told me liver function test is normal. In fact, my ALT is 6 (lowest limit of normal) but my hep b DNA is 19000. He want to refer me to see Gi doctor again. I do not mind to see one but I doubt I need treatment now and may be just keep monitor in next 6 months. Please advise. Thanks!
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Avatar universal
I agree the present guidelines suggest no treatment if ALT is normal (< 25 IU/L for women, < 35 IU/L for men) and hbvdna < 2,000 iu/ml. You did not specify your age and HBeAg status. Very low ALT in itself should be investigated (Vitamin B6 deficiency?). When hbvdna is high, it usually causes inflammation and ALT to rise. Your case is very unusual, to me. Have you ever had a Fibroscan or other non-invasive fibrosis scores?
2 Comments
Thanks for answering. I am 56 yo and hep b e antigen negative and hep b e antibody positive. I do not believe I have vit b6 deficiency. My ALT has been 6 most of time in my 56 yo of life. I believe hep DNA fluctuates quite a bit. One time, my hep DNA is 14000 and six months later dropped to 8000. I do ultrasound of liver once a year and it is normal. Lately, I am under a lot stress and got sick a few times. I do not think I need treatment as my hep DNA is still under 20000. I need to take care myself better. See what the GI doctor says this time. I would appreciate if you give me more comments. Thanks again.
Thank you for the update. I am glad you are monitoring your HBV regularly. I hope to learn why your rise in hbvdna does not cause a rise in ALT, as typical in the general situation. Your case is a good reminder that HBV is different for everyone and that there is still so much to learn about it. Best.
Avatar universal
Take vitamin D and your Hep DNA will go down.
2 Comments
Thanks for the advice. Usually, if people have vitamin D deficiency, it will have bad effect to health.  However,  if we do not have deficiency, I am wondering vitamin D supplementation can help. We need more research on this area.  Your suggestion is very interesting.
My friend. I understand your concern but trust me. Taking vitamin D is very important to fight Hep B. Everyone who has Hep B is vitamin D deficient because it is used up constantly in fighting the virus. In fact, the virus tries to block it.
I have been taking vitamin D and my HepB DNA is extremely low.  Take the vitamin D. You will thank me later.
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